Severe Thoracic Vertebral Spine Injury as a Complication of Component of Cardiopulmonary Resuscitation

2022 ◽  
pp. 000313482110586
Author(s):  
Elise F. Heidorn ◽  
Vicente Cortes ◽  
Adrian Ong
Keyword(s):  
Computed Tomography ◽  
Cardiopulmonary Resuscitation ◽  
Spinal Fractures ◽  
Spinal Fracture ◽  
Spine Injury ◽  
Unstable Fracture ◽  
Computed Tomography Scan ◽  
Chest Compressions ◽  
Electrical Shock ◽  
Tomography Scan

Chest compression has been a component of cardiopulmonary resuscitation (CPR) since 1960. Performance of high-quality CPR is critical for survival; however, chest compressions are traumatic and may result in injuries such as rib and sternal fractures. Spinal fractures have rarely been reported. We present a case of a 69-year-old male who suffered a cardiac arrest at home. He underwent 16 minutes of CPR with manual chest compressions, and no electrical shock and medications with return of spontaneous circulation (ROSC). Computed tomography scan showed unstable fracture of T9-T10. The patient was transferred to our Level I trauma center for continued post-arrest management and neurosurgical evaluation. An MRI confirmed the unstable spinal fracture which would have required surgical stabilization. The patient remained comatose, thus he was transitioned to comfort measures and expired. Spinal injuries following CPR are rare but should be considered in the post-arrest management stage. Computed tomography scan is the ideal screening modality.

scholarly journals Prediction Score for Cervical Spine Fracture in Patients with Traumatic Neck Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Natsinee Athinartrattanapong ◽  
Chaiyaporn Yuksen ◽  
Sittichok Leela-amornsin ◽  
Chetsadakon Jenpanitpong ◽  
Sirote Wongwaisayawan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Cervical Spine ◽  
Spine Fracture ◽  
Prediction Score ◽  
Spine Injury ◽  
Cervical Spine Fracture ◽  
Clinical Prediction ◽  
Computed Tomography Scan ◽  
Tomography Scan

Background. Cervical spine fracture is approximately 2%–5%. Diagnostic imaging in developing countries has several limitations. A computed tomography scan is not available 24 hours and not cost-effective. This study aims to develop a clinical tool to identify patients who must undergo a computed tomography scan to evaluate cervical spine fracture in a noncomputed tomography scan available hospital. Methods. The study was a diagnostic prediction rule. A retrospective cross-sectional study was conducted between August 1, 2016, and December 31, 2018, at the emergency department. This study included all patients aged over 16 years who had suspected cervical spine injury and underwent a computed tomography scan at the emergency department. The predictive model and prediction scores were developed via multivariable logistic regression analysis. Results. 375 patients met the criteria. 29 (7.73%) presented with cervical spine fracture on computed tomography scan and 346 did not. Five independent factors (i.e., high-risk mechanism of injury, paraparesis, paresthesia, limited range of motion of the neck, and associated chest or facial injury) were considered good predictors of C-spine fracture. The clinical prediction score for C-spine fracture was developed by dividing the patients into three probability groups (low, 0; moderate, 1–5; and high, 6–11), and the accuracy was 82.52%. In patients with a score of 1–5, the positive likelihood ratio for C-spine fracture was 1.46. Meanwhile, those with a score of 6–11 had an LR+ of 7.16. Conclusion. In a noncomputed tomography scan available hospital, traumatic spine injuries patients with a clinical prediction score ≥1 were associated with cervical spine fracture and should undergo computed tomography scan to evaluate C-spine fracture.

Radiographic Clearance of Blunt Cervical Spine Injury: Plain Radiograph or Computed Tomography Scan?

2003 ◽  
Vol 55 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Margaret M. Griffen ◽  
Eric R. Frykberg ◽  
Andrew J. Kerwin ◽  
Miren A. Schinco ◽  
Joseph J. Tepas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Plain Radiograph ◽  
Spine Injury ◽  
Computed Tomography Scan ◽  
Tomography Scan

Clinical Examination in Complement With Computed Tomography Scan: An Effective Method for Identification of Cervical Spine Injury

2009 ◽  
Vol 67 (6) ◽  
pp. 1297-1304 ◽  
Author(s):  
Richard P. Gonzalez ◽  
Glenn R. Cummings ◽  
Herbert A. Phelan ◽  
Patrick L. Bosarge ◽  
Charles B. Rodning
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Clinical Examination ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Computed Tomography Scan ◽  
Tomography Scan

scholarly journals Multiple Tracheal Diverticula in a COVID-19 Positive Patient

2021 ◽  
pp. 014556132110346
Author(s):  
Konstantinos Garefis ◽  
Konstantinos Tarazis ◽  
Konstantinos Gkiouzelis ◽  
Anastasia Kipriotou ◽  
Iordanis Konstantinidis ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Incidental Finding ◽  
Positive Patient ◽  
Computed Tomography Scan ◽  
Tracheal Diverticulum ◽  
Tomography Scan ◽  
Paratracheal Air Cyst

A tracheal diverticulum is a type of paratracheal air cyst and is usually an incidental finding after a computed tomography scan of the neck and thorax. With an incidence between 1% and 4% in adults, tracheal diverticula are rare entities that can be symptomatic in certain cases. We present a case of a COVID-19 positive patient who presented to our hospital and was diagnosed with multiple tracheal diverticula during his hospitalization.

scholarly journals Pulmonary coinfection of Mycobacterium tuberculosis and Tropheryma whipplei: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Binghua Zhu ◽  
Jing Tang ◽  
Rong Fang ◽  
Xuejie Fei ◽  
Qing Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Next Generation Sequencing ◽  
Tropheryma Whipplei ◽  
Diagnostic Methods ◽  
Next Generation ◽  
Computed Tomography Scan ◽  
Chest Computed Tomography ◽  
Tomography Scan ◽  
Generation Sequencing

Abstract Background We diagnosed a clinical case of pulmonary infection involving Mycobacterium tuberculosis and Tropheryma whipplei in a patient with acute respiratory distress syndrome. The diagnosis was assisted by metagenomic next-generation sequencing of bronchoalveolar lavage fluid. Case presentation A 44-year-old Han Chinese inmate was transferred to the emergency department because of dry cough, chest tightness, and shortness of breath. The patient’s body temperature rose to 39.3 °C following empirical cephalosporin treatment for 1 week. The blood CD4+/CD8+ ratio was 0.7, suggesting immunodeficiency. Routine microbiological tests were performed, and tuberculosis interferon gamma release assays were positive. Mycobacterium tuberculosis polymerase chain reaction was also positive. Chest computed tomography scan revealed miliary nodules and ground-glass opacifications, which were in accordance with tuberculosis. To fully examine the etiology, we performed routine laboratory tests and metagenomic sequencing, the results of which indicated the presence of Mycobacterium tuberculosis and Tropheryma whipplei. We administered anti-tuberculosis regimen in combination with trimethoprim/sulfamethoxazole. The patient recovered, with chest computed tomography scan showing absorption of lesions. Conclusions Compared with traditional diagnostic methods such as culture and serology, metagenomic next-generation sequencing has the advantage of detecting a wide array of microorganisms in a single test and therefore can be used for clinical diagnosis of rare pathogens and microbial coinfections. It is particularly useful for immunocompromised patients as they are more prone to infection by opportunistic microorganisms.

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