Category Archives: General

General
Gallery Leave a comment

Figure It Out! The Answer

Several readers emailed the correct answer yesterday. The picture is a child with a bicycle handlebar injury to the epigastrium. The plastic grip over the end of the handlebar has a small hole in the middle leaving the distinctive mark seen in the photo.

Children are more likely to sustain significant injuries from this mechanism because they have little muscle in their abdominal wall, so it can’t protect as well as it does in adults. Everything between the handlebar and the spine gets crushed together, frequently resulting in serious injury.

Possible injuries include:

  • Pancreatic injury / transection
  • Liver laceration (left lobe)
  • Duodenal injury / hematoma
  • Retrohepatic vena cava injury

I’ve listed them in what I believe to be the usual order. The literature varies a bit because there aren’t a lot of series published. In this case, the injury was a pancreatic transection.

Bottom line: Handlebar injuries in children (and to a lesser degree, adults) are a significant marker for serious abdominal injury. CT scan is mandatory to find the diagnosis. Proper management of a pancreatic injury is a good topic for a future post!

Print Friendly, PDF & Email
General
Gallery Leave a comment

Figure It Out!

Here’s a test of your observational skills and trauma knowledge. This picture tells you everything you need to know. What happened, and what’s the likely diagnosis?

Answer tomorrow!

Source: Private archive. Patient not treated at Regions Hospital

Print Friendly, PDF & Email
General

Best Of: Forensic Nursing

Leave a comment

Forensic Nursing combines nursing science with the investigation of injuries or deaths that involve accidents, abuse, violence or criminal activity. Sexual Assault Nurse Examiners (SANE nurses) are one of the most recognized types of forensic nurses, but they have special training in one type of injury. Forensic nursing programs typically involve a broader set of skills, encompassing some or all of the following:

  • Interpersonal violence, including domestic violence, child and elder abuse/neglect, psychological abuse
  • Forensic mental health
  • Correctional nursing
  • Legal nurse consulting
  • Emergency/trauma services, including auto and pedestrian accidents, traumatic injuries, suicide attempts, work-related injuries, disasters
  • Patient care facility issues, including accidents/injuries/neglect, inappropriate treatments & meds
  • Public health and safety, including environmental hazards, alcohol and drug abuse, food and drug tampering, illegal abortion practices, epidemiology, and organ donation
  • Death investigation, including homicides, suicides, suspicious or accidental deaths, and mass disasters

Forensic nurses find that their additional training improves their basic nursing skills, and allows them to derive greater career satisfaction from helping patient in another rather unique way.

Approximately 37 training programs exist, ranging from certificate programs that require a specific number of hours of training, to degree programs (typically Masters level programs). Many of the certificate programs are available as online training. 

Source: International Association of Forensic Nurses (http://www.iafn.org/)

Print Friendly, PDF & Email
General
Gallery Leave a comment

Minority Report In The OR

The movie “Minority Report” showed an interesting way to manipulate visual data using hand gestures. It required a special glove and used large transparent display surfaces. Microsoft has helped make this achievement both easy and cheap using their Kinect controller using a combination of visual and infrared imaging.

Now Siemens Healthcare has embraced this technology and developed a hands-off image manipulation system for use in the OR. The Kinect system projects an infrared grid into the room and records them using an offset camera. This allows the system to construct a 3D representation of objects in the room. The Kinect software can identify movements and objects using this data.

Siemens is using special software with the Kinect that allows it to detect and interpret fine movement of a surgeon’s hands in the operating room. The final product will allow a surgeon to browse, pan and zoom relevant patient images while they remain scrubbed and sterile, just by gesturing with their hands. This product will be tested in two hospitals in the near future.

Here’s my prediction: why will we need a big, clunky robotic system interface like DaVinci? Just have the surgeon sit in a comfortable chair, waving their hands to move the laparoscopic camera and instruments. I see especially interesting applications of this technology in military settings and in space!

Reference: Siemens Game Console Technology

Print Friendly, PDF & Email