Blunt laryngeal trauma presenting as bilateral massive pneumothoraces and subcutaneous emphysema: a multidisciplinary approach to management

2020 ◽  
Vol 13 (3) ◽  
pp. e234623
Author(s):  
Christopher W Noel ◽  
Suneel Kumar Pooboni ◽  
Gamal Metwalli Metwalli ◽  
Safeena Kherani
Keyword(s):  
Respiratory Distress ◽  
Emergency Room ◽  
Endotracheal Tube ◽  
Clinical Diagnosis ◽  
Subcutaneous Emphysema ◽  
Chest Tube ◽  
Multidisciplinary Approach ◽  
Watchful Waiting ◽  
Loss Of Consciousness ◽  
Laryngeal Trauma

A 3-year-old boy had an unwitnessed fall from a highchair. The child had no loss of consciousness, vomiting, stridor or respiratory distress but within a few minutes had significant swelling in the neck, scalp and around the eyes. He was brought immediately to the emergency room where he deteriorated rapidly and was intubated with a cuffed oral endotracheal tube. A clinical diagnosis of blunt laryngeal trauma was made. Imaging showed no laryngeal disruption, but did reveal massive bilateral pneumothoraces, that were managed with chest tube. A multidisciplinary meeting with family led to a watchful waiting approach. The patient was successfully extubated at 1 week and healed with a clear voice.

Multidisciplinary Management of a ‘Double Tooth’

Dental Update ◽  
2021 ◽  
Vol 48 (4) ◽  
pp. 266-270
Author(s):  
Niraj Halai ◽  
Shash Bhakta
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Relevance ◽  
Multidisciplinary Approach ◽  
Case Reports ◽  
Multidisciplinary Management ◽  
Neutral Term

The term double tooth has often replaced the clinical diagnosis of gemination or fusion. If teeth have been extracted or exfoliated, the use of the neutral term ‘double tooth’ avoids the need to arbitrarily decide if it was gemination or fusion in origin. This case reports on a 16-year-old male who presented with an UL2 ‘double tooth’ and his combined restorative, surgical and orthodontic intervention to achieve his ideal result. CPD/Clinical Relevance: A multidisciplinary approach should be adopted when treating patients with a double tooth and an appropriate protocol as cited can be used.

scholarly journals Prognosis and Complications of Attempted Suicidal Hanging

2019 ◽  
Vol 9 (4) ◽  
pp. 191-198
Author(s):  
Azadeh Memarian ◽  
Kamran Aghakhani ◽  
Babak Soltani ◽  
Siamak Soltani
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Prognostic Factors ◽  
Respiratory Distress ◽  
Cause Of Death ◽  
Cerebral Edema ◽  
Medical Center ◽  
The Body ◽  
Loss Of Consciousness ◽  
Duration Of Hospitalization

Background: Hanging is a form of strangulation, in which the body is suspended through the neck and the weight of the body acts as a constricting force. This study assessed various factors on the outcome of hanging and identification of prognostic factors related to the outcomes.Methods: Ninety-nine hanging victims from 1995 to 2015 in Iran were evaluated; then, variables such as the cause of death, distribution of mortality, duration of hospitalization, substance abuse consumption, respiratory distress, and cerebral edema were studied in these people. Finally, the data were analyzed.Results: Major cases of suicide by hanging were men. In connection with prognosis, about 12% of the deaths occurred in men and about 21% were represented in women. More importantly, in the matter of suspension, the model was largely incomplete to complete. Also, the outcomes of pulmonary stress and cerebral edema were recognized in association with the type of hanging and mortality prognosis.Conclusion: Only two risk factors, including loss of consciousness at the time of entry into the medical center, as well as the complete suspension, would be predictive operations of death and unsuccessful revival.

scholarly journals Repair of displaced thyroid cartilage fracture using miniplate osteosynthesis

2018 ◽  
Vol 11 (1) ◽  
pp. e226677 ◽  
Author(s):  
Bassel Hallak ◽  
Sonia Von Wihl ◽  
Franciscus Boselie ◽  
Salim Bouayed
Keyword(s):  
At Risk ◽  
Physical Examination ◽  
Emergency Room ◽  
Internal Fixation ◽  
Open Reduction ◽  
Thyroid Cartilage ◽  
Older Individuals ◽  
Laryngeal Trauma ◽  
Vital Functions ◽  
Miniplate Osteosynthesis

Acute laryngeal trauma is estimated to occur in approximately one patient per 14 500 to 42 500 emergency room admissions. If the larynx is injured, its vital functions are affected and can be threatened in case of severe injury. Soft cartilage offers no protective advantage, which is the reason why young as well as older individuals are at risk of thyroid cartilage fracture. Experimentation on cadaver larynx has demonstrated that virtually all laryngeal fractures are longitudinally oriented. Furthermore, muscular pull can contribute to a misalignment of the fractures. As stated by Bent and Porubsky, a fracture is considered severely rather than moderately displaced, if it is freely mobile on physical examination, has more than two fracture lines or demonstrates a displacement greater than the width of the thyroid cartilage on CT imaging. We present two cases of severely displaced thyroid cartilage fracture treated in our department by open reduction and internal fixation using miniplates. Functional and radiological outcomes were excellent.

Synkope, epileptischer oder psychogener Anfall? Der Weg zur richtigen Diagnose

2019 ◽  
Vol 144 (12) ◽  
pp. 835-841
Author(s):  
Tobias Baumgartner ◽  
Rainer Surges
Keyword(s):  
Emergency Room ◽  
Daily Life ◽  
Epileptic Seizures ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Daily Life Activities ◽  
Transient Loss ◽  
Impact On Treatment ◽  
Key Features ◽  
The Impact

AbstractTransient loss of consciousness (TLOC) is a frequent cause of referral to an emergency room. In view of the impact on treatment and the patients’ daily life activities (e. g. profession, driving license), an accurate and timely diagnosis is of uttermost importance. This article provides key features and suggests a practical step-by-step approach of how to differentiate syncope, epileptic and psychogenic non-epileptic seizures as the commonest causes of nontraumatic TLOC.

scholarly journals New acute respiratory management in tracheal rupture caused by chest trauma

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Cheng Shen ◽  
Lin Ma
Keyword(s):  
Mechanical Ventilation ◽  
Oxygen Saturation ◽  
Emergency Room ◽  
Subcutaneous Emphysema ◽  
Emergency Surgery ◽  
Chest Trauma ◽  
Tracheal Rupture ◽  
Respiratory Management ◽  
Respiratory State ◽  
Ventilation Method

Abstract We report a case who is a 33-year-old man admitted to our Emergency room for chest trauma caused by the factory’s mechanical arm. Despite the endotracheal tube, the patient’s respiratory state was poor and the oxygen saturation did not improve and the subcutaneous emphysema progressed. To improve distressed breathing, we first proposed the concept “mechanical ventilation with dual ventilator” to maintain oxygen saturation of the patient. This is, to our knowledge, the first report of using a special mechanical ventilation method in emergency surgery.

scholarly journals Pneumopericardium

2014 ◽  
Vol 34 (2) ◽  
pp. 163-165 ◽  
Author(s):  
Meen Raj Pathak ◽  
Disuja Shakya
Keyword(s):  
Chest Pain ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Subcutaneous Emphysema ◽  
Distress Syndrome ◽  
Paediatric Population ◽  
Male Child ◽  
Pericardial Cavity ◽  
Life Threatening ◽  
Tension Pneumopericardium

Pneumopericardium may be defined as the presence of air within pericardial cavity which results due to spontaneous or iatrogenic cause. It is rare but life threatening entity, commonly caused by respiratory distress syndrome and vigorous resuscitation, in the paediatric population. Although, pneumopericardium is often asymptomatic, it may cause chest pain, dyspnoea and subcutaneous emphysema. The course of pneumopericardium is usually benign and self-limited. Treatment is crucial in tension pneumopericardium, a complication of pneumopericardium. Here, we report a case of pneumopericardium in a nine month old male child after vigorous resuscitation and intubation for respiratory distress syndrome. DOI: http://dx.doi.org/10.3126/jnps.v34i2.11152 J Nepal Paediatr Soc 2014;34(2):163-165

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