A case of post-traumatic pseudoaneurysm of the hepatic artery treated with endovascular embolization and review of the literature.

AIM: The pseudoaneurysm of the hepatic artery (HAP) is mainly associated with liver trauma. Post-traumatic HAP is usually asymptomatic and found at imaging follow-up. Its detection warrants correction, irrespective of size or symptoms. MATERIAL OF STUDY: We report a case of post-traumatic liver pseudoaneurysm treated with endovascular embolization. An 80-year-old man developed pseudoaneurysm of the S6 branch of the hepatic artery, 14 days after a motorcycle accident. RESULTS: The patient was treated with radiological embolization of the pseudoaneurysm, which completely disappeared. After the intervention, the patient developed acute anemia and leukocytosis. At discharge, the white blood cell count was normal, as well as hemoglobin and bilirubin concentrations. DISCUSSION: Treatment options include endovascular embolization, ultrasound-guided thrombin injection, placement of an angiographic stent, surgical ligation, and surgical resection. KEY WORDS: Aneurysm, Pseudoaneurysm, Abdominal trauma, Liver, Post-Traumatic.

Narcan and Narcan't: Implementation factors influencing police officer use of Narcan.

First responders-including police officers-play a prominent role in managing the risk of fentanyl overdoses. In many jurisdictions, they have Naloxone (also commercially available as Narcan) at their disposal to counter the effects of an opioid overdose. Little empirical research exists on how effectively police are incorporating this emergency rescue medication into routine practice. Between 2018 and 2019, we conducted semi-structured interviews with police officers from two Western Canadian police organizations. We also administered organization-wide web surveys to determine what factors facilitate or inhibit the incorporation of Narcan into police practice by looking at two domains: 1) the inner setting of the police organization and 2) personal knowledge of, and attitudes toward, an intervention. Whether officers administered Narcan depended on several personal and organizational factors, including: 1) having sufficient knowledge and concern about the fentanyl situation, 2) being knowledgeable about Narcan and trained in its use, 3) the medication being readily available to officers, and 4) being willing to administer it to citizens.