1/7. Complications with use of the Epistat in the arrest of midfacial haemorrhage.Control of midfacial haemorrhage can be difficult, especially in the multiply injured patient, either at the scene of injury, or in the Accident and Emergency Department. The use of Epistats has proven invaluable in this setting. Potential problems exist with their use and this is illustrated with examples, together with strategies for overcoming them. A summary of the didactic method of safe use of this life saving technique is insert the Epistat, aiming for a fingertip placed at the soft palate;inflate the posterior cuff;withdraw the Epistat slightly, to position the posterior cuff within the nasal choanae;inflate the anterior (intranasal) cuff.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/7. Superselective embolization for control of facial haemorrhage.A case on the successful management of acute facial bleeding from the maxillary artery by superselective embolization is described. A 26-year-old male sustained a gunshot wound (GSW) to the face leading to profuse bleeding from the site of bullet entry, the nose and the mouth. Local measures failed to arrest the bleeding. The patient was stabilised haemodynamically, then the source of bleeding was located by angiography and the bleeding was arrested by superselective embolization.- - - - - - - - - - ranking = 0.8keywords = haemorrhage (Clic here for more details about this article) |
3/7. Death due to positional asphyxia under severe alcoholisation: pathophysiologic and forensic considerations.In contrary to "physical restraint", describing a fixed body position due to external devices, "positional restraint" is defined as an abnormal body position, resulting from accidental fixation under unfortunate circumstances. We report on a remarkable case of positional asphyxia of an alcoholised young man after a fall down a staircase. On external examination, the body showed petechiae of the conjunctivae and oral mucosa, abrasions on the left zygomatic region and scratch marks, respectively. Neither broken fingernails, etc. nor signs of external violence against the neck were found. autopsy revealed haemorrhages in the praevertebral cervical musculature and Simon's sign. Haemorrhagic pulmonary edema and cerebral edema were observed; blood alcohol concentration: 2.60 g/l, urine alcohol concentration: 3.26 g/l. As cause of death, positional asphyxia after blunt head trauma has to be considered as well as lethal ethanol intoxication. To us, alcoholisation attributed to the fall and together with unconsciousness following blunt head trauma circumvented self-rescue efforts, and therefore, aggravated the potentially lethal impact of positional restraint.- - - - - - - - - - ranking = 0.2keywords = haemorrhage (Clic here for more details about this article) |
4/7. Traumatic aniridia after small incision cataract extraction.INTRODUCTION: phacoemulsification and falls are both common in the elderly population. We present a case of acquired total aniridia and vitreous haemorrhage occurring as a result of trauma in a pseudophakic eye. methods: Interventional case report with history, clinical photograph and discussion with literature review. RESULTS: A previously healthy 74-year-old Caucasian female was referred with a painful left eye and poor vision following a fall and trauma to the left side of her face. Initial examination confirmed visual acuity of perception of light with total hyphaema and vitreous haemorrhage. Subsequent examination revealed complete aniridia with an intact capsular bag and well-centred posterior chamber intraocular lens and attached retina. Final visual acuity after treatment was 6/9. CONCLUSIONS: Blunt trauma may cause total iris disinsertion in and expulsion from pseudophakic eyes. This relatively novel injury may present increasingly commonly to casualty departments and ophthalmologists.- - - - - - - - - - ranking = 0.4keywords = haemorrhage (Clic here for more details about this article) |
5/7. Haemostasis by angiographic embolisation in exsanguinating haemorrhage from facial arteries. A report of 2 cases.life-threatening exsanguinating haemorrhage from arteries of the face following trauma is uncommon. When it occurs it is often located in the relatively inaccessible parts of the vessels and requires deep face or neck exploration and ligation of the main feeding vessel. The procedure requires expert head and neck vascular surgery performed under general anaesthesia, which is often not suitable in these haemodynamically unstable patients. In addition, surgery is often rendered more difficult by the associated post-traumatic swelling and disfigurement. Because of these considerations, angiographic embolisation of the bleeding vessels was performed as an alternative to surgical exploration. This report illustrates its use in achieving haemostasis in 2 patients.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/7. Delayed spontaneous retrobulbar haemorrhage. A case report.Retrobulbar haemorrhage is an important complication. The extremely infrequent condition of a spontaneous haemorrhage occurring three days after the injury is presented.- - - - - - - - - - ranking = 1.2keywords = haemorrhage (Clic here for more details about this article) |
7/7. Awake fibreoptic intubation in the semi-prone position following facial trauma.A fit 27-year-old man presented with severe facial trauma following an industrial accident. Initial assessment showed severe swelling around the lower jaw and haemorrhage from the mouth, nose, scalp and left ear. The patient was conscious with a Glasgow coma Score of 13 but in respiratory distress. Following adoption of the prone position his airway improved. Relief of the patient's airway obstruction was a priority and the patient underwent awake fibreoptic intubation in the prone position prior to induction of anaesthesia. Computed tomography scans of his head and neck were unremarkable and after fixation of a bilateral mandibular fracture he made an uneventful recovery. intubation in the semi-prone position may be a useful technique in injuries of this type.- - - - - - - - - - ranking = 0.2keywords = haemorrhage (Clic here for more details about this article) |