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The Journal of Hand Surgery Jun 2022A dramatic increase in firework-related blast injuries to the hand and upper extremity resulted in record-setting numbers at our institution over the July 4, 2018,... (Review)
Review
A dramatic increase in firework-related blast injuries to the hand and upper extremity resulted in record-setting numbers at our institution over the July 4, 2018, holiday. This led our hand and upper extremity department to create a public service announcement (PSA) campaign regarding firework safety and injury prevention. This PSA was broadcast in advance of the next July 4 holiday via several media platforms including television, radio, and the internet. The following year only 4 patients required surgery for firework-related blast injuries to the hand and upper extremity over the same 10-day period, including the weekends before and after the July 4, 2019, holiday. This represented a considerable reduction compared with the 14 patients seen within the same time frame in 2018. The purpose of this article was to outline the process and report the impact of creating and disseminating a public service announcement for firework-related blast injury prevention.
Topics: Humans; Blast Injuries; Explosions; Hand; Hand Injuries
PubMed: 35078693
DOI: 10.1016/j.jhsa.2021.11.030 -
Aerospace Medicine and Human Performance Nov 2022Altitude chambers are used for training aircrews in a hypobaric hypoxic environment to better prepare them for pressurization and oxygen malfunction incidents during... (Review)
Review
Altitude chambers are used for training aircrews in a hypobaric hypoxic environment to better prepare them for pressurization and oxygen malfunction incidents during flights. However, adverse effects may occur during training sessions, with decompression sickness (DCS) being a major concern. The aim of this study was to examine the risks of different adverse effects during altitude chamber trainings (ACT) in the Israeli Air Force (IAF) facility and to compare them to other training facilities. We retrospectively reviewed the records of 1627 individuals in the IAF who were trained in the altitude chamber between 2015 and 2019. Data regarding adverse effects and training safety were extracted. Literature review of altitude chamber trainings was performed and adverse effects rates were compared. There were a total of 91 adverse effects cases in the IAF during the study period. The overall risk rate for an adverse effect was 5.59%. The most common adverse effect was middle ear and sinus barotrauma (69.3% of adverse effects cases), followed by breathing problems (14.3%) and DCS cases (9.9%). Mitigating the risk for DCS should be major concern during ACT. We recommend setting a standard protocol for an ACT which includes a 45-min preoxygenation period, a maximal ascent rate of 3000 ft · min (914 m · min), and setting a maximum altitude of 25,000 ft (7620 m) for fixed-wing trainees.
Topics: Humans; Aerospace Medicine; Decompression Sickness; Altitude; Retrospective Studies; Barotrauma
PubMed: 36309795
DOI: 10.3357/AMHP.6048.2022 -
Journal of the Royal Army Medical Corps Feb 2019The majority of patients injured in the recent conflicts in Iraq and Afghanistan were as a result of explosion, and terrorist incidents have brought blast injuries to... (Review)
Review
The majority of patients injured in the recent conflicts in Iraq and Afghanistan were as a result of explosion, and terrorist incidents have brought blast injuries to the front door of many civilian hospitals that had not previously encountered such devastation. This article reviews the physics and pathophysiology of blast injury with particular relevance to the presentation and management of primary blast injury, which is the mechanism least familiar to most clinicians and which may cause devastating injury without externals signs.
Topics: Animals; Biomedical Research; Blast Injuries; Humans; Military Medicine; Military Personnel
PubMed: 30317218
DOI: 10.1136/jramc-2018-001058 -
Critical Care (London, England) Oct 2018
Topics: Animals; Barotrauma; Disease Models, Animal; Humans; Pulmonary Atelectasis; Ventilator-Induced Lung Injury
PubMed: 30360756
DOI: 10.1186/s13054-018-2199-2 -
The New England Journal of Medicine Oct 2017
Topics: Adult; Decompression Sickness; Embolism, Air; Humans; Male; Portal Vein; Radiography, Abdominal; Skin; Tomography, X-Ray Computed; Vomiting
PubMed: 29045210
DOI: 10.1056/NEJMicm1615505 -
Neurologia I Neurochirurgia Polska 2015The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications... (Review)
Review
The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.
Topics: Barotrauma; Carotid Artery, Internal, Dissection; Diving; Foramen Ovale, Patent; High Pressure Neurological Syndrome; Humans; Inert Gas Narcosis
PubMed: 25666773
DOI: 10.1016/j.pjnns.2014.11.004 -
Refu'at Ha-peh Veha-shinayim (1993) Apr 2017The aim of this article is to introduce the concepts of military aviation dentistry, including facial barotraumas (external otitic barotrauma, barosinusitis and...
The aim of this article is to introduce the concepts of military aviation dentistry, including facial barotraumas (external otitic barotrauma, barosinusitis and barotitis- media), dental barotrauma, barodontalgia, and dental care for aircrews. Special considerations have to be made when planning restorative, endodontic, prosthodontic and surgical treatment to an aircrew patient. The article supplies the military dental officer with diagnostic and treatment guidelines, and the principles of prevention, periodic examination, and dental-related flight restriction.
Topics: Aerospace Medicine; Barotrauma; Dental Care; Humans; Military Dentistry; Military Personnel; Practice Guidelines as Topic
PubMed: 30699475
DOI: No ID Found -
Journal of Emergency Nursing Jan 2020
Review
Topics: Blast Injuries; Emergency Nursing; Humans; Mass Casualty Incidents
PubMed: 31918809
DOI: 10.1016/j.jen.2019.10.013 -
Chinese Medical Journal May 2018Mechanical ventilation (MV) has long been used as a life-sustaining approach for several decades. However, researchers realized that MV not only brings benefits to... (Review)
Review
OBJECTIVE
Mechanical ventilation (MV) has long been used as a life-sustaining approach for several decades. However, researchers realized that MV not only brings benefits to patients but also cause lung injury if used improperly, which is termed as ventilator-induced lung injury (VILI). This review aimed to discuss the pathogenesis of VILI and the underlying molecular mechanisms.
DATA SOURCES
This review was based on articles in the PubMed database up to December 2017 using the following keywords: "ventilator-induced lung injury", "pathogenesis", "mechanism", and "biotrauma".
STUDY SELECTION
Original articles and reviews pertaining to mechanisms of VILI were included and reviewed.
RESULTS
The pathogenesis of VILI was defined gradually, from traditional pathological mechanisms (barotrauma, volutrauma, and atelectrauma) to biotrauma. High airway pressure and transpulmonary pressure or cyclic opening and collapse of alveoli were thought to be the mechanisms of barotraumas, volutrauma, and atelectrauma. In the past two decades, accumulating evidence have addressed the importance of biotrauma during VILI, the molecular mechanism underlying biotrauma included but not limited to proinflammatory cytokines release, reactive oxygen species production, complement activation as well as mechanotransduction.
CONCLUSIONS
Barotrauma, volutrauma, atelectrauma, and biotrauma contribute to VILI, and the molecular mechanisms are being clarified gradually. More studies are warranted to figure out how to minimize lung injury induced by MV.
Topics: Animals; Barotrauma; Humans; Reactive Oxygen Species; Ventilator-Induced Lung Injury; Wounds and Injuries
PubMed: 29553050
DOI: 10.4103/0366-6999.226840 -
The Laryngoscope Jul 2024To understand the role of a single laryngologist, Andrew Heermance Smith, in elucidating the mechanisms of Caisson Disease and controlling it effects on bridge workers. (Review)
Review
OBJECTIVE
To understand the role of a single laryngologist, Andrew Heermance Smith, in elucidating the mechanisms of Caisson Disease and controlling it effects on bridge workers.
DATA SOURCES
Scientific and lay publications, letters and records of the Roebling family, obituaries and internet sources.
REVIEW METHODS
Historical review.
RESULTS
AH Smith combined physiological observations and experiments in the Brooklyn Bridge caissons with a review of the existing engineering and medical literature to describe the Caisson Disease and to devise strategies to ameliorate its effects.
CONCLUSION
Despite an incorrect conclusion about the pathophysiology of decompression sickness, Smith's stringent standards and timely interventions allow completion of the masonry towers of the Brooklyn Bridge.
LEVEL OF EVIDENCE
NA Laryngoscope, 134:3044-3048, 2024.
Topics: Humans; History, 19th Century; History, 20th Century; Otolaryngology; Decompression Sickness
PubMed: 38284795
DOI: 10.1002/lary.31306