1/17. lightning strikes at a mass gathering.Among natural disasters, lightning is a leading cause of morbidity and mortality throughout the world. A well-informed bystander and an astute physician can make the difference between an outcome of death or lifelong disability versus complete or near-complete recovery. What is done in the first few minutes after such an event is the predominant predictor of success. This case report describes a young woman who was struck by lightning while talking on a cellular telephone at a mass gathering in an outdoor stadium. The discussion that follows the case centers on the pathophysiology of being struck by lightning and on issues unique to being struck in a stadium full of people.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/17. Whole blood transfusion for exsanguinating coagulopathy in a US field surgical hospital in postwar kosovo.An urgent blood drive in which active duty military field surgical hospital personnel volunteered to donate whole blood was conducted, and administration of warm, whole blood prevented the exsanguination of a normothermic coagulopathic patient who had received a massive transfusion. In austere care settings in which full blood banking capability may not be available, physicians should consider that exsanguinating hemorrhage can potentially be controlled surgically, but nonsurgical bleeding requires specific replacement therapy, and whole blood may be the best selection for repleting deficiencies of components that are otherwise unavailable.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/17. Spontaneous hemothorax. Report of 6 cases and review of the literature.We present 6 cases of spontaneous hemothorax and comprehensively review the medical literature on this subject. We categorize the reported causes and offer a rational diagnostic approach to patients with nontraumatic hemothorax. We recommend specific treatments for specific etiologies, and emphasize the importance of well-established surgical principles for the treatment of hemothorax. Our suggestions should enable physicians to accurately diagnose and expeditiously treat patients with spontaneous hemothorax.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/17. Hollow visceral injury after blunt lower thoracic and abdominal trauma.The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for physicians in the Emergency Department, although the early diagnosis of hollow viscous injury decreases morbidity and mortality. After a description of two cases of hollow viscous injury after blunt abdominal trauma, a literature review is performed concerning the indications and limitations of diagnostic imaging modalities. Focused abdominal sonography for trauma, computed tomography scan and diagnostic peritoneal lavage are described. On the basis of the review a proposal for maximal diagnostic accuracy is made.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/17. sports-related pneumothorax in children.pneumothorax after blunt chest trauma in the absence of rib fractures is uncommon and has only rarely been reported as a result of sporting activity. Presentation may vary from an apparently normal physical examination in the presence of a small pneumothorax to hemodynamic compromise in the presence of a tension pneumothorax. High fitness levels in athletes may result in failure to recognize symptoms and delay diagnosis, potentially increasing morbidity. It is imperative for the emergency physician to exclude pneumothorax in children who present with chest pain after blunt chest trauma from sports injury. We report our experience with and the management of 3 patients with pneumothoraces.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/17. Bronchoscopic electrocautery for palliation of post-anastomotic tracheal stricture in a patient with complete tracheal transection following blunt chest trauma.There are many strategies available to treat palliation of airway obstruction due to benign or malignant conditions. The initial choice depends on the urgency of the situation, the extent of the disease process as assessed bronchoscopically, as well as the individual experience and preference of the physician. We present a rare case of complete tracheal transection following a traffic accident. Respiratory distress, which resulted from post-anastomotic tracheal stricture, developed progressively about 2 months after surgical repair. Symptomatic relief and improved ventilatory function were achieved in this patient once patency of the trachea was restored successfully using bronchoscopic electrocautery. The technique is a straightforward, safe, and quick method to palliate airway obstruction.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/17. Traumatic tricuspid insufficiency with chordae tendinae rupture: a case report and literature review.With the increase in the number of automobile accidents, traumatic tricuspid insufficiency, a rare complication of non-penetrating blunt chest injury, has become an important problem. This kind of injury has been found more frequently during the last decade, partly because of better diagnostic procedures and a better understanding of the pathology. Here, we report a 22-year-old male patient who suffered chest trauma from an automobile accident. echocardiography demonstrated tricuspid chordae tendinae rupture with remarkable tricuspid regurgitation. We discuss this case in comparison with the previous literature. This case reminds us that physicians in the emergency department should be aware of this potential complication following non-penetrating chest trauma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/17. Traumatic asphyxia: an indicator of significant pulmonary injury.Traumatic asphyxia has often been described as a rare syndrome with little prognostic significance. In the authors' series, however, all cases secondary to deceleration injury or compression of the anterior thorax were associated with pulmonary injury. The signs of venous congestion of the face and anterior thorax are not always recognized in the emergency department where they should be most clinically evident. Increased awareness of this syndrome by emergency physicians will result in better reporting and understanding of its clinical implications.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/17. Cardiac injuries caused by blunt chest trauma in children.Two illustrative cases with different features of cardiac injury caused by blunt chest trauma are described. The first patient had mild and obscure symptoms, detected on physical examination, and required observation only. The second patient had acute pericardial tamponade, necessitating surgical treatment. We present the different medical procedures that should be taken into consideration in management of such cases, although continuous monitoring, repeated physical examination, electrocardiograms, chest x-rays, and echocardiography proved sufficient in managing our two children. It is important that physicians who provide care to children suffering from blunt chest trauma have increased awareness of possible cardiac injuries.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/17. Blunt trauma and liver abscess.Three cases of pyogenic liver abscess following blunt trauma to the torso are described. The association between blunt trauma with liver contusion and the development of bacterial pyogenic liver abscess is explored. Reported series of liver abscess are reviewed. It is suggested that physicians look for the development of liver abscess in patients who have had major blunt trauma to the torso. physicians should also inquire about blunt trauma in patients with documented pyogenic liver abscesses.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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