RESUMO
Occipital condyle fractures are rarely reported in the Emergency Medicine literature. It is unclear whether these fractures are rare or under-diagnosed. Occipital condyle fractures are associated with high-energy blunt trauma with significant cranial-cervical torque or axial loading. We report a case of a female patient with an occipital condyle fracture. The patient only complained of shoulder pain, but was found to have high cervical spine tenderness, after a moderate-speed front-end motor vehicle collision. Initial cervical spine radiographs were non-diagnostic. Computed tomography of the cervical spine demonstrated a non-displaced occipital condyle fracture. Conservative management with a semi-rigid cervical collar was successful in treating this patient's fracture. A review of the literature covers the diagnosis, radiographic findings, and management of this fracture.
Assuntos
Fraturas Ósseas/terapia , Traumatismos Cranianos Fechados/diagnóstico por imagem , Osso Occipital/lesões , Fraturas Cranianas/terapia , Acidentes de Trânsito , Adulto , Feminino , Fixação de Fratura/métodos , Fraturas Ósseas/classificação , Fraturas Ósseas/diagnóstico por imagem , Traumatismos Cranianos Fechados/terapia , Humanos , Fraturas Cranianas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Procedural sedation is a common practice in Emergency Medicine. Propofol has supplanted benzodiazepines in many centers as the drug of choice for procedural sedation. This article reports a case of seizure-like activity in an elderly man undergoing procedural sedation for a fracture reduction. The seizure-like activity was attributed to propofol. A review of the literature is discussed. When using propofol for sedation one should be aware of the risk of seizure-like activity.
Assuntos
Hipnóticos e Sedativos/efeitos adversos , Propofol/efeitos adversos , Convulsões/induzido quimicamente , Idoso , Anticonvulsivantes/efeitos adversos , Sedação Consciente , Medicina de Emergência , Antagonistas GABAérgicos/efeitos adversos , Humanos , MasculinoAssuntos
Serviços Médicos de Emergência/métodos , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Uretra , Cistoscopia , Corpos Estranhos/etiologia , Humanos , Cálculos Renais/terapia , Masculino , Pessoa de Meia-Idade , Autocuidado/efeitos adversos , Resultado do Tratamento , Cateterismo UrinárioRESUMO
Over the past three decades more than 200 children have died in the U.S. of treatable illnesses as a result of their parents relying on spiritual healing rather than conventional medical treatment. Thirty-nine states have laws that protect parents from criminal prosecution when their children die as a result of not receiving medical care. As physicians and citizens, we must choose between protecting the welfare of children and maintaining respect for the rights of parents to practice the religion of their choice and to make important decisions for their children. In order to make and defend such choices, it is essential that we as health care professionals understand the history and background of such practices and the legal aspects of previous cases, as well as formulate an ethical construct by which to begin a dialogue with the religious communities and others who share similar beliefs about spiritual healing. In this paper, we provide a framework for these requirements.
