Southern medical journal
-
The word "hiccup" refers to an involuntary, spasmodic contraction of the diaphragm that is followed by the abrupt closure of the glottis to produce the characteristic sound. Among the many documented causes of this occurrence are those due to neurogenic dysfunction. ⋯ We describe a postsurgical patient in whom two successive intravenous infusions of lidocaine, 1.5 mg/kg followed the next day by 0.75 mg/kg, terminated his hiccup twice, whereas multiple other treatments failed to alleviate the problem. Various causes of this phenomenon are discussed, as well as a possible mechanism for the successful treatment.
-
Salvage surgery is an essential method in the armamentarium of the surgeon caring for the severely injured patient. The patient in unstable condition with multiple abdominal injuries is a challenge, even to the most experienced trauma surgeon. The first priority should be to control major vascular injuries and other sources of bleeding that are immediately life-threatening. ⋯ Once surgically correctable bleeding has been addressed, such patients are best served by cessation of the operation, packing of the abdomen, and transfer to the intensive care unit. Resuscitative steps should then be taken. Once the physiologic derangement has been corrected, the patient can undergo definitive operative procedures.
-
Advances in technology have made it possible for telemedicine to be used in multiple areas of medicine, including trauma care. Teleradiology and teleconsultation are becoming standard operating procedure for many rural facilities. ⋯ The medicolegal and financial impact of telemedicine remains to be determined. The potential influence of telemedicine in the care of future trauma patients will likely be important and may alter patterns of referral, consultation, and treatment.