Trocar during Times of Trauma

​Seventy-five percent of trauma injuries involve some kind of thoracic insult, a quarter of which need a procedural intervention like a chest tube. (Surg Clin North Am 2007;87[1]:95; http://bit.ly/2HaoX90.) Long-term illness, lung disease, and post-operative complications may cause pleural effusions or a pneumothorax, so treating these conditions quickly can significantly decrease patient morbidity and mortality. Other indications for chest tube placement include:Trauma: Pneumothorax, hemopneumothorax, or tension pneumothoraxLong-term illness: Pleural effusion (cancer, pneumonia)Infection: Empyema, purulent pleuritisPost-surgery, especially after lung, heart, or esophageal surgeryBronchoscopyA CT showing a chest tube in the right lung and pneumothorax in the left lung from trauma. Scan courtesy of Clinical Cases.Inserting a chest tube is literally hit or miss. If you miss, you may seriously compromise the outcome, so you need to embrace a few simple concepts: know your landmarks, know your technique and tools, and know the cautions and what can go wrong.This 49-year-old morbidly obese woman had a spontaneous pneumothorax four days after elective bronchoscopy. Note the misplaced pigtail catheter in the subcutaneous tissue to the left of the fifth intercostal space on the right side of the patient's rib cage. The standard approach was used for this insertion without success.The BasicsChest tube insertion should be well-rehearsed and instinctive. You should not hesitate t...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Related Links:

Abstract: The US industrial revolution led to a significant increase in the amount of dietary sugar consumed annually. The impact has become a public health crisis over the past several decades. The consequences are seen in the dramatic rise in rates of obesity, type 2 diabetes mellitus, and cardiovascular disease.
Source: The Nurse Practitioner - Category: Nursing Tags: Feature: SUGAR CONSUMPTION Source Type: research
We describe a case of a 49-year-old, male, Caucasian, pharmaco-resistant patient with a recurrent major depressive disorder, who developed acute pulmonary embolism during a course of inpatient right-unilateral ultra-brief electroconvulsive therapy. After the stabilization of his somatic condition, we were able to safely continue with further ECT applications until his mood normalized and he was able to return to his normal life outside the hospital. Case reports on this topic are scarce – our article demonstrates that electroconvulsive treatment, with proper precautionary measures (anti-aggregative or anti-coagulatio...
Source: Brain Stimulation - Category: Neurology Source Type: research
Authors: Herth FJF, Reinmuth N, Wormanns D, Antoch G, Biederer J, Vogel-Claussen J, Kauczor HU, Pfeifer M, Vorstand der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin, Vorstand der Deutschen Röntgengesellschaft Abstract Substantial new data on early detection of lung cancer with low-dose CT has become available since the last joint statement of the German Roentgenological Society and the German Respiratory Society was published in 2011. The German S3 guideline on lung cancer was revised in 2018 and now contains a weak recommendation towards early detection of lung cancer with low-dose CT in a...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
Publication date: 21–27 September 2019Source: The Lancet, Volume 394, Issue 10203Author(s): The Lancet
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionsAdiponectin had no role in the development of gastropathy. Patients with gastropathy had a significant increase in the serum level of cholesterol and triglyceride. There is a significant negative correlation between adiponectin and weight, body mass index, waist circumference, triglyceride, and low-density lipoprotein.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Publication date: Available online 19 September 2019Source: Annals of Medicine and SurgeryAuthor(s): Ayad Ahmad MohammedAbstractGall bladder polyps occur in 0.4% of patients undergoing cholecystectomy, the majority of gall bladder polyps are benign, they are classified into 3 types: epithelial or adenomatous polyps, mesenchymal polyps, and pseudopolyps. Gall bladder polys mostly affect females and those more than 50 years of age. Ultrasound is a very sensitive tool in the diagnosis.An 88-year-old woman presented with epigastric pain and right hypochondrial pain, fever, and vomiting for 1 week. Clinical examination showed j...
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Background: children
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
We report the case of a 10-year-old child treated for latent tuberculosis infection (LTBI) with pyrazinamide (PZA) and levofloxacin after contact with a smear-positive multidrug-resistant tuberculosis adult. Over the course of the treatment, the patient developed a drug-induced fulminant hepatitis attributed to the combination of PZA and levofloxacin. This case highlights the hepatotoxicity of the association of second-line anti-TB treatment in children.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Antimicrobial Reports Source Type: research
Background: The incidence of drug-resistant forms of tuberculosis (DR-TB) and the number of children treated with second-line drugs (SLDs) are increasing. However, limited amount of information is available regarding the use of SLDs in this population. Methods: To describe the treatment of pediatric TB with SLDs and factors associated with use of SLDs in children with and without documented DR-TB, records of pediatric TB patients referred to a center in Italy from 2007 to 2018 were reviewed retrospectively. Results: Of 204 children diagnosed with active TB during the study period, 42 were treated with SLDs because ...
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Antimicrobial Reports Source Type: research
Conclusions: The AS04-adjuvanted HPV-16/18 vaccine administered according to a 2-dose schedule to girls 4–6 years of age induced a high and sustained immunologic response with an acceptable safety profile during the 30 months following vaccination.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Vaccine Reports Source Type: research
More News: Anatomy | Anesthesia | Anesthesiology | Asbestosis | Autoimmune Disease | Bile | Blogging | Brain | Bronchoscopy | Cancer | Cancer & Oncology | Cardiology | Cardiovascular & Thoracic Surgery | Children | Coronary Artery Bypass Graft | Cytology | Eating Disorders & Weight Management | Emergency Medicine | Esophagus Cancer | Eyes | Fungal Infections | Gastric (Stomach) Cancer | Heart | Lidoderm | Lymphoma | Neurology | Neuroscience | Neurosurgery | Obesity | Orthopaedics | Pancreatitis | PET Scan | Pneumonia | Pneumothorax | Pulmonary Thromboembolism | Respiratory Medicine | Rural Health | Sarcoidosis | Science | Study | Thoracostomy | Toxicology | Tuberculosis | UK Health | Ultrasound | X-Ray