...Studies have also stated that patients with a low risk of injury can undergo 3-projection cervical spine radiography.13 Plain-film radiographs can be insensitive for cervical spine injuries, with inadequate imaging rates of 37% to 72%. Inadequate images can occur due to, overlapping of the shoulder girdle and rib cage on the lateral projection, Suboptimal images, Patient size and body habitus, incorrect interpretations by physicians and incomplete visualization of the cervical spine from the skull base to T1. Some studies have also stated that NEXUS and CCR are inadequate and cervical spine fractures cannot be excluded without CT. CT imaging is the preferred method due to its high accuracy, speed, and ability to reconstruct images in the coronal...
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...shearing and causes lesions and brain swelling characteristic of AHT, have been determined to be hypoxic-ischemic in nature rather than traumatic. Thus, more attention has been directed on identifying spinal injuries in AHT. Prior to this discovery, spinal injuries were rarely reported in conjunction with AHT cases, mainly because no one ever looked for them. Autopsy protocol prior to 2000 removed the brain and severed the spinal cord. Since then, the protocol was changed and the spinal cord is now removed with the brain. Spinal injuries have now been identified in 70% of abusive head trauma cases that ended in fatality. In this paper, research was conducted to study the spine in AHT victims in order to discover the prevalence of spinal injuries in AHT compared to accidental and nontraumatic groups. The entire study included a total of 183 children under the age of 48 months who had spinal MRIs sometime between 2000 and 2012. Radiographical and clinical findings were collected and analyzed for traumatic spinal injuries. Between the three groups the incidence, distribution, and radiological characteristics of bone, ligamentous injuries, and soft-tissue injuries of the spine...
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...Forensic Significance of Radiography in Evaluation of Gunshot Wounds to the Spine Samantha Lawson Introduction Gunshot wounds cases are continuing to increase across the country. One of the most severe cases of gunshot wounds is the spinal injuries as a result of penetration of bullet fragments towards the spinal column. Determining the projectile of the bullet and its position is vital for physicians to treat such an injury. Forensic Radiography is a technique that can be used in medical facilities to determine the exact position of the bullet fragments. Forensic Radiography is quite useful in the medical profession. Understanding the right type of radiography is vital in ensuring that physicians are able to make sound decisions in treating patients with spinal injuries as a...
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...inflammation and in turn relieves pain. They are sometimes used in the treatment and management of cervical nerve root injuries. Other usages include treatment of joint arthritis, bursitis, tendinitis, and many other painful conditions. Nerve injuries such as brachial plexus neuropraxia, also known as a “stinger” or “burner”, involve the cervical nerves usually 5 through 7 and the brachial plexus. Stingers can be caused by stretching, traction or compression of the brachial plexus nerves. Injury results in shooting pains from the neck down the arm out to the fingertips. Sometimes numbness and muscle weakness are present in the affected area. These injuries may produce severe complaints, as they do cause very sharp pain to radiate through the arm. When treating a stinger the first goal is to relive that pain. When physicians are presented with that task some evidence is showing that corticosteroids may be a safe way to successfully return an athlete to play following one of these injuries. There is an increased risk of getting a “stinger” in sports such as football and wrestling. The cervical nerve roots and the brachial plexus come in contact with a lot of stress during these competitions. In football we see that contact from hard hits or direct blows to the neck and shoulder cause traction or compression to those nerves causing damage. In wrestling it is common to see cervical injuries from repetitive stress to the area. Unlike football there are not much direct blows...
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...and the tighter it becomes, the looser its antagonist becomes because of reciprocal inhibition. In acute conditions, the cycle can be described as continuing spasm–pain–spasm. The result is tightness that progresses from the acute condition of muscle contraction to muscle contracture, leading to chronicity. In chronic conditions, the cycle is described as pain–looseness–pain.3 In the cervical...
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...residents. However counselor members, there is one big flaw of this program and it deals with public safety. Even with all the positives of this program, the fact that it lacks a helmet requirement is daunting, especially in a city of “fume-belching buses, speeding cabs, honking drivers and texting pedestrians, which turn even short rides into obstacle courses” (McKernan, 2013). The Citi bike program projected to accommodate approximately 10,000 cyclists-both NYC residents as well as tourist. Without a helmet requirement, this creates a recipe for disaster. Consider the following facts, the leading cause of death and permanent disability in bicycle crashes are head injuries. They accounts for 60% or more of bicycle related deaths. A case study involving 129 accidental cycling deaths between January 1 2006 and December 2010 looked to find a relationship between the nonuse of helmets and an increased risk of fatal head injury (Persaud, Coleman, Zwolakowski, Lauwers &...
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...Pediatric Chiropractic Care: Scientifically Indefensible? Published by Sam Homola under Chiropractic,Science and Medicine Comments: 37 In a paper published in 2008, two academic chiropractors offered this observation: “The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions.”1 Despite lack of support by the medical and scientific community, chiropractic treatment of children is growing in popularity, and more chiropractors are specializing in “chiropractic pediatrics.” The International Chiropractic Association offers a post-graduate “Diplomate in Clinical Chiropractic Pediatrics” (DICCP) and publishes a “peer reviewed” Journal of Clinical Chiropractic Pediatrics. The diplomate syllabus is a 30-module, 360+ hours classroom course during weekends over a three-year period. There is no hospital training and no contact with diseased or injured children — only a “mandatory observational/training weekend at a chiropractic center for special needs children under multi-disciplinary care.”2 A post-graduate certification in chiropractic pediatrics (CICCP) can be earned after 180 hours of classroom instruction. In a June 2008 joint press release, the American Chiropractic Association’s (ACA) Council on Chiropractic Pediatrics and the Council...
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...throughout the world. A specialist reviewed the fact through an interview that a large number of students are tending to suffer from neck pain with the popularization of computers as well as the growing loads of study. Whereas, specific research on teenager neck pain seems to be vague, clear clues have not shown to the public. Over the last 5 months, the research conducted in this area has worked out the conclusion that improper living habits are threatening teenagers’ health of their neck. Detailed information about the prevalence and causing factors for the disease are displayed in this report. 2. Definition of teenage neck pain Neck pain, which is called (cervical) spondylosis in medical term, is a kind of spinal compression attributes to the degeneration of disks and joints in the vertebrae. Unlike the pain in front of the neck, symptoms of neck pain usually behave as headaches, dizziness, and neck stiffness -- which sometimes radiates to the shoulders and limbs and thus lead to the feeling of weakness, numbness and pain (Penick, 2010). Compared to that among the elderly, neck pain among teenagers has some slight differences, chronic diseases like osteoporosis and HIVD (Herniation of intervertebral disc) are not common to see in young people. A new concept of “cervical spondylosis like disease” was proposed by Dr. Dong, Yan and Liang (2009) in Beijing. It was explained that teenage patients are often in the second peak of growth, which means the growth of their muscle may...
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...MHA device related conference call Incidence The incidence of device related pressure ulcers nationwide is unknown. An analysis of Minnesota AHE reports from Oct 7 2008 to Aug 1 2009 showed an average of 25% of hospital acquired stage III, IV, and unstagable pressure ulcers were caused from medical devices. Types of devices associated with pressure ulcers • Respiratory equipment like oxygen tubing, CPAP masks, endotrachial tubes (ETT) • Nasogastric (NG) tubes • Orthotics (splints and collars) Good news This group of AHE includes zero pressure ulcers caused from antiembolism stockings as seen in previous years Risk Factors for device related pressure ulcers • Use of a medical device • Impaired sensory perception (impaired ability to respond meaningfully to pressure-related discomfort). Patients without sensory perception impairment remove or request removal of shoes, stockings, or medical devices that feel uncomfortable or too tight. Conversely, patients with sensory perception impairment may not adequately communicate discomfort such as with confusion, disorientation, over-sedation or unresponsiveness. Patients who are alert and oriented may also be unable to communicate discomfort if they are orally intubated, speak a different language than their caregivers, or cannot feel pain due to paralysis or neuropathy. • Moisture may be a cofactor for the development of device related pressure ulcers making the skin less resilient...
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...Background and purpose: Spondyloarthropathy (SpA) is a rare inflammatory arthritic condition misdiagnosed due to its presentation of similar diagnoses. The purpose of this case report is to demonstrate the physical therapist’s capability to differentially diagnose SpA with a thorough examination and evaluation of the clinical findings. Case Description: The patient is a 48-year-old Caucasian male who presents with pain and a progressive loss of mobility bilaterally in the neck and shoulders over the past two years in addition to a ten-year history of chronic low back and neck pain. The outcome measure utilized was the neck disability index (NDI). The physical therapist evaluated the patient for physical therapy, differentially diagnosed...
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...presentation * absence of other explanation or other underlying disease * absence of cutaneous lesions * otherwise normal neuro exam * Proceed with imaging (MRI) if * Atypical Presentation * Slowly progressive over 2-3 weeks * If no improvement in symptoms in 6 wks * Electrophysiology (CMAP) performed if complete facial paralysis remains after 1 week of treatment Treatment * PT management: modalities, facial exercise, massage * Manual closing of eye such as with tape while sleeping, lubricating eye drops * Steroids * +/-Acyclovir * Surgical Decompression – no good evidence to support Prognosis * 80% recover within weeks to months * If motor nerve conduction studies show evidence of...
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...Remote Robotic Surgery in Germany By: Christopher Redman MIS535 I will discuss how robots entered our lives, and this has historical roots after the play by the author Karel Capek, then those robots entered all aspects of our lives, and my topic is the medical field; the first robotic usage was performed in 1987, and there was many drawbacks to those first experiences such as restricted degrees of motion, decreased sense of touch, and .increased sensitivity to hand movement. The main issues that surrounds this procedures is safety measures and maintenance, as there is no grantee that the computer systems of robot is going to work in high safe. Other issues comes from the cost, since robotic surgery is more expensive than traditional, this will make it unavailable for public hospitals, and those who are poor may not be able to benefit from this technology, but this transfer from traditional methods in medicine must happen, as technology affected all aspects of our lives. Robot might sound as a very modern scientific invention, but it is not as the first time “robot” was introduced and coined was in 1921, in a play written by the Czech writer Karel Capek, and since then robots took a place in many aspects of our lives, they also take place in dangerous and highly precise tasks, such as aviation, and here we will discuss the medical usage of robots, starting from the history, to political and economic questions, also Psychological considerations...
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...fact, since the introduction of prehospital trauma life support (PHTLS), 89.4% of all trauma patients transported to the emergency department by ambulance have some form of cervical spine control, compared to 2.1% of patients prior to PHTLS (Kon Jin, Goslings & Ponsen). According to Kon Jin, Goslings & Ponsen (2013), “the reason for applying such a broad criterion for prehospital immobilization is the fear of missing injury to the spine, which can potentially have drastic consequences for both the patient and medical personnel.” Some prehospital care providers even admit to immobilizing patients without evidence of spinal injury...
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...Paramedic Case Studies Name Institution Table of Contents Introduction 3 1.1 Clinical plans are prior to arrival on the scene. 4 1.2 Patient selection Criteria for RSI 5 1.3 Steps in an RSI Procedure 6 Step 1 - Preparation 6 Step 2- Preoxygenation 6 Step 3- Pretreatment 7 Step 4- Rapid sequence Induction and Paralysis 7 Step 5- Protection and Positioning 7 Step 6- Placement of the Endotracheal Tube in the Trachea 8 Step 7- Post-intubation Management 8 1.4 Risks and benefits associated with RSI 9 Case 2 10 2.1 Discussion 10 2.2 Clinic plan and initial management 10 2.3 Notification of Arrival 11 Conclusion 11 Case 3 12 Introduction 12 Incident 1 12 Incident 2 13 Incident 3 13 Incident 4 14 Case 4 15 Conclusion 16 References 17 Introduction The basic concept of retrieval medicine is a combination of transfer and care of a patient from one medical institution, site of trauma, and pre-hospital management to a medical institution to provide higher and better level of care. The transfer and retrieval of severely ill and wounded patients entail high-risk activities (Ellis & Hooper, 2010). This paper looks into various case studies to determine the various control measures that might and should be put in place in various retrieval situations so as to increase patient safety and efficiency in pre-hospital care. This comprises of communication procedures, team resource management...
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...Ackowledgement First of all, I would like to praise ALLAH THE ALL MIGHTHY. His will, I will not be able to complete the assignment. I would like to express my gratitute to all who gave me the possibility to complete this assignment. I want to thank the Dean of Nursing Faculty, I for giving the support, encouragement towards compliting the assignment. I deeply indebted to my tutor who gave an idea and suggestion and encouragement, helped me at the time of writing the assignment. My colleagues from Nursing Faculty who supported me in my assignment work. I thank them for all their support, help, interest and valuable hints. Last but not least, I would like to thank my family especially my husband whose patient love enable me to complete this work. Table of Content | | |Page No. | |1. |Introduction |1 – 2 | |2. |Clinical Assessment |3 – 6 | |3. |Management Related To Head Injury |7 - 8 | |4. |Immediate Care And Management Of Patient ...
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