1/7. neck needle foreign bodies: an added risk for autopsy pathologists.The risk to pathologists of contracting diseases due to cuts or needles punctures while performing autopsies is well known. An additional risk is an accidental needle puncture due to retained needle fragments within the subcutaneous tissues or internal organs of intravenous drug addicts. We report 4 cases of drug addicted patients infected with human immunodeficiency virus who came to autopsy and had retained needle fragments within their cervical-clavicular soft tissues. The presence of retained needle fragments increases the risk to the autopsy pathologist of accidental needle puncture and exposure to disease. Because of this phenomenon, the pathologist should take precautions in addition to those currently prescribed when performing autopsies on possible drug abusers.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
2/7. Saccular aneurysm in arm secondary to accidental arterial puncture.We present a rare case of saccular aneurysm localised in the arm of a breast-feeding baby, secondary to accidental arterial puncture. Colour Doppler echography showed a cystic lesion with turbulent arterial flow related to the humeral artery. Complete surgical resection of the aneurysm was achieved.- - - - - - - - - - ranking = 1.6666666666667keywords = puncture (Clic here for more details about this article) |
3/7. Pseudoaneurysms of the brachial artery following venipuncture in infants.Pediatric vascular injuries are increasing in frequency and represent a challenging problem in pediatric surgical practice. Increased survival of low birth weight infants and advances in invasive diagnostic procedures have resulted in a dramatic increase in the number of these injuries. Formation of pseudoaneurysm of the brachial artery in infants is a very rare complication of venipuncture, with only two cases reported in the literature. We report three cases of brachial artery pseudoaneurysm in infants following venipuncture who were operated upon in our institution, aged 43-64 days at the time of operation. The period from the injury to the operation ranged from 25 to 42 days. All three infants were referred from different institutions. In two infants, the pseudoaneurysms and the involved part of the artery were resected, and arterial continuity was restored with an end-to-end anastomosis; in the other infant, reconstruction was done using a venous interposition graft. All three infants were diagnosed with duplex ultrasonography, and the child requiring a more complex reconstructive procedure was also evaluated with helical contrast computed tomography. brachial artery pseudoaneurysms are a rare but possible complication of multiple venipuncture in infants. early diagnosis and microvascular reconstruction are key points in managing these injuries.- - - - - - - - - - ranking = 2.3333333333333keywords = puncture (Clic here for more details about this article) |
4/7. phentolamine reversal of epinephrine-induced digital vasospasm. How to save an ischemic finger.A 17-year-old girl accidently injected her thumb with an adult autoinjector epinephrine syringe, resulting in rapid digital ischemia. Local infiltration of 0.5% phentolamine mesylate injected at the puncture site immediately resolved the ischemia and resulted in no long-term sequelae. Similar cases of epinephrine-induced digital ischemia are reviewed herein, revealing phentolamine to be the drug of choice for reversal of this type of ischemia. Alternative attempts to restore blood flow included warm water immersion, amyl nitrite inhalations, metacarpal nerve block, and application of topical nitroglycerin paste; each was found to be ineffective. We conclude that digital ischemia secondary to accidental injection of epinephrine can be quickly and safely reversed with the use of 0.5% phentolamine locally infiltrated in the region of accidental injection.- - - - - - - - - - ranking = 0.33333333333333keywords = puncture (Clic here for more details about this article) |
5/7. False aneurysm of the brachial artery in an infant following attempted venipuncture.False aneurysms have rarely been described in the pediatric age-group. Here a case of false aneurysm of the brachial artery following accidental arterial puncture at the site of attempted venipuncture is reported. Having obtained vascular control with digital compression, the arterial repair was performed by direct suture technique. The characteristics and differential diagnosis of false aneurysms are described. The majority of false aneurysms occur as complications of percutaneous catheterization.- - - - - - - - - - ranking = 2keywords = puncture (Clic here for more details about this article) |
6/7. infection control and hiv-related discrimination and anxiety. Glove use during venipuncture.OBJECTIVE: Reports into hiv-related discrimination reveal continuing concerns about the behaviour of health care workers, particularly with reference to practices such as excessive or selective infection control. This study examines whether the selective adoption of an infection control procedure (using gloves during venipuncture) is related to discriminatory attitudes, anxiety about hiv/AIDS and the degree of contact with hiv-infected patients. METHOD: In 1993 and 1994, 451 general practitioners (GPs) were surveyed in six of the 12 new south wales health Areas and Regions. The sample included 49 anti-retroviral prescribers. GPs were presented with six patient scenarios and asked with whom they would use gloves during venipuncture. RESULTS: 41.9% of GPs reported that they would selectively use gloves, and generally targeted the homosexual patient only, or combinations of patients that included the homosexual man. GPs revealed poor compliance with universal precautions, as only 37.5% reported that they would use gloves with all of the six patients. Intended glove use was significantly related to hiv-related discrimination (p < 0.0001) and anxiety about hiv/AIDS (p < 0.0001). GPs who selectively chose to use gloves had the highest discrimination and anxiety scores; GPs who chose not to use gloves with any of the patients had the lowest discrimination and anxiety scores, and were more likely to work in hiv medicine. Except for differences in health Area, this study did not identify any factors that helped to explain which GPs consistently followed universal precautions. CONCLUSION: This study demonstrates that selective infection control is related to discriminatory attitudes and anxiety about hiv/AIDS. GPs can avoid a discriminatory practice by consistently following universal precautions. More research is needed to identify the factors that promote good infection control practices.- - - - - - - - - - ranking = 2keywords = puncture (Clic here for more details about this article) |
7/7. Intracranial subdural haematoma complicates accidental dural tap during labour.A 19-year-old, healthy nulliparous woman developed an intracranial subdural haematoma after unintentional dural puncture in connection with epidural analgesia for labour pain. The haematoma was evacuated and the patient recovered completely. Anaesthesiologists and obstetricians should be aware of this rare but potentially dangerous complication to epidural analgesia.- - - - - - - - - - ranking = 0.33333333333333keywords = puncture (Clic here for more details about this article) |