Caring for an individual
Ross Balchin, Rudi Coetzer, Christian Salas, Jan Webster in Addressing Brain Injury in Under-Resourced Settings, 2017
Medical staff should be alerted by your information and take some of the actions listed previously. The patient may need: A tracheotomy (a hole made in the neck to allow a tube to be inserted directly into the windpipe to assist breathing)A nasogastric tube (a tube for carrying food and medicine to the stomach via the nose)A catheter (a flexible tube inserted through the bladder to remove urine)An IV drip in a bag above the bed to administer drugs and fluids directly into a vein
Anticoagulant Therapy
Hau C. Kwaan, Meyer M. Samama in Clinical Thrombosis, 2019
As seen in Table 3, bleeding can occur in various organs giving rise to a variety of syndromes. For example, intramural bleeding into the intestines may produce a picture of acute intestinal obstruction;159 retroperitoneal hemorrhage can give rise to neuropathy due to compression by the hematoma.160 An acute femoral neuropathy has also been reported.161 Sudden bleeding into the ovary can give rise to an acute abdominal syndrome with hemoperitoneum requiring immediate and aggressive therapy.162 Acute adrenocortical failure may be the result of bleeding into the adrenal capsule or due to compression of the adrenal veins by a massive retroperitoneal hemorrhage. In these cases, the severe and sustained hypotension would not respond to blood transfusion or to vasopressors. This syndrome must be recognized early so that appropriate therapy with large doses of hydrocortisone can be instituted. Bleeding into the vocal cords may result in acute stridor requiring emergency tracheotomy.
Percutaneous tracheostomy
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Essentials of Anesthesia for Neurotrauma, 2018
One of the most feared complications is Tracheo-innominate artery erosion. Risk factors for the development of trachea-innominate fistula include excessive movement of the tracheostomy, high pressure (or overinflated) cuff, or a tube that has been placed too low. The innominate artery lies adjacent to the trachea and crosses it at approximately the ninth tracheal ring. If the tracheostomy tube is placed too low (below the third tracheal ring), the inferior concave surface of the cannula may erode into the artery and may result in torrential bleeding. It occurs in less than 1% of patients. Approximately, 75% will occur within 3 to 4 weeks of placement of tracheostomy. The mortality rate is as high as 100%, even when surgical intervention is undertaken. The most common clinical presentations are bleeding around the tracheostomy tube or massive hemoptysis.
Tracheotomy as a predictor of remission and demise for juvenile-onset recurrent respiratory papillomatosis
Published in Acta Oto-Laryngologica, 2022
Zijie Niu, Yang Xiao, Lijing Ma, Xiaoli Qu, Yuge Wang, Sihan Zhou, Jun Wang
The disease often appears in the vocal cords, false vocal cords, epiglottic larynx, and subglottis. The main clinical manifestation is hoarseness. If papillomas obstruct the airway seriously, it could cause dyspnea and even threaten children’s life. The laryngeal cavity of young children is narrow, which increases the probability of dyspnea. Tracheotomy is a classic treatment to keep the airway adequate in emergency and enhance the safety during the operation [2]. Nonetheless, tracheotomy disrupts airway mucosa, which will increase the squamo-columnar junction, provide a site suitable for seeding of virus particles and papillomas, and even promote lower airway dissemination of papillomas [3,4]. The pros and cons of tracheotomy seem to be recognized, and it has become an accepted view that tracheotomy should be avoided in patients with JORRP and every effort should be made to remove the tracheal cannula when it is unavoidable [5]. Although it has been reported that tracheotomy may be associated with poor prognosis [6], there is relatively limited information assessing the exact impact of tracheotomy on prognosis for JORRP.
Necrotizing fasciitis of the scalp stemming from odontogenic infection
Published in Baylor University Medical Center Proceedings, 2020
Michael H. Lee, Samuel S. Votto, Andrew M. Read-Fuller, Likith V. Reddy
The patient was taken to the operating room less than 4 hours after arrival. An open tracheotomy was performed. The right mandible was explored, multiple teeth were removed, and necrotic bone was debrided. A tract extending superiorly from the lateral surface of the temporalis toward the scalp was noted. The right postauricular tissue was then explored and the full thickness of the necrotic area was excised. The surrounding tissues were then examined, and the deeper layers dissected readily, revealing extension of the infection into those planes. A coronal flap was raised and reflected anteriorly and posteriorly (Figure 2). Extensive gross necrosis was noted encompassing the periosteum, areolar connective tissue, and galea across most of the scalp, with copious output of dishwater fluid throughout the scalp, forehead, and upper eyelids. All questionable tissue was removed, including galea, connective tissue, and pericranium across most of the scalp. Multiple drains were placed.
The Protective Effects of Thymosin-β-4 in a Rat Model of Ischemic Acute Kidney Injury
Published in Journal of Investigative Surgery, 2021
Ugur Aksu, Onur M. Yaman, Ibrahim Guner, Gulcan Guntas, Fuat Sonmez, Gamze Tanriverdi, Mediha Eser, Aris Cakiris, Sibel Akyol, İsmail Seçkin, Hafize Uzun, Nermin Yelmen, Gulderen Sahin
Pentobarbital sodium (60 mg/kg i.p.) was used to anesthetize the rats. A tracheotomy was performed to allow spontaneous breathing. Throughout the experiments, body temperature of the rats was kept at 37 ± 0.5 °C by an external heating pad. Following midline laparotomy the abdominal aorta was gently exposed by deflecting the intestines and other internal organs to the left. After isolation of the infrarenal aorta, an atraumatic suture was placed under for easy access. The abdomen was then closed by a continuous suture to prevent evaporation. Five minutes before the ischemia period, heparin (50 U/kg i.v.) was administered to each animal. An atraumatic microvascular clamp (vascu-statts II, midi straight 1001-532; Scanlan Int. St Paul, MN, USA) was placed on infrarenal abdominal aorta (IAA) for 90 min (ischemia) and reperfusion period started with the removal of the clamp (180 min). The experiment was terminated by withdrawal of the blood via the aorta, and the kidney tissue was sampled.
Related Knowledge Centers
- Branchial Cleft Cyst
- Head & Neck Cancer
- Inflammation
- Respiratory Tract
- Stoma
- Trachea
- Tracheal Tube
- Angioedema
- Surgical Airway Management
- Facial Trauma
- Head & Neck Cancer