Missed injuries, commonly referred to as the trauma surgeon’s nemesis, are an expected occurrence in the management of multiply injured patients. The definition of a missed injury is institution specific. Generally speaking, however, a missed injury is an injury identified at some defined time after the initial assessment. Missed injuries are not frequently life-threatening. However, […]
Hyperbaric oxygen therapy is currently used in various clinical treatment regimens like for treating carbon monoxide poisoning. These include decompression sickness, carbon monoxide poisoning, cyanide poisoning, gas embolus, gas gangrene, resistant anaerobic infections, and threatened split-thickness skin grafts. The mechanism of action in treating carbon monoxide poisoning purportedly involves increasing tissue oxygenation, which increases collagen
When a patient returns from the operating room following spinal surgery it is important to establish with the surgical team any spine instability as well as the integrity of the dura. This information is critical should the patient need to be reintubated, vomit, or elevate the head of bed. There would be no greater catastrophe
The major complications of transfusion of blood are the following: 1. Transfusion Reactions : These reactions may be allergic or haemolytic: Haemolytic Reactions These are again divided in to Delayed Hemolytic reactions and Acute Hemolytic reactions. Allergic Reactions These are usually mild, manifesting as urticaria and are mainly due to plasma proteins. Treatment: Antihistamines (Avil)
Chronic atrial fibrillation (A fib) has an incidence of 0.4% in the general population (approximately 10% of those more than 60 years of age) and many of these patients are admitted to intensive or intermediate care units for reasons unrelated to this diagnosis. Chronic atrial fibrillation needs to be clearly differentiated from new-onset atrial fibrillation
Dural tear is a known complication of spinal surgeries, such as laminectomies, spinal fusions, and disc excisions. It most commonly occurs in the lumbar region. In general, the tear is noted at the time of operation when leakage of cerebrospinal fluid (CSF) is noted by the surgeon. A tear in the dura results in decompression
Cauda equina syndrome arises from compression of the lumbosacral nerve roots. Large herniated lumbar intervertebral discs are the most common culprit. Other sources of compression include spinal or sacral fractures or surgery common in ICU trauma patients, lumbosacral neoplasms, spinal stenosis, nonneoplastic masses such as cysts, peripheral neuropathy, and infectious processes. Low back pain is
Nitrogen is present in the atmosphere and it constitutes 78.08% of total air. Moreover, the use of nitrogen is growing very rapidly these days. Use of nitrogen in medicine is helpful as it can be used as diluent of oxygen in order to avoid oxygen toxicity. It is stored in either compressed air or in
Post operative hypoxia is caused by several factors : I. General—patient’s factors Exaggerated preoperative problems such as: • Extreme obesity • Geriatric age • Pre-existing cardiopulmonary disease 2. Diminished inspired oxygen • Lack of oxygen supplementation devices • Excessive suctioning • Diffusion hypoxia after nitrous oxide 3. Impaired ventilatory inefficiency • Obstructed upper airway
There are 4 types of Hypoxia . The 4 types of Hypoxia are as follows: 1. Anoxic hypoxia or Diffusion hypoxia Anoxic hypoxia also called as diffusion hypoxia is essentially due to the deficiency of oxygen being absorbed by the lungs. This is either due to a decrease in the inspired concentration of oxygen in the air
