ABSTRACT
Caustic ingestions (alkalis, acids) may cause severe chemical burns and lifelong complications, which worsen life quality. Approximately 80% of caustic ingestions occur in children. They mostly intoxicate because of chemical substances kept insecurely or in inappropriate containers. Until now, there is no general opinion about diagnostics and management of caustic ingestions. Therefore, the main aim of this article is accurately represent diagnostic and treatment options believing that this information would help physicians to diagnose caustic ingestions easier and faster, to provide emergency management correctly, and to avoid acute and chronic complications.
Subject(s)
Burns, Chemical , Caustics/toxicity , Acids/toxicity , Acute Disease , Adult , Alkalies/toxicity , Anti-Bacterial Agents/therapeutic use , Burns, Chemical/complications , Burns, Chemical/diagnosis , Burns, Chemical/drug therapy , Burns, Chemical/epidemiology , Burns, Chemical/mortality , Burns, Chemical/prevention & control , Burns, Chemical/therapy , Child , Child, Preschool , Emergencies , Emergency Treatment , Esophageal Stenosis/chemically induced , Esophageal Stenosis/diagnosis , Humans , Intubation, Intratracheal , Prognosis , Time FactorsABSTRACT
Electrical trauma can be caused by low-voltage current (from 60 to 1000 V, usually 220 or 360 V), high-voltage (more than 1000 V) current, lightning, and voltaic arc. Often victims are little children, teenagers, and working-age adults. Electrical injuries and clinical manifestations can vary a lot and range from mild complaints not demanding serious medical help to life-threatening conditions. Lightning causes serious injuries in 1000-1500 individuals every year worldwide. The case fatality rate is about 20-30%, with as many as 74% of survivors experiencing permanent injury and sequela. The primary cause of death in victims of lightning strike or other electrical trauma is cardiac or respiratory arrest. That is why appropriate urgent help is essential. Subsequently electrical burns, deep-tissue and organ damage caused by electricity, secondary systemic disorders often demand intensive care and prompt, usually later multistage surgical treatment; therefore, prevention of electrical trauma, which would help to reduce electrical injuries in children and working-age population, is very actual. The most important is to understand the possible danger of electricity and to avoid it.
Subject(s)
Electric Injuries , Adolescent , Adult , Age Factors , Burns, Electric/diagnosis , Burns, Electric/epidemiology , Burns, Electric/etiology , Burns, Electric/mortality , Burns, Electric/prevention & control , Burns, Electric/therapy , Cause of Death , Child , Child, Preschool , Critical Care , Electric Injuries/diagnosis , Electric Injuries/epidemiology , Electric Injuries/etiology , Electric Injuries/mortality , Electric Injuries/prevention & control , Electric Injuries/therapy , Electrocardiography , Female , Fetal Death/etiology , First Aid , Heart Arrest/etiology , Heart Arrest/therapy , Humans , Infant , Lightning Injuries/diagnosis , Lightning Injuries/epidemiology , Lightning Injuries/mortality , Lightning Injuries/prevention & control , Lightning Injuries/therapy , Male , Pregnancy , Pregnancy Complications , Prognosis , ResuscitationABSTRACT
HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome is a severe, life-threatening pregnancy pathology, which occurs in 0.2-0.8% of all pregnancies, and approximately 10% (2-20%) of pregnancies are complicated with severe preeclampsia. This syndrome usually develops in the third trimester of pregnancy in preeclamptic patients, sometimes it occurs in the second trimester of pregnancy, and very rarely HELLP syndrome may develop within 48-72 hours after delivery. Diagnosis is complicated as there are no specific clinical signs, therefore, this syndrome may be confused with other pathologies like acute fatty liver of pregnancy, idiopathic thrombocytopenia, hemolytic uremic syndrome, appendicitis, and etc. The patients with HELLP syndrome should be treated in the tertiary care hospital, where appropriate diagnostics and multidisciplinary help for mother and fetus can be assured. When the syndrome was described for the first time, L. Weinstein recommended prompt delivery as the only possible treatment. Current studies show that conservative treatment of patients with HELLP syndrome is safe, without an increase in morbidity and mortality. That is why now many authors agree that treatment approach should be based on the estimated gestational age and the condition of the mother and fetus.
