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Biomedical subjects

S Mellesmo

Publications and source records attributed to S Mellesmo.

4 recordsLinked to original sources
PubMed1992

[Injuries from mines].

In autumn 1991, 157 patients injured by mine explosions were taken care of by a Norwegian military medical unit attached to the United Nations mission in the demilitarized zone between Iraq and Kuwait. 146 of the patients were seen during a three week period of Iraqi mine harvesting in the desert. The detachment worked according to the principles of a second echelon surgical installation. The patients were operated upon if necessary, stabilized and evacuated to Iraqi hospitals. 20 patients in all (13%) died primarily. Four of 109 patients evacuated to the field hospital died (4%). 68 patients had major amputations, in seven of them two extremities were blown off. One patient had an open chest wound, two had tracheal puncture wounds, and one had penetrating head injury. 27 patients had eye injuries, 13 of which were penetrating. 64 major surgical procedures were performed. When evacuation times are long after mine injuries, approximately six hours, almost only patients with injuries to the extremities can be expected to reach hospital for treatment. The pattern of injury was regular, with crushed extremities, amputations and damaged eyes.

Adult↗
PubMed1992

[Not a tourniquet, but compressive dressing. Experience from 68 traumatic amputations after injuries from mines].

In autumn 1991, 68 patients with traumatic amputations after injuries caused by mines were evacuated to the United Nation's field hospital in the demilitarized zone between Iraq and Kuwait. Most were seen during a three week period when civilians harvested mines. During the first days of this period, continuous bleeding distally to applied tourniquets was frequently observed. Orders were issued to remove any tourniquets and cover the wounds with a very tight elastic bandage. Prehospital intravenous infusions were decreased. Three out of 18 patients died prior to the change of routine compared with one out of 50 afterwards. The new directives led to visibly less haemorrhage. Haemoglobin on admission was mean 8.6 g/100 ml during the first part of the observation period compared with mean 10.5 g/100 ml with the new routine. 23 patients received blood transfusions. Fewer patients needed transfusions after the use of tourniquets was discontinued. A tourniquet should not be used in the treatment of bleeding extremity injuries. In extensive crush injuries and traumatic amputations a compressive dressing should be used, applied from the end of the extremity in a proximal direction.

Adult↗
PubMed1991

[Intra-osseous infusion--a simple, rapid and lifesaving method].

One of the major challenges in the initial treatment of critically ill or injured patients is the establishment of a well functioning intravenous access. This can be very difficult in patients with circulatory collapse, and almost impossible in infants. Central venous cannulation is time-consuming and requires skill. Nor can intratracheal and rectal administration of drugs and fluids fully replace the intravascular route. In such situations the old but forgotten technique of intraosseous infusion represents an elegant and easy way of gaining rapid intravascular access. The method is simple, safe and almost foolproof, and can easily be performed under field conditions, e.g. by paramedical personnel. Very few contra indications exist, and the success rate even by untrained personnel is high. In this review the physiological aspects and the technique itself is discussed and illustrated by case reports.

Aged↗