Ultrasound-guided supracondylar radial nerve block in pain management of distal radius fractures

Radius fracture causes severe pain and requires extensive pain management. We aimed to present the efficacy of ultrasound (US)-guided supracondylar radial nerve block (SCRNB) in pain relief of two distal radius fracture cases. Two patients with distal radius fracture presented to emergency department. Both patients received US-guided SCRNB to provide analgesia during and after the closed reduction procedure. Reduction of displaced distal radial fractures is extremely painful and requires adequate analgesia. US-guided SCRNB is easy to administer, and comfortable with low complication risk. In previous studies, the preferred local anesthetic was lidocaine. Using bupivacaine in addition to lidocaine can provide long term analgesia. US-guided SCRNB is a safe and simple technique to perform with a minimal risk of complication and may replace commonly used sedo-analgesia in distal radius fracture at emergency department. [Med-Science 2019; 8(2.000): 473-5

Assessment of firearm injuries undergoing advanced airway management: Role II hospital experience

BACKGROUND: Airway problems are one of the most important factors affecting mortality in firearm injuries. The present study aims to examine the data of patients who underwent advanced airway support due to explosion and bullet injuries in a Role II hospital

Case Report: Ultrasound-Guided Infraclavicular Brachial Plexus Block for a Case with Posterior Elbow Dislocation.

Background: The interest in regional anesthesia procedures for the management of upper-extremity emergencies has increased. Toward that end, supraclavicular, interscalene, or infraclavicular approaches, with or without ultrasound guidance, are used for brachial plexus nerve blocks. Although many studies have reported on the use of ultrasound-guided supraclavicular and interscalene brachial plexus blocks for upper-extremity dislocations, very few studies have reported on the use of ultrasound-guided infraclavicular brachial plexus blocks. Case Report: We present an adult patient with posterior elbow dislocation that is treated with reduction after applying an ultrasound-guided infraclavicular brachial plexus block. Additionally, we describe the infraclavicular block in detail and demonstrate the technique using images. Why Should an Emergency Physician Be Aware of This?: Based on our experience, the ultrasound-guided infraclavicular block is a fast, safe, and efficient anesthesia technique that can be an excellent alternative to sedoanalgesia and other brachial plexus blocks for the management of elbow dislocations in the emergency department. (C) 2017 Elsevier Inc. All rights reserved

Interscalene or suprascapular block in a patient with shoulder dislocation.

Shoulder dislocation is one of the most painful orthopedic emergencies. There are various peripheral nerve blockage methods used for pain management in shoulder dislocation. However, there is no consensus as to which method is superior. We compared the effectiveness and practicality of 2 methods: ultrasound-guided interscalene brachial plexus block (ISBPB) and suprascapular nerve block (SSNB), in this case report. A 21-year-oldmale patient presented to the emergency department (ED) for recurrent shoulder dislocation. We have given ultrasound-guided ISBPB to the same patient during his previous visit for left shoulder dislocation 3 months ago and reduced the visual analog scale from 85 to 40. This time, the patient received ultrasound-guided SSNB, and the visual analog scale was reduced to 45 from the initial score of 95. Both methods allowed easy reduction of the shoulder without any complication. We managed to provide similarly effective pain management in both methods and observed no complications. However, ISBPB requires more experience to perform compared to the SSNB and carries higher risk of complications due to its close proximity to the anatomical structures. Although both of these methods are similarly effective, we recommend using the ultrasound-guided SSNBmethod, which is easier to performand carries lower risk for complications, in the ED

Ultrasound-Guided Femoral Nerve Blockage in A Patellar Dislocation: An Effective Technique for Emergency Physicians.

Background: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). Case Report: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee. We performed an ultrasound-guided femoral nerve blockage to provide a pain-free and comfortable patellar reduction. To our best knowledge, there is no manuscript except an old case series about use of the ultrasound-guided femoral nerve blockage in the management of patellar reduction in the medical literature. Procedural sedation is the preferred method used for this purpose in ED, but these medications need to be closely monitored because of their potential complications, such as nausea, vomiting, allergic reactions, and respiratory depression. Why Should an Emergency Physician Be Aware of This?: Ultrasound-guided femoral nerve blockage gave rapid and effective pain control without any complication during the reduction in this patient. Therefore, we suggest this technique be used for pain management during the reduction of a dislocated patella in the ED. (C) 2017 Elsevier Inc. All rights reserved

Analysis of anatomical localization and severity of injury in patients with blood transfusion in urban terrain hospital

BACKGROUND: Blood loss is the most significant cause of mortality in trauma cases. In injured patients, rapid evaluation and appropriate transfusion is lifesaving. The present study aims to analyze the blood/blood products requirement based on available data and find any associations between the transfusion requirements and injury severity scores (ISS) and anatomical locations of injuries of transfused patients

The Efficacy of Mesenchymal Stem Cell Transplantation in Caustic Esophagus Injury: An Experimental Study

Introduction. Ingestion of corrosive substances may lead to stricture formation in esophagus as a late complication. Full thickness injury seems to exterminate tissue stem cells of esophagus. Mesenchymal stem cells (MSCs) can differentiate into specific cell lineages and have the capacity of homing in sites of injury. Aim and Methods. We aimed to investigate the efficacy of MSC transplantation, on prevention of esophageal damage and stricture formation after caustic esophagus injury in rats. 54 rats were allocated into four groups; 4 rats were sacrificed for MSC production. Group 1, untreated controls (n: 10). Group 2, membrane labeled MSCs-treated rats (n: 20). Group 3, biodistribution of fluorodeoxyglucose labeled MSCs via positron emission tomography (PET) imaging (n: 10). Group 4, sham operated (n: 10). Standard caustic esophageal burns were created and MSCs were transplanted 24 hours after. All rats were sacrificed at the 21st days. Results. PET scan images revealed the homing behavior of MSCs to the injury site. The histopathology damage score was not significantly different from controls. However, we demonstrated Dil labeled epithelial and muscle cells which were originating from transplanted MSCs. Conclusion. MSC transplantation after caustic esophageal injury may be a helpful treatment modality; however, probably repeated infusions are needed