ABSTRACT
For the practitioner working in the wilderness environment, burns represent a significant challenge. There may be a requirement for non-specialists to provide care with fewer resources than would be available in a specialist unit in the UK. In the wilderness setting, delay prior to reaching specialist care is likely to be an ever present factor. Secondary complications of the burn wound, such as respiratory problems or sepsis may therefore supervene. The paper examines certain aspects of treatment relevant to the wilderness environment, including airway injury, fluid resuscitation and local treatment of the burn wound. Escharotomy and aspects of electrical and chemical injury are also considered.
Subject(s)
Barotrauma , Diving/adverse effects , Barotrauma/diagnosis , Barotrauma/etiology , Barotrauma/therapy , Gas Poisoning/diagnosis , Gas Poisoning/etiology , Gas Poisoning/therapy , Humans , Inert Gas Narcosis/diagnosis , Inert Gas Narcosis/etiology , Inert Gas Narcosis/therapy , Naval Medicine , United KingdomABSTRACT
Intercostal pulmonary hernia, a protrusion of lung parenchyma with overlying pleural membranes through an abnormal defect in the thoracic cage, is an uncommon phenomenon. Rib fractures caused by coughing similarly represent an infrequently occurring clinical presentation. Pulmonary herniation through an intercostal defect caused by cough fractures has been described twice in the literature to our knowledge. We present a case of pulmonary herniation secondary to cough fracture in a chronic bronchitic, successfully treated by thoracotomy with application of the basic principles of hernia repair, and a discussion of the mechanisms of injury.
