International journal of critical illness and injury science
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Int J Crit Illn Inj Sci · Jul 2016
Clinical and functional outcomes of acute lower extremity compartment syndrome at a Major Trauma Hospital.
Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy. ⋯ Escalation in leg pain and changes in sensation are the cardinal signs for CS rather than reliance on assessing for firm compartments and pressures. The severity of nerve injury worsens with the delay in performing fasciotomy. Standardized diagnostic protocols and wound treatment strategies will result in improved outcomes from this complication.
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Int J Crit Illn Inj Sci · Jul 2016
Mass awareness regarding snake bite induced early morning neuroparalysis can prevent many deaths in North India.
In North India snake bite deaths are predominantly seen with neurotoxic envenomations (NEs) whereas in South India the hemotoxic envenomation (HE) is more common. Krait is responsible for most deaths in North India. It bites people sleeping on the floors, mostly at night. We describe the profile of venomous snake bites over 1 year in 2013. ⋯ Almost all (97.5%) bites during sleep resulted in NE in our study. About 96% of NE sought first aid from alternate practitioners or religious healers in hope of some magical treatment. Thus, a deadly combination of krait bite during sleep and wrong health seeking behavior is responsible for high mortality krait bites in this region. Mass public awareness regarding krait bites can prevent mortality in many such cases.
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Int J Crit Illn Inj Sci · Apr 2016
A comparison of ketamine versus etomidate for procedural sedation for the reduction of large joint dislocations.
Ketamine and etomidate are used for procedural sedation (PS) to facilitate the performance of painful procedures. We hypothesized that ketamine produces adequate and comparable sedation conditions for dislocated large joint reduction when compared to etomidate and results in fewer adverse events. ⋯ Ketamine produces PS conditions for successful large joint dislocation reduction that are adequate and comparable to etomidate. The increased likelihood of myoclonus, of the requirement for airway assistance, and of hypoxia observed with etomidate suggest potential benefits with the utilization of ketamine for PS for dislocated large joint reduction.
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Int J Crit Illn Inj Sci · Apr 2016
Comparison of effectiveness of class lecture versus workshop-based teaching of basic life support on acquiring practice skills among the health care providers.
Basic life support (BLS) is an integral part of emergency medical care. Studies have shown poor knowledge of it among health care providers who are usually taught BLS by lecture-based teachings in classes. ⋯ Workshop-based BLS teaching is more effective and lecture-based class teaching better is replaced in medical education curriculum.
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Int J Crit Illn Inj Sci · Jan 2016
What happens to the hemodynamic responses for laryngeal mask airway insertion when we supplement propofol with butorphanol or fentanyl for induction of anesthesia: A comparative assessment and critical review.
There is a delicate balance between respiratory tract anatomy, its physiology, physiological response to anesthetic agents, and airway management. The traditional gadgets to secure airway are face masks or endotracheal tubes. Recently, laryngeal mask airway (LMA) is gaining popularity. It does not require laryngoscopy thereby minimizing hemodynamic responses. For LMA placement, propofol is the induction agent of choice. Propofol, when used alone, requires large doses and leads to undesirable cardiorespiratory depression. To culminate its dose, various adjuncts are combined with it. ⋯ The use of propofol-butorphanol combination produces stable hemodynamics as compared to propofol-fentanyl combination.