ABSTRACT
Aims: To present a novel method of securing nasogastric (NGT) feeding tubes in pediatric burn patients. Presentation of Case: We have developed an arrangement of tube, twill tie and suture, to secure a feeding tube in position, in which a twill tie is secured around the patient’s head and interwoven into the burn dressing. The NGT is secured to the twill tie via a locking suture. Discussion: Nasogastric feeding tubes are important in pediatric burn patients to facilitate the healing process by meeting their increased metabolic demand for protein and calories. These tubes are typically secured via tape to the face, but in patients with facial burns tape may not adequately anchor the feeding tube, allowing for unintended dislodgement of the NGT. Inadvertent removal of nasogastric tubes places patients at risk for complications including prolonged healing time and aspiration, as well as the need for replacement of the NGT. Conclusion: We present a novel method of securing nasogastric feeding tubes in pediatric burn patients, which has decreased the inadvertent dislodgement of NGTs in the pediatric burn patients.
ABSTRACT
The diagnosis and management of aortic lacerations has been gradually improving. Historically, aortic laceration were a common cause of cause of exsanguination with extremely rate. However, in modern trauma systems with advanced ressuscitation and rapid radiology imaging, the diagnosis of an aortic injury is improving with an emphasis on preventing the progression of intimal flaps and pseudoaneurysms to frank dissection or rupture. Both diagnostic modalities and the paradigm of immediate operative intervention have changed. The evolution of endovascular steting may play a future role in definitive care.