جستجوی مقالات مرتبط با کلیدواژه « نافذ » در نشریات گروه « پزشکی »

Managing neck trauma is a challenging issue in the emergency department. Stable-appearing patients may suffer from vascular, laryngeal, or neurologic complications. The patient was a 41-year-old man who was transported to the hospital by a pre-hospital emergency medical service, following a fight and stabbing in the II area of the neck on the right side. The site of the trauma was the middle part of the right side of the neck. The patient was fully conscious. He had spontaneous speech and his airway was open. The patient was transferred to the operating room after the initial procedures in the emergency department. during surgery, the knife was removed from the neck. Clinical management and providing a suitable platform to accelerate the process of interventions can have a favorable effect on the prognosis of patients.

Cardiac tamponade occurs when excessive fluids in pericardium is build up and lead to right ventricular failure and even obstructive shock. The most common cause of tamponade is stab wound, which is a medical emergency and often affects   young men and is caused by gunshot, stab wound, or an explosion. Herein we have reported a successful treatment of tamponade in cardiac stab wound by bed side sonography in Emergency Department

Case Report: 

A 22-year-old man presented to the emergency with a complaint of stab wound to the fifth intercostal space on the left, he was undergone stabilization in ED. Bedside ultrasound showed evidence of severe pericardial effusion with clots and pressure on the right ventricle, according to the surgical consultation he was candidate for emergent surgery.  While preparing to be transferred to the operating room and despite receiving crystalloids, the patient experienced a sudden drop in blood pressure (6/ P). Ultrasound showed the exacerbation of the accumulation of fluid in the pericardial space with right ventricular collapse. Therefore, in the emergency room, under ultrasound guidance, about 40 cc of blood was drained from the pericardial space. After draining the blood pressure reached 95/65 and was transferred to the operating room. Finally he was discharged home with good condition.

Rapid diagnosis of tamponade and attention to the patientchr('39')s vital sign, even during in hospital transfer can save their lives.

Abdominal Trauma seems to be one of the most common etiological factors of mortality in human populations following encountering different types of trauma. This study was designed to evaluate the role of sonography in clinical diagnosis of internal injuries of abdomen as well as verification and confirmation of the presence of free liquids in the abdominal cavity. This study was conducted to compare the importance of the role of sonography results with the clinical trend of trauma, specially the results of surgical operations in the studied cases. The present periodic study was conducted on all 104 patients (80 males and 24 females) who referred to Ali-ibne Abitaleb Hospital of Rafsanjan due to penetrating and blunt abdominal trauma between January 2000 and April 2001. Personal characteristics of the patients such as age, cause of trauma, nature of the problem (fixed or temporary), clinical examination result, sonography result, laparatomy result-if done-, and the final diagnosis were recorded. Then, positive and negative results of sonography were matched with those of laparotomy and clinical trend. Finally, the obtained data was analyzed by EPI-5 software using chi-square test at the significant level of P= 0.05. Totally, sonography was done on 104 patients with abdominal trauma, who had homeodynamic status.. Presence of free fluid in the abdominal cavities of some patients, as well as possible visceral lesions and gross pathologic changes of abdominal organs were recorded. Besides, sonography findings were negative in 85 patients (81.7%) and positive in 19 cases (18.3%). After comparing sonography findings with those coincident with surgery sonography accuracy and specificity were determined 85% and 65%, respectively. The results of this study generally support the role of sonography as one of the primary diagnostic techniques in the patients who are affected by abdominal trauma and have constant vital clinical signs. However, in order to make decision for laparatomy and surgical treatment, physical examinations, clinical observations and using other diagnostic techniques such as CT-Scan is imperative and can be helpful.

Trauma is the most common cause of death, admission and disability in all age groups ranging between 1-40 years. The present study was conducted to survey the frequency of chest trauma (blunt and penetrating) in Air Force Hospital in a two-year period, 2002–2004. A retrospective study was conducted at Surgery and Emergency departments of Air Force hospital on all consecutive (blunt and penetrating) chest trauma patients treated between March 2002 and March 2004. Totally, 814 cases referred with chief complain of chest trauma. Blunt chest trauma was reported in 78.1% of cases (636 patients) and penetrating chest trauma in the remaining 21.9% (178 patients). Totally, 84.7% were males and 76.4% aged 14-40 years. The most common site of injury was chest wall (90.3%) and soft tissue injury was the most prevalent form of trauma (31.6%). Extremities were the most common site of co-injury (13.3%). Car accident was by far the most frequent cause of trauma (57.9%). The mortality rate was 3.8% (31 patients). Car accident was the most common cause of chest trauma. Meanwhile, soft tissue injury was the most frequent type of injury.