RESUMO
We measured cervical spine movement during orotracheal intubation in 16 anesthetized patients without neck injury. Comparisons were made using straight and curved laryngoscope blades without stabilization, Philadelphia collar stabilization, and in-line stabilization by an assistant. There was cervical spine movement in all cases. There was no significant difference in movement without stabilization when comparing straight and curved laryngoscope blades (P = .8536). There was no significant decrease in movement when a Philadelphia collar was applied (P = 1.000). There was a significant decrease in movement when in-line stabilization was applied (P = 0.0056). Although none of the methods tested totally prevented cervical spine movement during orotracheal intubation, the least movement was obtained by the use of in-line stabilization by an assistant. The type of laryngoscope blade used or application of a Philadelphia collar did not reduce movement significantly.
Assuntos
Laringoscopia/métodos , Movimento , Coluna Vertebral , Adulto , Vértebras Cervicais , Feminino , Humanos , Intubação Intratraqueal , MasculinoRESUMO
Presented is the case of a motor vehicle accident (MVA) victim with hypotension and evisceration of small intestine. Vigorous resuscitation in the emergency department was required, after which a portion of small bowel was resected at laparotomy. Evisceration secondary to trauma in an MVA is a rare injury. Significant blood loss occurs. Although abdominal sepsis did not occur in our case, this is a complication for which the patient must be monitored closely.
Assuntos
Músculos Abdominais/lesões , Acidentes de Trânsito , Intestino Delgado/lesões , Músculos Abdominais/cirurgia , Adulto , Desbridamento , Hidratação , Humanos , Intestino Delgado/cirurgia , Masculino , Ressuscitação , Ruptura , Choque/etiologia , Choque/terapiaRESUMO
We report the case of a patient presenting with blunt chest and head injuries. Initial emergency department evaluation revealed a pulmonary contusion and suspected closed head injuries. Computed tomographic scan of the head was unremarkable. An angiogram performed to further investigate the nature of his head injuries revealed a disruption of the brachiocephalic artery. The lesion was surgically repaired in the operating room and the patient was moved to the intensive care unit, where he remained comatose and died from complications of his head and chest injuries on the seventh post-operative day. The pathophysiology and clinical manifestations of injuries to the brachiocephalic artery are discussed.