1/7. Right thalamic hemorrhage resulting from high-voltage electrical injury: a case report.A 12-year-old boy was admitted with electrical burn and loss of consciousness. On physical examination his general condition was poor. Extensive burn areas, second and third degree, were present on his face, scalp, bilateral auricles, right cervical region, shoulders, right axilla, upper region of the thorax, and proximal region of the upper extremities. The total burned surface area was about 25%. Pupils were isocoric, but response to light was bilateral poor. He was stuporous and responsive only to pain. Deep tendon reflexes were exaggerated and plantar responses were bilateral extensor. Bilateral decorticate rigidity was noted. Computerized tomography of brain revealed brain edema and right thalamic hemorrhage. magnetic resonance imaging of brain, examined 25 days after admission, revealed right thalamic hemorrhage and mild right subdural effusion. He was discharged form hospital 40 days after admission. However, spastic quadriplegia and severe mental retardation remained as sequela. On the 4th month of follow-up, no improvement was noted in his neurological examination. On the 9th month of follow-up, his clinical condition was better, but bilateral electric cataract was diagnosed. Both eyes were operated on and intraocular lenses were implanted with good results. Now he is 16th month of follow-up: neurological examination revealed only mild hemiparesis on the left side and mild articulation disorder. His school performance was moderate and intelligence quotient was 71. magnetic resonance imaging of brain showed markedly improvement of the hemorrhage. To our best knowledge thalamic hemorrhage resulting from high-voltage electrical injury has not previously been reported in the literature.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. Implantable cardioverter defibrillator storm: nursing care issues for patients and families.Implantable cardioverter defibrillators (ICDs) are being used for primary and secondary prevention of life-threatening cardiac arrhythmias, and evidence suggests that increased use is likely in the future. ICD storm, the delivery of two or more shocks within 24 hours, occurs in 10% to 20% of patients who have ICDs and can have long-lasting psychological and physical consequences. An understanding of the factors associated with ICD storm, relevant assessment, and patient and family teaching and counseling can help clinicians to better meet the needs of patients who have experienced ICD storm.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Limb deficiency and prosthetic management. 3. Complex limb deficiency.This self-directed learning module highlights rehabilitation and prosthetic issues associated with complex limb deficiencies. It is part of the chapter on acquired limb deficiencies in the Self-Directed Physiatric education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses rehabilitation and prosthetic management of patients with amputations for complex limb deficiencies secondary to trauma. Mechanisms of injury, prosthetic issues, prosthetic components, and potential problems in prosthetic fitting will be discussed. overall Article Objective: To evaluate common problems associated with complex limb deficiency.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. Prevention and treatment of lightning injuries.Lightning ranks first among natural disasters in terms of fatalities and property damage each year. If fortunate enough to survive, the victim of a lightning or electrical accident often presents with numerous complicated clinical manifestations. The astute nurse practitioner will be challenged to identify the immediate signs and symptoms of possible system disruption, and to institute the follow-up management necessary to prevent further complications. This article explores the nurse practitioner's role in the physical assessment of the client and the protocol for management and follow-up care. Case studies are presented to illustrate the various multisystem findings of clients struck either directly or indirectly by lightning. Environmental precautions to decrease the likelihood of lightning's harmful effects are also discussed. It is easier to prevent a lightning and/or electrical accident than to treat the victim.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Bilateral scapular fractures from low-voltage electrical injury.Bilateral, characteristically distributed fractures of the scapula occur from low-voltage electrical injury due to tetanic muscle contraction involving the upper extremities and shoulder girdles. We present the case of a 43-year-old man who sustained bilateral scapular fractures after exposure to a 440-volt, 60 cycle-per-second current passing briefly through his upper extremities. Conservative management, consisting of shoulder immobilization, analgesia, and progressively physical therapy, led to healing of the fractures over six weeks with essentially normal shoulder function after a follow-up period of six months. The absence of an associated fall or other direct trauma should not dissuade the physician from the diagnosis of scapular fractures in electrical injury.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/7. Electrical shock injury.OBJECTIVE: To discuss the case of a patient who received an electrical shock injury to the back of his head and was co-managed by a neurologist and a chiropractor. The common manifestations of electrical shock injuries are presented. CLINICAL FEATURES: The patient was a 31-yr-old man. His initial symptoms consisted of headaches, dizziness, pain in the suboccipital area, tingling down both arms to the hands, nausea, blurred vision, increased sweating, chest pain, loss of appetite and memory lapses. The patient received a neurological examination, MRI of the brain, EEG, brain stem auditory evoked response and EKG. The neurologist's diagnosis was post-traumatic head syndrome following electrocution. INTERVENTION AND OUTCOME: He was treated by a neurologist and a chiropractor, with fair results. chiropractic treatments were directed toward correcting the fixations, fibrotic tissue and joint proprioception in his neck using manipulation, physical therapy and active care exercises. CONCLUSION: Electrical shocks commonly cause immediate damage to the heart, nervous system and musculoskeletal system. They can also cause delayed complications days to years later, including cholelithiasis, cataracts and nervous system conditions such as ALS. Chiropractors can play an important role in managing the musculoskeletal manifestations of electrical shock injuries.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. Investigation of deaths related to electrical injury.Even though the use of electricity is an integral part of our lives, the number of accidents and deaths related to electricity is on the decline. This is due to increased awareness of electrical hazards and, in large part, to increased inclusion of safety mechanisms by manufacturers. However rare, electrical injury and related death can present a complicated case in the emergency department and for death investigators. Sometimes the circumstances of the physical scene are unclear because of intentional or accidental alterations or the investigator's inability to reconstruct events leading to the injury. This may hinder the initial clinical assessment. We present cases of typical and atypical deaths from electrical injury and review clinical and investigative procedures to assist in the treatment of patients with electrical injuries.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |