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Investigative Duties on Scene
Published in Kevin L. Erskine, Erica J. Armstrong, Water-Related Death Investigation, 2021
The “buddy page” offers a message board for participants to post profiles, looking for other players to meet. The following is a warning that appears on this page:Warning! Underwater breath holding to the point of passing out is dangerous and can cause permanent brain damage. It is most likely that anyone without medical training will not be able to resuscitate/revive you if you pass out underwater. Inhaling water is likely to cause death. The webmaster takes no responsibility for the actions or consequences of those who choose to engage in underwater edge play. Don’t play alone and please play responsibly!—Thank you!
Drowning
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
The process of drowning comprises the following phases: Voluntary breath-holding.Reflex laryngospasm.Laryngospasm resolution.Penetration of liquid into the airways with gasping for air, dyspnoea and cough-like expiration.Loss of consciousness.Tonic–clonic seizures with persistent respiratory activity.Terminal gasping and cardiocirculatory arrest.Death.
Breath-holding
Published in Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy, Primary Child and Adolescent Mental Health, 2019
Quentin Spender, Judith Barnsley, Alison Davies, Jenny Murphy
The intervention that works best is active ignoring. As with the management of tantrums (seeChapter 17), the child should be given minimal or no attention, so as not to reinforce the breath-holding behaviour. The carer(s) should be encouraged to deal with the child calmly after the attack, with the minimum of fuss and no punishment, and to continue whatever activity was taking place before. It may also be worth emphasising what should be obvious to some parents – that the child should be protected from harm during the brief spell of unconsciousness. Also as with tantrums, it is usually helpful to identify triggers so that these can be avoided, and to use distraction (at an early stage) if possible: diverting the child to something he wants to do, to take his mind off his frustration. Some children can be helped to express their frustration in an alternative way: playing with drums, doing an extra-colourful drawing or running around outside for a while are possible examples.
The effects of maternal smoking on fetal cranial development. Findings from routine midtrimester sonographic anomaly screening
Published in Journal of Obstetrics and Gynaecology, 2023
Çağlar Çetin, Rabia Zehra Bakar, Taha Takmaz, Özge Pasin, Mehmet Serdar Kütük
Patients with chronic hypertension, pregestational diabetes, or fetal structural anomalies were not included in the study. After the routine detailed ultrasonography between 19 and 24 weeks, all pregnant women who were willing to enroll in the study underwent breath carbon monoxide (BCO) readings to determine their smoking status. BCO levels were performed using the inexpensive, handheld TABATABA CO-Tester V2 (FIM Medical, Lyon, France). To perform the breath test based on the manufacturer’s recommendation, the women were asked to exhale completely, inhale fully and breath-hold for 15 s. At the end of the breath hold, the women were asked to exhale slowly (over 15 s) and fully into the disposable mouthpiece adapter of the CO monitor. Non-smokers with BCO readings > 3 ppm and smokers with BCO readings < 3 ppm were not included in the final analysis, as previously recommended (Javors et al.2005, Reynolds et al.2018). Necessary safety protocols were put in place. The peak BCO reading (the monitor was watched until the CO reading declined) was taken as the subject’s BCO level. The device measured BCO levels in parts per million (ppm). Breath- holding allows the CO in the blood to form an equilibrium with the CO in the alveolar air. This technique is responsible for the high level of correlation between breath CO levels and COHb concentration. Approval was obtained from the local ethics committee for the study (BEAH 2020 06/109). All participants gave informed consent during enrollment into the study.
High-intensity focused ultrasound ablation of liver tumors in difficult locations
Published in International Journal of Hyperthermia, 2021
Simon H. Tsang, Ka Wing Ma, Wong Hoi She, Ferdinand Chu, Vince Lau, Shuk Wan Lam, Tan To Cheung, Chung Mau Lo
Temporarily halting respirations during sonication stops the movement of the liver, allowing smaller lesions to be safely ablated by HIFU energy applied in between the intercostal spaces [9,31]. The intermittent breath-holding can be performed during conventional ventilation through a single-lumen endotracheal tube, with the breath-holding performed under sustained airway pressures during sonication [33]. Intermittent breath-holding (up to 30 s each time) should be performed with greater caution in any patient with compromised cerebral circulation such as in the elderly, since these short periods of high airway pressure may have a detrimental effect on cerebral blood flow [36,37]. Propofol-based total intravenous anesthesia (TIVA) is the preferred anesthetic regime in order to provide for uninterrupted anesthesia during frequent breath-holds [33], and it has the added advantage of attenuating the detrimental effects of breath-holds on cerebral perfusion [38].
Iron deficiency and cyanotic breath-holding spells: The effectiveness of iron therapy
Published in Pediatric Hematology and Oncology, 2018
Sherifa A. Hamed, Eman Fathalla Gad, Tahra Kamel Sherif
Breath holding spells are common sudden reflexive, nonepileptic paroxysmal behavioral involuntary episodes occurring in up to 5.9% of otherwise healthy children. The attacks occur in early childhood (0.5–3 years) but are selflimited and usually disappear (90%) by school age (4–5 years old).1,2 Very rarely (4–5%), it may persist to the age of 7–8 years.3 A positive family history is present in 20–34% indicating genetic predisposition.4,5 During the past two decades, several studies have addressed the clinical views, differential diagnosis, pathophysiology, prognostic significance and treatment of Breath holding spells. Classically, Breath holding spells were classified as cyanotic (blue), pallid (pale) and mixed based on the color change of the child during the spell.1,6 In general, cyanotic spells are more common than pallid spells. They have been classically described in a toddler with excessive crying and excessive temper tantrums (stubborn, easily frustration or annoyed).7–10 Cyanotic Breath holding spells (CBHS) (or better defined as prolonged expiratory apnea) have been suggested to be a result of increased intrathoracic pressure due to spontaneous Valsalva maneuver and decrease in cerebral blood flow, cyanosis, loss of consciousness, postural tone and rarely seizures.1,7,8 The mechanisms of Breath holding spells are controversial. The most suggested cause of cyanotic breath holding spells is dysregulation or instability of the autonomic nervous system, exaggerated vagal response in response to noxious stimuli, inhibition of respiratory effort and cyanosis.6,11,12