ABSTRACT
A study was undertaken to assess the availability and use of non-invasive ventilation (NIV) for the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) in emergency departments in Belgium. A questionnaire was sent to the head physicians of 145 emergency departments (EDs) found in the list of the Belgian College of Emergency Physicians (BeCEP). Ninety eight questionnaires were analysed (representing 68% of the questionnaires sent). NIV was used in 49% of the EDs. In the hospitals where NIV was not used, the most important reasons given were no available equipment in 71%, lack of experience with this form of treatment in 32.7%, and more time consuming for physicians and nursing staff in 22.8%. Only 3.8% of the physicians doubted the benefit of NIV treatment. In the hospitals where NIV was used, the patient was watched during the first hour by one nurse only in 19.6%, by one physician in 8.6% and by a nurse and a physician in 54.5%. NIV was used for more than 4 h in 33% of EDs. Pressure-controlled ventilation (with home respirators) was used more often than volume-controlled ventilation.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Positive-Pressure Respiration/statistics & numerical data , Pulmonary Disease, Chronic Obstructive/therapy , Attitude of Health Personnel , Belgium , Equipment and Supplies, Hospital , Humans , Surveys and QuestionnairesABSTRACT
Occipital condyle fractures are rarely reported in survivors of trauma. Most cases involve patients with a major head trauma, lower cranial nerve palsy, and/or suspected lesions demonstrated on plain x-ray films of the skull or cervical spine. The authors describe a traffic-accident victim in whom an atlanto-occipital joint lesion was suspected based only on mobility investigation of the skull. Axial high-resolution computerized tomography of the atlanto-occipital joint showed a fracture of the right occipital condyle.
Subject(s)
Atlanto-Occipital Joint/physiopathology , Neck/pathology , Occipital Bone/injuries , Pain/pathology , Skull Fractures/diagnosis , Adult , Follow-Up Studies , Humans , Joint Dislocations/diagnosis , Male , MovementABSTRACT
To our knowledge, no case of occipital condyle fracture after minor head trauma in the pediatric population has been published. We report the case of a 12-year-old girl with a Jefferson's fracture detected on x-ray films. Axial high resolution computed tomography and coronal reconstruction images demonstrated the additional occipital condyle fracture.
