1/3. Traumatic asphyxia complicated by unwitnessed cardiac arrest.We report a case of traumatic asphyxia complicated by unwitnessed cardiac arrest in which the patient has made a good, functional recovery. Traumatic asphyxia is an uncommon clinical syndrome usually occurring after chest compression. Associated physical findings include subconjunctival hemorrhage and purple-blue neck and face discoloration. These facial changes can mimic those seen with massive closed head injury; however, cerebral injury after traumatic asphyxia usually occurs due to cerebral hypoxia. When such features are observed, the diagnosis of traumatic asphyxia should be considered. Prompt treatment with attention to the reestablishment of oxygenation and perfusion may result in good outcomes.- - - - - - - - - - ranking = 1keywords = asphyxia (Clic here for more details about this article) |
2/3. Isolated subconjunctival hemorrhages in nonaccidental trauma.PURPOSE: To establish child abuse as part of the differential diagnosis of isolated bilateral subconjunctival hemorrhages in infants. methods: To review three cases of nonaccident trauma initially presenting with isolated bilateral subconjunctival hemorrhages as the only significant clinical finding. RESULTS: Ophthalmic examination in cases 1 and 2 were entirely normal except for the large bilateral subconjunctival hemorrhages. Hematological parameters were normal in all three infants. Initial radiological findings were normal in case 1 but multiple healing rib fractures were identified when the chest X-ray was repeated 3 weeks later. Case 2 had skin and skeletal X-ray findings compatible with abuse at time of presentation to the ophthalmologist. Case 3 was admitted to hospital for multiple unexplained limb fractures but had been seen 2 weeks prior for poorly explained bilateral isolated subconjunctival hemorrhages and facial petechiae. CONCLUSION: Nonaccidental trauma should be considered in the differential diagnosis of bilateral isolated subconjunctival hemorrhages in infants especially if associated with facial petechiae. These isolated subconjunctival hemorrhages may be part of the traumatic asphyxia syndrome caused by severe, prolonged compression of the child's chest and upper abdomen. Appropriate assessment includes a complete ophthalmic and pediatric examination as well as hematological testing and imaging studies. If the coagulation profile and initial imaging studies are normal yet there remains a high suspicion of abuse, an immediate nuclear scan or a repeat skeletal survey or chest film 2 weeks later is indicated.- - - - - - - - - - ranking = 0.125keywords = asphyxia (Clic here for more details about this article) |
3/3. Traumatic asphyxia syndrome.Although the craniofacial changes associated with TAS are usually not life threatening, the syndrome is not benign. The mechanism of injury needed to create TAS is sufficient to warrant extreme caution in the approach to these patients. It is vital for the physician to recognize the pathophysiology of the injury pattern and to remain cognizant of the high likelihood of potentially lethal associated injuries. Aggressive and directed management of the cardiopulmonary systems coupled with prompt recognition and treatment of associated injuries is essential for optimal patient outcome.- - - - - - - - - - ranking = 0.5keywords = asphyxia (Clic here for more details about this article) |