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Neurological and Neurourological Complications of Electrical Injuries
REVIEW ARTICLE Neurologia i Neurochirurgia Polska Polish Journal of Neurology and Neurosurgery 2021, Volume 55, no. 1, pages: 12–23 DOI: 10.5603/PJNNS.a2020.0076 Copyright © 2021 Polish Neurological Society ISSN 0028–3843 Neurological and neurourological complications of electrical injuries Konstantina G. Yiannopoulou1, Georgios I. Papagiannis2, 3, Athanasios I. Triantafyllou2, 3, Panayiotis Koulouvaris3, Aikaterini I. Anastasiou4, Konstantinos Kontoangelos5, Ioannis P. Anastasiou6 1Neurological Department, Henry Dunant Hospital Centre, Athens, Greece 2Orthopaedic Research and Education Centre “P.N. Soukakos”, Biomechanics and Gait Analysis Laboratory “Sylvia Ioannou”, “Attikon” University Hospital, Athens, Greece 31st Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece 4Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece 51st Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece 61st Urology Department, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece ABSTRACT Electrical injury can affect any system and organ. Central nervous system (CNS) complications are especially well recognised, causing an increased risk of morbidity, while peripheral nervous system (PNS) complications, neurourological and cognitive and psychological abnormalities are less predictable after electrical injuries. PubMed was searched for English language clinical observational, retrospective, -
Case Report Myelopathy and Amnesia Following Accidental Electrical Injury
Spinal Cord (2002) 40, 253 ± 255 ã 2002 International Spinal Cord Society All rights reserved 1362 ± 4393/02 $25.00 www.nature.com/sc Case Report Myelopathy and amnesia following accidental electrical injury J Kalita*,1, M Jose1 and UK Misra1 1Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow, India Objective: Documentation of MRI and neurophysiological changes following accidental electrical injury. Setting: Tertiary care referral teaching hospital at Lucknow, India. Results: A 30-year-old lady developed amnesia and spastic paraparesis with loss of pin prick sensation below the second thoracic spinal segment following electrocution. Her spinal MRI was normal and cranial MRI revealed T2 hyperintensity in the right putamen. Peroneal, sural and electromyography were normal. Tibial central sensory conduction time was normal but central motor conduction time to lower limbs and right upper limb was prolonged. Conclusion: Neurophysiological study and MRI may help in understanding the pathophy- siological basis of neurological sequelae following electrical injury. Spinal Cord (2002) 40, 253 ± 255. DOI: 10.1038/sj/sc/3101275 Keywords: electrical injury; MRI; evoked potential; myelopathy; amnesia Introduction Rural electri®cation has received great attention from across the road. Her hands were wet, the road was the government for improving agricultural and small ¯ooded with water and the wire was conducting AC of scale industry development in India. This has inherent 11 000 V. Immediately, she had fallen down and the hazards because of the ignorance of villagers and poor wire stuck to her chest. The current ¯ow was maintenance of electrical cables. This results in several discontinued after about 5 min and she was discovered electrical accidents caused by the touching of live wires. -
Hypercapnia in Hemodialysis (HD)
ISSN: 2692-532X DOI: 10.33552/AUN.2020.01.000508 Annals of Urology & Nephrology Mini Review Copyright © All rights are reserved by David Tovbin Hypercapnia in Hemodialysis (HD) David Tovbin* Department of Nephrology, Emek Medical Center, Israel *Corresponding author: David Tovbin, Department of Nephrology, Emek Medical Received Date: February 04, 2019 Center, Afula, Israel. Published Date: February 14, 2019 Introduction 2 case reports and in our experience with similar patients, BiPAP Acute intra-dialytic exacerbation of hypercapnia in hemodialysis prevented intra-dialytic exacerbation of hypercapnia and possibly (HD) patient has been initially reported 18 years ago [1]. Subsequent respiratory arrest [1,2]. In recent years, new interest was raised similar case was reported few years later [2]. Common features of to HD dialysate bicarbonate concentration. After standardizing to both patients were morbid obesity, a previously stable HD sessions and an acute respiratory infection at time of hypercapnia [1,2]. HD pre-dialysis serum bicarbonate level was recommended as >22 patients with decreased ventilation reserve, due to morbid obesity inflammation malnutrition complex and comorbidities midweek mEq/L [11]. As higher dialysate bicarbonate concentration became with or without obstructive sleep apnea (OSA) and/or obesity more prevalent, a large observation cohort study demonstrated hypoventilation syndrome (OHS) as well as chronic obstructive that high dialysate bicarbonate concentration was associated pulmonary disease (COPD), are at increased risk. COPD is common with worse outcome especially in the more acidotic patients among HD patients but frequently under-diagnosed [3]. Most [12]. However, still not enough attention is paid to HD dialysate COPD patients do well during HD with only mild- moderate pCO2 bicarbonate in the increasing number of patients with impaired increases and slightly decreased pH as compared to non-COPD ventilation, and to their risk of intra-dialytic exacerbation of chronic HD patients [2,4]. -
Basic Life Support Health Care Provider
ELLIS & ASSOCIATES Health Care Provider Basic Life Support MEETS CURRENT CPR & ECC GUIDELINES Ellis & Associates / Safety & Health HEALTH CARE PROVIDER BASIC LIFE SUPPORT - I Ellis & Associates, Inc. P.O. Box 2160, Windermere, FL 34786-2160 www.jellis.com Copyright © 2016 by Ellis & Associates, LLC All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, write to the publisher, addressed “Attention: Permissions Coordinator,” at the address below. Ellis & Associates P.O. Box 2160, Windermere, FL 34786-2160 Ordering Information: Quantity sales. Special discounts are available on quantity purchases by corporations, associations, trade bookstores and wholesalers. For details, contact the publisher at the address above. Disclaimer: The procedures and protocols presented in this manual and the course are based on the most current recommendations of responsible medical sources, including the International Liaison Committee on Resuscitation (ILCOR) 2015 Guidelines for CPR & ECC. Ellis & Associates, however, make no guarantee as to, and assume no responsibility for, the correctness, sufficiency, or completeness of such recommendations or information. Additional procedures may be required under particular circumstances. Ellis & Associates disclaims all liability for damages of any kind arising from the use of, reference to, reliance on, or performance based on such information. Library of Congress Cataloging-in-Publication Data Not Available at Time of Printing ISBN 978-0-9961108-0-8 Unless otherwise indicated on the Credits Page, all photographs and illustrations are copyright protected by Ellis & Associates. -
Appendix A: Codes Used to Define Principal Diagnosis of COVID-19, Sepsis, Or Respiratory Disease
Appendix A: Codes used to define principal diagnosis of COVID-19, sepsis, or respiratory disease ICD-10 code Description N J21.9 'Acute bronchiolitis, unspecified' 1 J80 'Acute respiratory distress syndrome' 2 J96.01 'Acute respiratory failure with hypoxia' 15 J06.9 'Acute upper respiratory infection, unspecified' 7 U07.1 'COVID-19' 1998 J44.1 'Chronic obstructive pulmonary disease with (acute) exacerbation' 1 R05 'Cough' 1 O99.52 'Diseases of the respiratory system complicating childbirth' 3 O99.512 'Diseases of the respiratory system complicating pregnancy, second trimester' 1 J45.41 'Moderate persistent asthma with (acute) exacerbation' 2 B97.29 'Other coronavirus as the cause of diseases classified elsewhere' 33 J98.8 'Other specified respiratory disorders' 16 A41.89 'Other specified sepsis' 1547 J12.89 'Other viral pneumonia' 222 J12.81 'Pneumonia due to SARS-associated coronavirus' 2 J18.9 'Pneumonia, unspecified organism' 8 R09.2 'Respiratory arrest' 1 J96.91 'Respiratory failure, unspecified with hypoxia' 1 A41.9 'Sepsis, unspecified organism' 155 R06.02 'Shortness of breath' 1 J22 'Unspecified acute lower respiratory infection' 4 J12.9 'Viral pneumonia, unspecified' 6 Appendix B: Average marginal effect by month, main analysis and sensitivity analyses Appendix C: Unadjusted mortality rate over time, by age group Appendix D: Results restricted to COVID-19, sepsis, or respiratory disease Any chronic Adjusted mortality Standardized Average marginal Age, median Male, Mortality, Month N condition, (95% Poisson limits) mortality ratio -
Instructor Guide for Tactical Field Care 3C Communication, Evacuation Prioroties and Cpr 180801 1
INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3C COMMUNICATION, EVACUATION PRIOROTIES AND CPR 180801 1 Tactical Combat Casualty Care for Medical Personnel August 2017 Next, we will discuss communication, evacuation priorities, and 1. (Based on TCCC-MP Guidelines 170131) CPR in TFC. Tactical Field Care 3c Communication, Evacuation Priorities and CPR Disclaimer “The opinions or assertions contained herein are the private views of the authors and are not to be construed 2. as official or as reflecting the views of the Departments Read the text. of the Army, Air Force, Navy or the Department of Defense.” - There are no conflict of interest disclosures. LEARNING OBJECTIVES Terminal Learning Objective • Communicate combat casualty care items effectively in Tactical Field Care. Enabling Learning Objectives 3. Read the text. • Identify the importance and techniques of communication with a casualty in Tactical Field Care. • Identify the importance and techniques of communicating casualty information with unit tactical leadership. INSTRUCTOR GUIDE FOR TACTICAL FIELD CARE 3C COMMUNICATION, EVACUATION PRIOROTIES AND CPR 180801 2 LEARNING OBJECTIVES Enabling Learning Objectives • Identify the importance and techniques of communicating casualty information with evacuation assets or receiving facilities. 4. Read the text. • Identify the relevant tactical and casualty data involved in communicating casualty information. • Identify the evacuation urgencies recommended in the TCCC TACEVAC “Nine Rules of Thumb” and the JTS evacuation guidelines • Identify the information requirements and format of the 9-Line MEDEVAC Request. LEARNING OBJECTIVES Terminal Learning Objective • Describe cardiopulmonary resuscitation (CPR) considerations in Tactical Field Care. Enabling Learning Objectives 5. Read the text. • Identify considerations for cardiopulmonary resuscitation in tactical field care. -
Guidelines for BLS/ALS Medical Providers Current As of March 2019
Tactical Emergency Casualty Care (TECC) Guidelines for BLS/ALS Medical Providers Current as of March 2019 DIRECT THREAT CARE (DTC) / HOT ZONE Guidelines: 1. Mitigate any immediate threat and move to a safer position (e.g. initiate fire attack, coordinated ventilation, move to safe haven, evacuate from an impending structural collapse, etc). Recognize that threats are dynamic and may be ongoing, requiring continuous threat assessments. 2. Direct the injured first responder to stay engaged in the operation if able and appropriate. 3. Move patient to a safer position: a. Instruct the alert, capable patient to move to a safer position and apply self-aid. b. If the patient is responsive but is injured to the point that he/she cannot move, a rescue plan should be devised. c. If a patient is unresponsive, weigh the risks and benefits of an immediate rescue attempt in terms of manpower and likelihood of success. Remote medical assessment techniques should be considered to identify patients who are dead or have non-survivable wounds. 4. Stop life threatening external hemorrhage if present and reasonable depending on the immediate threat, severity of the bleeding and the evacuation distance to safety. Consider moving to safety prior to application of the tourniquet if the situation warrants. a. Apply direct pressure to wound, or direct capable patient to apply direct pressure to own wound and/or own effective tourniquet. b. Tourniquet application: i. Apply the tourniquet as high on the limb as possible, including over the clothing if present. ii. Tighten until cessation of bleeding and move to safety. -
Electrocution Death: Exit Mark Injury Use in the Suggestion of Body Posture During Forensic Investigation
Electrocution Death: Exit Mark Injury use in the Suggestion of Body Posture during Forensic Investigation Pudji Hardjanto1,4 Simon Martin Manyanza Nzilibili1,3 Ahmad Yudianto1,2 1Forensic Science Program, Post Graduate School Universitas Airlangga, 4-6 Airlangga Rd., 60286 Surabaya – Indonesia. 2Department of Forensic and Medico-legal, Faculty of Medicine, Universitas Airlangga, Surabaya – Indonesia 3Ministry of Health, Community Development, Gender Elderly and Children, Dodoma – Tanzania. 4Criminal Investigative Unit, Polrestabes Surabaya, Indonesia. Keywords: Body Posture, Electrocution, Exit Injury, Forensic Reconstruction Abstract: Since then, electrocution and forensic investigation of electric death associated with criminal offenses have established the importance of mark injuries. The marks (entry and exit) came into significance as they were/are used to establish fatality and extent of electric power electrocuted. Unlike entry, exit injury has presented attention to scientists on its adequate and vital use in explaining forensic incident despite being infrequent. To enrich forensic understanding and make use of this “silent witness – exit mark”, this study used four cases of related scenario. Three of the four cases were literature-based cases and one case involved in investigation. By interpreting the cases, this paper argued that exit injury contains useful information that can be related to posture of the body before electrocution. This paper thereby suggested the presence of the exit injury to be related to body posture, sole plantar exit injury in particular (stood position). This would help investigators and scientists to determine the immediate probable position and state of victim before electrocution. Furthermore, the suggestion would assist reconstruction processes that seek to find out the event originality through responding to fundamental and core principle tools of incidence investigation, CoPRRR, and the 6Ws. -
Electrical Injuries: a Review for the Emergency Clinician Czuczman AD, Zane RD
7ddekdY_d]0 <DGI8:K@:< >L@;<C@E<JLG;8K< M`j`k nnn%\Yd\[`Z`e\%e\k&^l`[\c`e\j kf[Xp]fipfli ]i\\jlYjZi`gk`fe Electrical Injuries: A Review October 2009 Volume 11, Number 10 For The Emergency Clinician Authors Amanda Dumler Czuczman, MD As usual, the emergency department is hopping. Two minutes before change Harvard Medical School, The Massachusetts General and Brigham and Women’s Hospitals, Boston, MA of shift, a trauma patient rolls in—an electrician in his mid-30s brought in by his coworkers. The patient, who was found unconscious near the genera- Richard D. Zane, MD tor he was repairing, is awake and alert but amnesic, with burns over his Vice Chair, Department of Emergency Medicine, Harvard Medical School chest and both arms. His vital signs are within normal limits. A number of Peer Reviewers management questions enter your mind, including the need for a cardiac Mary Ann Cooper, MD evaluation and hospital admission. As you begin formulating a plan, the Emerita Professor, University of Illinois at Chicago, Chicago, IL nurse tells you that a young woman has arrived after “getting shocked” by her hair dryer, which she was using while standing on a wet bathroom floor. Brian J. Daley, MD, MBA, FACS Professor of Surgery, Department of Surgery, University of She has no obvious injuries or complaints other than very mild erythema Tennessee Medical Center at Knoxville, Knoxville, TN of her right palm. The nurse asks if you want to order an ECG or send any CME Objectives blood tests. Upon completion of this article, you should be able to: It is unusual to have 2 electrical injuries in a single night. -
AC01 Page 1 of 2 Effective Jan
Contra Costa County Emergency Medical Services Cardiac Arrest History Signs and Symptoms Differential • Code status (DNR or POLST) • Unresponsive • Medical vs. trauma • Events leading to arrest • Apneic • VF vs. pulseless VT • Estimated downtime • Pulseless • Asystole • History of current illness • PEA • Past medical history • Primary cardiac event vs. respiratory arrest or drug • Medications overdose • Existence of terminal illness Decomposition AT ANY TIME Rigor mortis Criteria for death/no resuscitation Dependent lividity Yes Review DNR/POLST form Return of spontaneous circulation Injury incompatible with life or traumatic arrest with No asystole Follow FP09 ‐ Cardiac Arrest Go to Post Resuscitation TG Do not begin resuscitation Management Follow Policy 1004 – Determination of Death Begin continuous chest compressions Push hard (> 2 inches) and fast (100‐120/min) For suspected Excited Use metronome to ensure proper rate Delirium patients E Change compressors every 2 minutes (Limit changes/pulse checks to < 5 seconds) Consider fluid bolus early and Apply mechanical compression device contact Base Hospital for if available Sodium Bicarbonate order No ALS available? Yes E Apply AED if available Cardiac monitor P EtCO2 monitoring Shockable rhythm? Yes No Shockable rhythm? No Yes Continue CPR Automated defibrillation E 5 cycles over 2 minutes Follow Follow VF/VT Repeat and assess Asystole/PEA E Continue CPR and Airway TG and Airway TG 5 cycles over 2 minutes as indicated Repeat and assess as indicated Follow Airway TG Follow Airway TG Notify receiving facility. Contact Base Hospital for medical direction, as needed. Treatment Guideline AC01 Page 1 of 2 Effective Jan. 2016Effective Jan. 2020 Contra Costa County Emergency Medical Services Cardiac Arrest Pearls • Efforts should be directed at high quality and continuous chest compressions with limited interruptions. -
PALS Science Summary Table
2020 PALS Science Summary Table This table compares 2015 science with 2020 science, providing a quick reference to what has changed and what is new in the science of pediatric advanced life support. PALS topic 2015 2020 Pediatric Chain of 5 links for both chains (IHCA and OHCA Chains 6 links for both chains (IHCA and OHCA Chains Survival of Survival) of Survival); added a Recovery link to the end of both chains Pediatric • Rescue breathing: If there is a palpable • Rescue breathing: For infants and children Ventilation Rate pulse 60/min or greater but there is with a pulse but absent or inadequate inadequate breathing, give rescue breaths respiratory effort, give 1 breath every 2 to 3 at a rate of about 12 to 20/min (1 breath seconds (20-30 breaths/min). every 3-5 seconds) until spontaneous • During CPR with an advanced airway: target breathing resumes. a respiratory rate range of 1 breath every 2 • During CPR with an advanced airway: If the to 3 seconds (20-30 breaths/min), infant or child is intubated, ventilate at a accounting for age and clinical condition. rate of about 1 breath every 6 seconds Rates exceeding these recommendations (10/min) without interrupting chest may compromise hemodynamics. compressions. Cuffed Both cuffed and uncuffed ETTs are acceptable Cuffed ETTs can be used over uncuffed ETTs Endotracheal for intubating infants and children. In certain for intubating infants and children. When a Tubes circumstances (eg, poor lung compliance, high cuffed ETT is used, attention should be paid to airway resistance, or a large glottic air leak), a ETT size, position, and cuff inflation pressure cuffed ETT may be preferable to an uncuffed (usually less than 20-25 cm H2O). -
Neuropsychological, Psychological, and Injury Variables Associated with Post-Traumatic Stress Disorder in Individuals Who Suffered an Electrical Injury
Loyola University Chicago Loyola eCommons Dissertations Theses and Dissertations 2013 Neuropsychological, Psychological, and Injury Variables Associated with Post-Traumatic Stress Disorder in Individuals Who Suffered an Electrical Injury Jana Wingo Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_diss Part of the Clinical Psychology Commons Recommended Citation Wingo, Jana, "Neuropsychological, Psychological, and Injury Variables Associated with Post-Traumatic Stress Disorder in Individuals Who Suffered an Electrical Injury" (2013). Dissertations. 695. https://ecommons.luc.edu/luc_diss/695 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Dissertations by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 2013 Jana Wingo LOYOLA UNIVERSITY CHICAGO NEUROPSYCHOLOGICAL, PSYCHOLOGICAL, AND INJURY VARIABLES ASSOCIATED WITH POST-TRAUMATIC STRESS DISORDER IN INDIVIDUALS WHO SUFFERED AN ELECTRICAL INJURY A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL IN CANDICACY FOR THE DEGREE OF DOCTOR OF PHILOSOPHY PROGRAM IN CLINICAL PSYCHOLOGY BY JANA WINGO CHICAGO, ILLINOIS AUGUST 2013 Copyright by Jana Wingo, 2013 All rights reserved ACKNOWLEDGMENTS I would like to thank all of the people who made this dissertation possible, starting with the psychologists who helped guide my research. Dr. Fred Bryant provided me with a background in statistics and introduced me to the wonders of classification tree analysis using Optimal Data Analysis. Dr. Duke Han instigated my interest in traumatic brain injury and fostered my pursuit of neuropsychology.