11/13. Tactile orotracheal intubation.A previously described method for tactile (digital) endotracheal intubation was refined for use in deeply comatose patients. This technique, consisting of introduction of the endotracheal tube by palpation of the epiglottis, was practiced in cadaver subjects and then applied in both field and emergency department settings. Because the procedure can be carried out without movement of the head and neck and even with an immobilization device in place, it was found particularly suitable in trauma patients who might have suffered injury to the cervical spine. An added advantage is the ease of performance despite secretions or blood in the upper airway. This technique should prove useful to clinicians involved in the early care of critically ill or injured patients.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/13. Serial pulmonary function studies in survivors of near drowning.Determinations of standard lung volumes, mechanics of breathing, and single breath carbon monoxide diffusing capacity (DLCO) were obtained serially in two young patients who survived near drowning in fresh water. These patients were nonsmokers and neither had a past history of lung disease. Pulmonary function studies in both patients revealed a restrictive ventilatory defect with a decreased forced vital capacity and total lung capacity. One patient also exhibited a markedly decreased DLCO. No obstructive lung disease was found in either case. All pulmonary function abnormalities returned to normal during the 16 week follow-up period. near drowning in fresh water did not cause permanent pulmonary dysfunction in these two young patients.- - - - - - - - - - ranking = 1038.4975551419keywords = breathing (Clic here for more details about this article) |
13/13. diatoms and homicide.Six illustrative cases of homicidal drowning are reported in which the diatom test for drowning was a useful adjunct to the medicolegal investigation of death. In all six cases, diatom frustules were recovered from the femoral bone marrow. In five cases, diatoms extracted from the bone marrow were compared with diatoms obtained from samples of putative drowning medium. In all of these case, the same types of diatoms were observed in both the water samples and the marrow. In an additional case, watery fluid from the maxillary sinus contained the same diatom types as were present in the femoral bone marrow. Four of the six cases were found submerged in water and had autopsy findings consistent with drowning. In the remaining two cases, the bodies were found on land; one case was grossly decomposed and one body was extensively burned since the body was set afire on dry land after death. In some of the case drowning was associated with blunt force head injury (one case), sharp force injuries of the chest (one case), or strangulation (three cases). These results indicate that the diatom test for drowning is an important adjunct to the medicolegal investigation of homicidal drowning, particularly in those cases were autopsy and scene findings do not imply drowning as a cause of death.- - - - - - - - - - ranking = 19.023994957112keywords = chest (Clic here for more details about this article) |
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