MULTIPLE TRAUMA IN THE ACHONDROPLASTIC DWARF - AN EMERGENCY-MEDICINE PHYSICIAN PERSPECTIVE CASE-REPORT AND LITERATURE-REVIEW

被引:3
|
作者
DVORAK, DM [1 ]
RUSNAK, RA [1 ]
MORCOS, JJ [1 ]
机构
[1] UNIV MINNESOTA,HENNEPIN CTY MED CTR,DEPT EMERGENCY MED,701 PK AVE S,MINNEAPOLIS,MN 55415
来源
关键词
ACHONDROPLASIA; DWARFISM; MASSIVE EPIDURAL HEMATOMA; TRAUMA MANAGEMENT;
D O I
10.1016/0735-6757(93)90174-A
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Although uncommon, the achondroplastic dwarf (AD) may become the victim of multiple trauma, presenting special challenges for the emergency department (ED) physician. Traditional management of airway, breathing, circulation, and neurological disability is altered by the unique anatomic features of achondroplasia. Despite facial abnormalities observed in the AD, orotracheal and nasotracheal intubation are usually accomplished without particular difficulty; however, abnormalities of the base of the skull and cervical spine make hyperextension of the neck especially hazardous in these patients. The lungs are functionally normal, although vital capacity is decreased and thoracic case abnormalities and abdominal obesity impair lung expansion. Vascular access in the AD is difficult. Peripheral access is difficult because of excessive subcutaneous fat, whereas central venous access is complicated by neck, chest wall, and spinal abnormalities that obscure commonly used anatomic landmarks. Major neurological syndromes observed in ADs are hydrocephalus, cervical medullary compression, and thoracolumbar stenosis. The ED physician should recognize these syndromes, their potential to produce neurological disability, and their unique implications for trauma. © 1993.
引用
收藏
页码:390 / 395
页数:6
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