Manajemen Anestesi untuk Evakuasi Epidural Hemorrhage bersama dengan Operasi Fraktur Cruris Terbuka

Introduction: A number of recent well publicized deaths from police chokeholds have focused attention on the use and safety of chokeholds by law enforcement officers (LEO). LEO chokeholds are depicted as a safe non-lethal restraint technique. Use of chokeholds by LEO is purported to be in the middle range of force options when compared to other tools of force available. LEO chokeholds are often likened to judo chokeholds which have a long history of safety and have not directly contributed to the death of a judoka since the sport of Judo was founded in Japan in 1882. Some have posited that chokeholds employed by LEO are especially likely to be safe in young adults, as they are less likely to have underlying cardiovascular diseases. Chokeholds applied by LEO can unfortunately be associated with severe medical and neurological sequelae, including death. Methods: We reviewed autopsy data of 29 deaths associated with LEO chokeholds. Results: Subjects ranged in age from 19 to 58. Reported chokehold duration ranged from 4 seconds to 3 minutes in length. In ten cases, chokeholds were applied multiple times to a single subject. In one case chokeholds were applied five times to a single subject. At autopsy, two subjects were found to have carotid artery intimal tears. Two subjects had epidural hemorrhages. One subject sustained a subdural hemorrhage. One subject was found to have had a subarachnoid hemorrhage. Five subjects had pathology typical of global cerebral anoxia. One subject sustained multiple cervical spine fractures with crush injury to the spinal cord as well as spinal epidural hemorrhage. Two subjects had evidence of hemorrhage involving the cervical anterior longitudinal ligament. Atherosclerotic heart disease was found in five subjects. Two subjects had severe occlusive coronary artery disease. Four of these subjects were between the ages of 28 and 35. Myocardial fibrosis was found in five subjects. Cardiomegaly was found at autopsy in six subjects. Conclusions: LEO chokeholds are not widely considered to constitute deadly force, however our review of autopsy data from 29 deaths caused by chokeholds applied by LEO revealed that they can be associated with death and severe cerebrovascular, and central nervous system sequela in both young and older subjects.

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Gambaran Pasien yang Menjalani Prosedur Bedah Emergensi di RSUP Prof. Dr. R. D. Kandou Manado Periode Januari - September 2019

e-CliniC ◽

10.35790/ecl.v8i1.27356 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Utrecht Suleman ◽

Angelica M. J. Wagiu ◽

Stephanus J. Ch. Tangel

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Surgical Procedures ◽

Emergency Surgery ◽

Medical Records ◽

Health Centers ◽

Surgical Patients ◽

Age Group ◽

Adult Age ◽

Epidural Hemorrhage

Abstract: Emergency surgery is performed to avoid further complications of the disease or to save the patient's life. Albeit, there are lack of data in various health centers in Indonesia regarding the evaluation of emergency surgical patients, This study was aimed to obtain the profile of patients undergoing emergency surgical procedures in the Emergency Department of Surgery at Prof. Dr. R. D. Kandou Hospital Manado from January to September 2019. This was a retrospective and descriptive study using patients’ medical records. The results showed that there were 540 patients in this study. Most of the patients were adult age group (18-59 years) as many as 343 patients (63.5%), males 366 patients (67.8%), and non-traumatic cases 436 patients (80.4%). The most common cases of trauma was epidural hemorrhage as many as 23 patients (4.3%) meanwhile the most common non-traumatic cases was chronic kidney disease as many as 122 patients (22.6%). According to the type of surgery, CDL insertion and laparotomy were performed on 131 patients each (24.3%). In conclusion, most patients undergoing emergency surgical procedures were 18-59 years old, males, and non-traumatic cases.Keywords: emergency surgery, traumatic cases, non-traumatic cases Abstrak: Bedah emergensi dilakukan dalam keadaan sangat darurat untuk menghindari komplikasi lanjut dari proses penyakit atau untuk menyelamatkan jiwa pasien. Data mengenai pasien bedah emergensi di berbagai pusat kesehatan di Indonesia masih sangat kurang. Penelitian ini bertujuan untuk mendapatkan gambaran pasien yang menjalani prosedur bedah emergensi di IGD Bedah RSUP Prof. Dr. R. D. Kandou Manado periode Januari sampai September 2019. Jenis penelitian ialah deskriptif retrospektif, menggunakan data rekam medik pasien. Hasil penelitian menunjukkan bahwa dari 540 pasien, didapatkan pasien terbanyak dari golongan usia dewasa (18-59 tahun) yaitu 343 pasien (63,5%), jenis kelamin laki-laki 366 pasien (67,8%), dan kasus non-trauma 436 pasien (80,4%). Kasus trauma terbanyak yaitu epidural hemorrhage pada 23 pasien (4,3%) sedangkan kasus non trauma terbanyak chronic kidney disease pada 122 pasien (22,6%). Menurut jenis tindakan operasi yang terbanyak ialah insersi CDL dan laparotomy, masing-masing 131 pasien (24,3%). Simpulan penelitian ini ialah pasien yang menjalani prosedur bedah emergensi terbanyak ialah usia 18-59 tahun, jenis kelamin laki-laki, dan jenis kasus non-trauma.Kata kunci: bedah emergensi, kasus trauma, kasus non-trauma

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Acute Paraplegia After Vertebroplasty Caused by Epidural Hemorrhage

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-200708000-00023 ◽

2007 ◽

Vol 89 (8) ◽

pp. 1827-1831

Author(s):

Christof Birkenmaier ◽

Sebastian Seitz ◽

Bernd Wegener ◽

Christian Glaser ◽

Maximilian I. Ruge ◽

...

Keyword(s):

Epidural Hemorrhage ◽

Acute Paraplegia

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Epidural Hemorrhage Following Lumbar Epidural Block in LBP Patient without Coagulopathy - A case report -

Korean Journal of Anesthesiology ◽

10.4097/kjae.2007.53.5.660 ◽

2007 ◽

Vol 53 (5) ◽

pp. 660

Author(s):

Sang Hun Kim ◽

Kyung Joon Lim ◽

In Ho Yang

Keyword(s):

Case Report ◽

Epidural Block ◽

Epidural Hemorrhage

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Taser and Taser Associated Injuries: A Case Series

The American Surgeon ◽

10.1177/000313480807400920 ◽

2008 ◽

Vol 74 (9) ◽

pp. 862-865 ◽

Cited By ~ 4

Author(s):

Barry E. Mangus ◽

Luke Y. Shen ◽

Stephen D. Helmer ◽

Janae Maher ◽

R. Stephen Smith

Keyword(s):

Law Enforcement ◽

Head Injuries ◽

Skull Fracture ◽

Case Series ◽

Neuromuscular Control ◽

Law Enforcement Agencies ◽

Lethal Force ◽

Risk Of Injury ◽

Epidural Hemorrhage ◽

Trauma Surgeons

Taser devices were introduced in 1974 and are increasingly used by law enforcement agencies. Taser use theoretically reduces the risk of injury and death by decreasing the use of lethal force. We report a spectrum of injuries sustained by four patients subdued with Taser devices. Injuries identified in our review included: 1) a basilar skull fracture, right subarachnoid hemorrhage, and left-sided epidural hemorrhage necessitating craniotomy; 2) a concussion, facial laceration, comminuted nasal fracture, and orbital floor fracture; 3) penetration of the outer table and cortex of the cranium by a Taser probe with seizure-like activity reported by the officer when the Taser was activated; and 4) a forehead hematoma and laceration. The Taser operator's manual states that these devices are designed to incapacitate a target from a safe distance without causing death or permanent injury. However, individuals may be exposed to the potential for significant injury. These devices represent a new mechanism for potential injury. Trauma surgeons and law enforcement agencies should be aware of the potential danger of significant head injuries as a result of loss of neuromuscular control.

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