DOCSLIB.ORG

Asphyxia Death Caused by Epiglottic Abscess Rupture in an Adult: a Case Report

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Asphyxia Death Caused by Epiglottic Abscess Rupture in an Adult: a Case Report Rom J Leg Med [22] 233-236 [2014] DOI: 10.4323/rjlm.2014.233 © 2014 Romanian Society of Legal Medicine Asphyxia death caused by epiglottic abscess rupture in an adult: A case report Yong Cao 1,2, Youjia Yu1, Xiaohong Gao3, Hong Jin4, Meigui Lu1, Daoyin Gong5, Feijun Huang1,* _________________________________________________________________________________________ Abstract: We report a case of Asphyxia death caused by epiglottic abscess rupture. Patient was initially managed as acute epiglottis with parenteral antibiotics, about two hours later, the patient died with bleeding from his nose and mouth. In this case, the patient exhibited a hemorrhage at the top of the epiglottic abscess by the abscess surface mucosa rupture (0.5cm×0.1cm). We reviewed this case with respect to the autopsy findings, pathological changes and circumstantial correlations of the investigation. Key Words: epiglottic abscess, asphyxia death, autopsy, forensic pathology. different category of blast injuries is the one epiglottis mucosa and throat (Fig. C, D), together with related with exploding tyres. Injuries caused edema of throat mucosa, epiglottis and surrounding A by exploding tyres can be seen as direct injuries caused tissue. An epiglottic abscess nodule (1.6 × 1.3 × 0.6cm) by rim fragments and barotraumas as a result of high (Fig. E) was detected at the right side of the surface of pressures [1]. epiglottis. A 47-year-old male was found dead at home with The wall thickness of epiglottis was 1.0 cm (Fig. a lot of blood flowing from his nose and mouth 2 hours G). Extensive epiglottis interstitial hemorrhage and after leaving the hospital. From beginning to end, the severe congestion of epiglottis were observed (Fig. C). patient did not complain of expiratory dyspnea or show Large quantity of pink foamy liquid was retained in the sign of obstruction. The individual was pronounced dead trachea and bronchi (Fig. B) and overflowed from the after emergency treatment in the hospital. lung section. External examination revealed large amount of Microscopic investigation demonstrated diffused blood in oval and nasal cavity (Fig. A). The fingernails hemorrhage in the epiglottis interstitial (Fig. H, I), large and toenails showed severe cyanosis and the external number of neutrophils in the epiglottis abscess nodules, auditory canal were normal. No lesion was observed on granulation tissue around the abscess and congestion the surface of body. of multiple tissues and organs. Severe lung congestion, Autopsy revealed bloodstain on the surface of edema, focal hemorrhage and partial bronchospasm were 1) Department of Forensic Pathology, West China School of Basic Science and Forensic Medicine, Sichuan University, 3-17 Renmin South Road, Chengdu, Sichuan 610041, PR China * Corresponding author: Tel.: +86-130-9632-6175, Email: [email protected] 2) Department of Pathology, Mudanjiang Medical University, Aimin District, Mudanjiang 157011, PR China 3) Biotechnology Laboratory, Mudanjiang Medical University, Aimin District, Mudanjiang 157011, PR China 4) Department of Clinical Laboratory, Hongqi Hospital, Mudanjiang Medical University, Aimin District, Mudanjiang 157011, PR China 5) Institute of Basic Medicine, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Avenue, Wenjiang District, Chengdu, Sichuan 610000, PR China 233 Cao Y. et al Asphyxia death caused by epiglottic abscess rupture in an adult: A case report Figure. Autopsy revealed edema of epiglottis mucosa and surrounding tissue, hemorrhage of the epiglottic abscess surface and a lot of pink foamy liquid in the bronchi. A. A large amount of blood in oval and nasal cavity; B. Pink foamy liquid in the bronchi (white arrow); C and D. Severe laryngeal congestion and edema, epiglottis stenosis (white arrow); E. Epiglottic abscess nodule measuring 1.6 cm × 1.3cm× 0.6cm (white arrow) at the right side of the surface of epiglottis; F. Epiglottic abscess rupture measuring 0.5cm×0.1cm (white arrow). 234 Romanian Journal of Legal Medicine Vol. XXII, No 4(2014) Figure. G. The wall thickness of the epiglottis measuring 1.0cm (white arrow);H and I. The epiglottis interstitial diffuse hemorrhage and inflammatory cell infiltration. observed. Small amounts of hemorrhage were found in the No other lethal pathological changes and myocardial interstitial. Parts of the myocardial fibers were mechanical traumas were found during autopsy. wavy changed, small amount of fat cells and inflammatory The risk factors for epiglottic abscess include cells were observed in myocardial interstitial. There was age of onset, diabetes and the presence of foreign body evidence of cerebral edema. The cause of death was [2]. Berger et al. reported that 10 of the 116 epiglottitis deemed suffocation due to airway obstruction caused patients were diabetic, 16 of them had background disease by epiglottic abscess rupture (0.5cm×0.1cm) (Fig. F), [3]. The clinical features of epiglottic abscess include bleeding and severe laryngeal edema. fever, odynophagia and hoarseness. Interestingly, airway obstructions rarely become the presenting symptom as DISCUSSION compared to odynophagia and fever [4]. Therefore, CT examination is recommended for patients with a stable Acute laryngemphraxis refers to the upper airway and swollen epiglottis, even if the swelling is not respiratory obstruction caused by various diseases very obvious [5]. which induce laryngostenosis or obstructive breathing Although some patients did not have any difficulties. This symptom is more common in infants symptoms of airway obstruction, the laryngoscopy and young children, and also occurs in adults. It is a very findings which showed severely narrowed supralaryngeal critical condition that severe breathing difficulties would airway warrant us to perform tracheostomy in order to take place in a short time. Without timely treatment, establish airway as well as provide route for administration some patients may die from suffocation. Many causes of anesthesia and drainage of the abscess. However, recent may contribute to laryngeal obstruction, including report suggested other methods of treatment to avoid inflammation of the throat, allergic and certain systemic tracheotomy. Kim SG et al. reported that 11 epiglottic diseases, inhalation injury (inhalation hydrothermal hot abscesses were successfully treated with spinal needle toxic or irritating gases) etc [1]. aspiration that avoided the need for a tracheostomy [6]. About our case, five characteristics was At the same time, an iv antibiotics plus corticosteroids discovered by autopsy as follows: should be administrated the moment a suspicion of The deceased had an epiglottic abscess nodule epiglottitis is present [7]. (1.6 cm × 1.3 cm × 0.6cm) bleeding and laryngeal edema, This case shows that in the course of clinical in which large number of neutrophils were found. diagnosis and treatment of patients with sore throat, The deceased had focal pulmonary congestion, painful swallowing, the main symptoms of oropharyngeal edema, pulmonary hemorrhage, bronchospasm, etc, mucosa if no obvious lesions, especially, when some which were consistent with acute myocardial ischemic patients do not complain of breathing difficulty or show changes. sign of obstruction, all of them should be routine for Multifocal hemorrhage in myocardial interstitial, indirect laryngoscopy to rule out the existence of acute wave-like changes of multifocal myocardial fiber and epiglottitis, epiglottis abscesses and other emergencies congestion of multiple tissues and organs were found. All adopted after diagnosis and effective treatment to avoid of them were consistent with signs of acute respiratory serious complications. and circulatory system failure. 235 Cao Y. et al Asphyxia death caused by epiglottic abscess rupture in an adult: A case report References 1. Zhao ZQ. Forensic Pathology. Fourth Edition, People's Health Publishing House 2009.7.4:439-440. 2. Stack BC Jr, Ridley MB. Epiglottic abscess. Head Neck 1995; 17(3): 263-265. 3. Berger G et al., The rising incidence of adult acute epiglottitis and epiglottic abscess. Am J Otolaryngol, 2003. 24(6): p. 374-383. 4. Heeneman H, Ward KM. Epiglottic abscess: Its occurance and management. J Otolaryngol 1977; 6(1): 31-36. 5. Ito, K., H. Chitose, and M. Koganemaru, Four cases of acute epiglottitis with a peritonsillar abscess. Auris Nasus Larynx, 2011. 38(2): p. 284-248. 6. Kim SG, Lee JH, Park DJ et al. Efficacy of spinal needle aspiration for epiglottic abscess in 90 patients with acute epiglottitis. Acta Otolaryngol 2009; 129(7): 760-767. 7. Hindy J et al., Epiglottic abscess as a complication of acute epiglottitis. Am J Otolaryngol, 2013. 34(4): p. 362-365. 236.
Load more

Recommended publications
  • Traveler Information
    Traveler Information QUICK LINKS Marine Hazards—TRAVELER INFORMATION • Introduction • Risk • Hazards of the Beach • Animals that Bite or Wound • Animals that Envenomate • Animals that are Poisonous to Eat • General Prevention Strategies Traveler Information MARINE HAZARDS INTRODUCTION Coastal waters around the world can be dangerous. Swimming, diving, snorkeling, wading, fishing, and beachcombing can pose hazards for the unwary marine visitor. The seas contain animals and plants that can bite, wound, or deliver venom or toxin with fangs, barbs, spines, or stinging cells. Injuries from stony coral and sea urchins and stings from jellyfish, fire coral, and sea anemones are common. Drowning can be caused by tides, strong currents, or rip tides; shark attacks; envenomation (e.g., box jellyfish, cone snails, blue-ringed octopus); or overconsumption of alcohol. Eating some types of potentially toxic fish and seafood may increase risk for seafood poisoning. RISK Risk depends on the type and location of activity, as well as the time of year, winds, currents, water temperature, and the prevalence of dangerous marine animals nearby. In general, tropical seas (especially the western Pacific Ocean) are more dangerous than temperate seas for the risk of injury and envenomation, which are common among seaside vacationers, snorkelers, swimmers, and scuba divers. Jellyfish stings are most common in warm oceans during the warmer months. The reef and the sandy sea bottom conceal many creatures with poisonous spines. The highly dangerous blue-ringed octopus and cone shells are found in rocky pools along the shore. Sea anemones and sea urchins are widely dispersed. Sea snakes are highly venomous but rarely bite.
    [Show full text]
  • Asphyxia Neonatorum
    CLINICAL REVIEW Asphyxia Neonatorum Raul C. Banagale, MD, and Steven M. Donn, MD Ann Arbor, Michigan Various biochemical and structural changes affecting the newborn’s well­ being develop as a result of perinatal asphyxia. Central nervous system ab­ normalities are frequent complications with high mortality and morbidity. Cardiac compromise may lead to dysrhythmias and cardiogenic shock. Coagulopathy in the form of disseminated intravascular coagulation or mas­ sive pulmonary hemorrhage are potentially lethal complications. Necrotizing enterocolitis, acute renal failure, and endocrine problems affecting fluid elec­ trolyte balance are likely to occur. Even the adrenal glands and pancreas are vulnerable to perinatal oxygen deprivation. The best form of management appears to be anticipation, early identification, and prevention of potential obstetrical-neonatal problems. Every effort should be made to carry out ef­ fective resuscitation measures on the depressed infant at the time of delivery. erinatal asphyxia produces a wide diversity of in­ molecules brought into the alveoli inadequately com­ Pjury in the newborn. Severe birth asphyxia, evi­ pensate for the uptake by the blood, causing decreases denced by Apgar scores of three or less at one minute, in alveolar oxygen pressure (P02), arterial P02 (Pa02) develops not only in the preterm but also in the term and arterial oxygen saturation. Correspondingly, arte­ and post-term infant. The knowledge encompassing rial carbon dioxide pressure (PaC02) rises because the the causes, detection, diagnosis, and management of insufficient ventilation cannot expel the volume of the clinical entities resulting from perinatal oxygen carbon dioxide that is added to the alveoli by the pul­ deprivation has been further enriched by investigators monary capillary blood.
    [Show full text]
  • Failure of Hypothermia As Treatment for Asphyxiated Newborn Rabbits R
    Arch Dis Child: first published as 10.1136/adc.51.7.512 on 1 July 1976. Downloaded from Archives of Disease in Childhood, 1976, 51, 512. Failure of hypothermia as treatment for asphyxiated newborn rabbits R. K. OATES and DAVID HARVEY From the Institute of Obstetrics and Gynaecology, Queen Charlotte's Maternity Hospital, London Oates, R. K., and Harvey, D. (1976). Archives of Disease in Childhood, 51, 512. Failure of hypothermia as treatment for asphyxiated newborn rabbits. Cooling is known to prolong survival in newborn animals when used before the onset of asphyxia. It has therefore been advocated as a treatment for birth asphyxia in humans. Since it is not possible to cool a human baby before the onset of birth asphyxia, experiments were designed to test the effect of cooling after asphyxia had already started. Newborn rabbits were asphyxiated in 100% nitrogen and were cooled either quickly (drop of 1 °C in 45 s) or slowly (drop of 1°C in 2 min) at varying intervals after asphyxia had started. When compared with controls, there was an increase in survival only when fast cooling was used early in asphyxia. This fast rate of cooling is impossible to obtain in a human baby weighing from 30 to 60 times more than a newborn rabbit. Further litters ofrabbits were asphyxiated in utero. After delivery they were placed in environmental temperatures of either 37 °C, 20 °C, or 0 °C and observed for spon- taneous recovery. The animals who were cooled survived less often than those kept at 37 'C. The results of these experiments suggest that hypothermia has little to offer in the treatment of birth asphyxia in humans.
    [Show full text]
  • The Post-Mortem Appearances in Cases of Asphyxia Caused By
    a U?UST 1902.1 ASPHYXIA CAUSED BY DROWNING 297 Table I. Shows the occurrence of fluid and mud in the 55 fresh bodies. ?ritfinal Jlrttclcs. Fluid. Mud. Air-passage ... .... 20 2 ? ? and stomach ... ig 6 ? ? stomach and intestine ... 7 1 ? ? and intestine X ??? Stomach ... ??? THE POST-MORTEM APPEARANCES IN Intestine ... ... 1 Stomach and intestine ... ... i CASES OF ASPHYXIA CAUSED BY DROWNING. Total 46 9 = 55 By J. B. GIBBONS, From the above table it will be seen that fluid was in the alone in 20 LIEUT.-COL., I.M.S., present air-passage cases, in the air-passage and stomach in sixteen, Lute Police-Surgeon, Calcutta, Civil Surgeon, Ilowrah. in the air-passage, stomach and intestine in seven, in the air-passage and intestine in one. As used in this table the term includes frothy and non- frothy fluid. Frothy fluid is only to be expected In the period from June 1893 to November when the has been quickly recovered from months which I body 1900, excluding three during the water in which drowning took place and cases on leave, 15/ of was privilege asphyxia examined without delay. In some of my cases were examined me in the due to drowning by it was present in a most typical form; there was For the of this Calcutta Morgue. purpose a bunch of fine lathery froth about the nostrils, all cases of death inhibition paper I exclude by and the respiratory tract down to the bronchi due to submersion and all cases of or syncope was filled with it. received after into death from injuries falling The quantity of fluid in the air-passage varies the water.
    [Show full text]
  • Respiratory and Gastrointestinal Involvement in Birth Asphyxia
    Academic Journal of Pediatrics & Neonatology ISSN 2474-7521 Research Article Acad J Ped Neonatol Volume 6 Issue 4 - May 2018 Copyright © All rights are reserved by Dr Rohit Vohra DOI: 10.19080/AJPN.2018.06.555751 Respiratory and Gastrointestinal Involvement in Birth Asphyxia Rohit Vohra1*, Vivek Singh2, Minakshi Bansal3 and Divyank Pathak4 1Senior resident, Sir Ganga Ram Hospital, India 2Junior Resident, Pravara Institute of Medical Sciences, India 3Fellow pediatrichematology, Sir Ganga Ram Hospital, India 4Resident, Pravara Institute of Medical Sciences, India Submission: December 01, 2017; Published: May 14, 2018 *Corresponding author: Dr Rohit Vohra, Senior resident, Sir Ganga Ram Hospital, 22/2A Tilaknagar, New Delhi-110018, India, Tel: 9717995787; Email: Abstract Background: The healthy fetus or newborn is equipped with a range of adaptive, strategies to reduce overall oxygen consumption and protect vital organs such as the heart and brain during asphyxia. Acute injury occurs when the severity of asphyxia exceeds the capacity of the system to maintain cellular metabolism within vulnerable regions. Impairment in oxygen delivery damage all organ system including pulmonary and gastrointestinal tract. The pulmonary effects of asphyxia include increased pulmonary vascular resistance, pulmonary hemorrhage, pulmonary edema secondary to cardiac failure, and possibly failure of surfactant production with secondary hyaline membrane disease (acute respiratory distress syndrome).Gastrointestinal damage might include injury to the bowel wall, which can be mucosal or full thickness and even involve perforation Material and methods: This is a prospective observational hospital based study carried out on 152 asphyxiated neonates admitted in NICU of Rural Medical College of Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra from September 2013 to August 2015.
    [Show full text]
  • Perinatal Asphyxia Neonatal Therapeutic Hypothermia
    PERINATAL ASPHYXIA NEONATAL THERAPEUTIC HYPOTHERMIA Sergio G. Golombek, MD, MPH, FAAP Professor of Pediatrics & Clinical Public Health – NYMC Attending Neonatologist Maria Fareri Children’s Hospital - WMC Valhalla, New York President - SIBEN ASPHYXIA From Greek [ἀσφυξία]: “A stopping of the pulse” “Loss of consciousness as a result of too little oxygen and too much CO2 in the blood: suffocation causes asphyxia” (Webster’s New World Dictionary) On the influence of abnormal parturition, difficult labours, premature birth, and asphyxia neonatorum, on the mental and physical condition of the child, especially in relation to deformities. By W. J. Little, MD (Transactions of the Obstetrical Society of London 1861;3:243-344) General spastic contraction of the lower Contracture of adductors and flexors of lower extremities. Premature birth. Asphyxia extremities. Left hand weak. Both hands awkward. neonatorum of 36 hr duration. Hands More paralytic than spastic. Born with navel-string unaffected. (Case XLVII) around neck. Asphyxia neonatorum 1 hour. (Case XLIII) Perinatal hypoxic-ischemic encephalopathy (HIE) Associated with high neonatal mortality and severe long-term neurologic morbidity Hypothermia is rapidly becoming standard therapy for full-term neonates with moderate-to-severe HIE Occurs at a rate of about 3/1000 live-born infants in developed countries, but the rate is estimated to be higher in the developing world Intrapartum-related neonatal deaths (previously called ‘‘birth asphyxia’’) are the fifth most common cause of deaths among children under 5 years of age, accounting for an estimated 814,000 deaths each year, and also associated with significant morbidity, resulting in a burden of 42 million disability adjusted life years (DALYs).
    [Show full text]
  • Perinatal Asphyxia in the Term Newborn
    www.jpnim.com Open Access eISSN: 2281-0692 Journal of Pediatric and Neonatal Individualized Medicine 2014;3(2):e030269 doi: 10.7363/030269 Received: 2014 Oct 01; accepted: 2014 Oct 14; published online: 2014 Oct 21 Review Perinatal asphyxia in the term newborn Roberto Antonucci1, Annalisa Porcella1, Maria Dolores Pilloni2 1Division of Neonatology and Pediatrics, “Nostra Signora di Bonaria” Hospital, San Gavino Monreale, Italy 2Family Planning Clinic, San Gavino Monreale, ASL 6 Sanluri (VS), Italy Proceedings Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014) Cagliari (Italy) · October 25th, 2014 The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken Abstract Despite the important advances in perinatal care in the past decades, asphyxia remains a severe condition leading to significant mortality and morbidity. Perinatal asphyxia has an incidence of 1 to 6 per 1,000 live full-term births, and represents the third most common cause of neonatal death (23%) after preterm birth (28%) and severe infections (26%). Many preconceptional, antepartum and intrapartum risk factors have been shown to be associated with perinatal asphyxia. The standard for defining an intrapartum hypoxic-ischemic event as sufficient to produce moderate to severe neonatal encephalopathy which subsequently leads to cerebral palsy has been established in 3 Consensus statements. The cornerstone of all three statements is the presence of severe metabolic acidosis (pH < 7 and base deficit ≥ 12 mmol/L) at birth in a newborn exhibiting early signs of moderate or severe encephalopathy. Perinatal asphyxia may affect virtually any organ, but hypoxic-ischemic encephalopathy (HIE) is the most studied clinical condition and that is burdened with the most severe sequelae.
    [Show full text]
  • Carbon Monoxide Poisoning in the Home Cyril John Polson
    Journal of Criminal Law and Criminology Volume 44 | Issue 4 Article 15 1954 Carbon Monoxide Poisoning in the Home Cyril John Polson Follow this and additional works at: https://scholarlycommons.law.northwestern.edu/jclc Part of the Criminal Law Commons, Criminology Commons, and the Criminology and Criminal Justice Commons Recommended Citation Cyril John Polson, Carbon Monoxide Poisoning in the Home, 44 J. Crim. L. Criminology & Police Sci. 531 (1953-1954) This Criminology is brought to you for free and open access by Northwestern University School of Law Scholarly Commons. It has been accepted for inclusion in Journal of Criminal Law and Criminology by an authorized editor of Northwestern University School of Law Scholarly Commons. CARBON MONOXIDE POISONING IN THE HOME* Cyril John Poison Cyril John Polson, M.D., F.R.C.P., is a Barrister-at-Law and Professor of Legal Medicine, University of Leeds, England. This article, the second of his to be published in this Journal, is based upon a public lecture delivered in the Uni- versity of Leeds, October 24, 1952.-EDIToR. Carbon monoxide poisoning in the home has for long been a common- place. It is clear, however, that so long as accidental poisoning con- tinues to occur there is room for recurrent reminders of the dangers of carbon monoxide. The present account is based on a detailed examination of the records of over 700 fatalities which have occurred during the past twenty five years in the City of Leeds. THE DANGERS PECULIAR TO CARBON MONOXIDE It requires no reflection to appreciate that any poison which is gaseous, and at the same time colourless, non-irritant and, may be, odourless, has grave potential dangers.
    [Show full text]
  • Lost Floodplain Wetland Environments and Efforts to Restore Connectivity, Habitat, and Water Quality Settings on the Great Barrier Reef
    fmars-06-00071 February 25, 2019 Time: 15:47 # 1 POLICY AND PRACTICE REVIEWS published: 26 February 2019 doi: 10.3389/fmars.2019.00071 Lost Floodplain Wetland Environments and Efforts to Restore Connectivity, Habitat, and Water Quality Settings on the Great Barrier Reef Nathan J. Waltham1,2*, Damien Burrows1, Carla Wegscheidl3, Christina Buelow1,2, Mike Ronan4, Niall Connolly3, Paul Groves5, Donna Marie-Audas5, Colin Creighton1 and Marcus Sheaves1,2 1 Centre for Tropical Water and Aquatic Ecosystem Research, College of Science and Engineering, James Cook University, Townsville, QLD, Australia, 2 Science for Integrated Coastal Ecosystem Management, School of Marine Biology and Aquaculture, College of Science and Engineering, James Cook University, Townsville, QLD, Australia, 3 Rural Economic Development, Department of Agriculture and Fisheries, Queensland Government, Townsville, QLD, Australia, 4 Department of Environment and Science, Queensland Government, Brisbane, QLD, Australia, 5 Great Barrier Reef Marine Park Authority, Australian Government, Townsville, QLD, Australia Edited by: Mario Barletta, Departamento de Oceanografia da Managers are moving toward implementing large-scale coastal ecosystem restoration Universidade Federal de Pernambuco projects, however, many fail to achieve desired outcomes. Among the key reasons for (UFPE), Brazil this is the lack of integration with a whole-of-catchment approach, the scale of the Reviewed by: A. Rita Carrasco, project (temporal, spatial), the requirement for on-going costs for maintenance, the Universidade do Algarve, Portugal lack of clear objectives, a focus on threats rather than services/values, funding cycles, Jacob L. Johansen, New York University Abu Dhabi, engagement or change in stakeholders, and prioritization of project sites. Here we United Arab Emirates critically assess the outcomes of activities in three coastal wetland complexes positioned *Correspondence: along the catchments of the Great Barrier Reef (GBR) lagoon, Australia, that have Nathan J.
    [Show full text]
  • A Review of SCUBA Diving Impacts and Implication for Coral Reefs Conservation and Tourism Management
    SHS Web of Conferences 12, 01093 (2014) DOI: 10.1051/shsconf/20141201093 C Owned by the authors, published by EDP Sciences, 2014 A Review of SCUBA Diving Impacts and Implication for Coral Reefs Conservation and Tourism Management Siti Zulaiha Zainal Abidin1 , Badaruddin Mohamed2 1Sustainable Tourism Research Cluster, Universiti Sains Malaysia, 11800, Penang, Malaysia 1,2School of Housing, Building and Planning, Universiti Sains Malaysia, 11800, Penang, Malaysia Abstract. Dive tourism has become important in term of magnitude and significantly contributes to regional economies. Nevertheless, in the absence of proper controls and enforcement, unplanned tourism growth has caused environmental degradation which undermines the long-term sustainability of the tourism industry. The purpose of this paper is to explore factors that contribute to the SCUBA diving impacts on coral and fish communities. This paper explains the causes of a certain event, validating the problem of impacts, defining the core issues and identifies possible causes leading to an effect. The phenomenon of diving impacts on coral reefs is a result of intensive use of dive site over the long-term. The divers can reduce their impacts towards coral reefs through responsible diving behaviors. The causes of cumulative diver’s contacts are more complicated than it seems. In response, this paper proposes the best mitigation strategies that need to be considered for future dive tourism management. 1 Introduction Marine tourism or tourism based on ocean and coral reefs is an important component of the global tourism industry and is rapidly growing than any other tourism sector particularly in many tropical countries [1]. The increasing interest in marine tourism can be considered at two levels.
    [Show full text]
  • Carbon Monoxide Poisoning
    J R Army Med Corps: first published as 10.1136/jramc-73-02-02 on 1 August 1939. Downloaded from 79 CARBON MONOXIDE POISONING: A REVIEW. By BREVET LIEUTENANT-COLONEL A. E. RICHMOND, O.B.E., Royal Army Medical Corps. CARBON monoxide, together with the dioxide, occurs in the combustion of organic matter, and the less oxygen there is available the greater the proportion of carbon monoxide produced. It is colourless and odourless, and on these accounts its presence is normally only detectable by the symptoms it causes, which adds much to the risk of poisoning from it. It it also inflammable and in strong concentration may give rise to explosions. It has been recognized as a poison since ancient times, and has assumed special importance within the last half-century owing to the increased amounts of it produced consequent upon the augmented use of gas for by guest. Protected copyright. illuminating, cooking, and heating purposes, and upon the introduction of the internal combustion engine. It is the favourite means of the suicide to encompass his aim, while accidental poisoning with it frequently occurs. From a military point of view carbon monoxide intoxication is a subject which deserves the close attention and study of all military medical officers in these days of intensive mechanization, and unlimited employment of explosives; and the object of the writer is to lay before his readers in as concise and compact a form as possible those details of moment in connexion with the various aspects of this important subject. In endeavouring to attain this object references have been made to certain publications dealing with carbon monoxide poisoning.
    [Show full text]
  • A Retrospective Study of 51 Pediatric Cases of Traumatic Asphyxia
    A Retrospective Study of 51 Pediatric Cases of Traumatic Asphyxia luo huirong Chongqing Medical University Pediatric College: Chongqing Medical University Aliated Children's Hospital https://orcid.org/0000-0002-2741-2238 xin jin ( [email protected] ) Chongqing Medical University Pediatric College: Chongqing Medical University Aliated Children's Hospital https://orcid.org/0000-0001-9549-6704 Research Article Keywords: Traumatic asphyxia, pediatric, thoracic trauma Posted Date: April 5th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-357514/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Abstract Background traumatic asphyxia (TA) is a rarely reported disease characterized as thoraco-cervico-facial petechiae, facial edema and cyanosis, subconjunctival hemorrhage and neurological symptoms. This study aimed to report 51 children of TA at the pediatric medical center of west China. Methods scanned medical reports were reviewed and specic variables as age, sex, cause of injury, clinical manifestations and associated injuries were analyzed using SPSS 25.0. Results aged as 5.3±2.9 (1.3-13.2), 30 (58.8%) were boys and 21 (41.2%) were girls. Most TAs occurred during vehicle accident, object compression and stampede. All patients showed facial petechiae (100.0%, CI 93.0%-100.0%), 25 (49.0%, CI 34.8%-63.2%) out of 51 presented with facial edema, 29 (56.9%, CI 42.8%-70.9%) presented with subconjunctival hemorrhage, including bilateral 27 and unilateral 2. 6 patients had facial cyanosis (11.8%, CI 2.6%-20.9%). Other symptoms were also presented as epileptic seizure, vomiting, incontinence, paraplegia, etc.
    [Show full text]