We describe a case of an acute paraoesophageal hernia in the early post-operative period following a laparoscopic Nissen fundoplication. Patient developed intraoperative tension pneumothorax requiring an immediate chest drain and subsequently needed respiratory support of a continuous positive airway pressure (CPAP) ventilation. A short discussion of this rare but deleterious complication and t...

clinic attendees who were solely managed by the nurse and needed no doctor review, only four patients believed that their care would have benefitted from further doctor review. This further demonstrates that patients were happy with their management and with the proficiency of the healthcare professional who reviewed them in clinic. However, it is still important to ensure that patients are ful...

Background: Tube thoracostomy is an essential skill, and in thoracic trauma can be lifesaving. Yet a complication rate of up to 30% has been widely reported in the literature. Our primary aim was to look at the complication rate associated with chest drain insertion in trauma patients at our institution. Our secondary objectives included indications for tube thoracostomy and the differences in ...

OBJECTIVES Pediatric emergency medicine (PEM) physicians receive little opportunity to practice and perform chest tube insertion. We sought to develop and validate a scoring tool to assess chest tube insertion competency and identify areas where training is required for PEM physicians. METHODS We developed a 40-point, 20-item (scored 0, 1, or 2) assessment tool entitled the Tool for Assessing...

To determine the safety and complications of chest tube clamping, a retrospective chart review was conducted at Baylor University Medical Center's level I trauma center. The records of 243 patients with pneumothoraces, hemothoraces, or a combination were identified and analyzed; 134 patients underwent clamping according to the care path, and 109 did not. The demographic characteristics of age, ...

STUDY OBJECTIVE To determine the success and complication rates of fibrinolytic therapy (FL) in the treatment of thoracic empyema. DESIGN AND PATIENTS Between December 1992 and November 1994, all patients referred with empyema thoracis (ET) were offered FL. FL consisted of streptokinase (275,000 +/- 170,000 IU) or urokinase (121,000 +/- 57,000 IU) daily for a mean of 6.2 +/- 2.1 days. SETTI...

BACKGROUND Previous studies have identified no strong correlation between patients' height and tracheal length in anaesthetized patients. We have attempted to compare vocal cords-carina distance (VCD) in Chinese patients with the dimensions of five commonly used tracheal tubes. In addition, we attempted to find a surface anatomy measurement that would identify patients with 'short tracheas'. ...

The NPSA issued a patient safety alert (NPSA/2011/ PSA002) and new guidelines regarding the confirmation of safe nasogastric feeding tube placement. Between September 2005 March 2010. There were 21 deaths 79 cases harm attributed to incorrect placement tubes in UK. In report chest radiograph misinterpretation was 12 45 100 incidents. • Feeding through misplaced (NGT) is ‘Never Event’. Associate...

a three day old neonate was referred to our department with a problem of a sternal cleft. sternal clefts are often associated with a myriad of other abnormalities ranging from mild to severe. we present our experience with such a problem, and review the current literature concerning it.

PURPOSE Although rare, the misplacement of nasogastric tubes into the pleural space has been described. The prognosis of such injuries is improved by prompt recognition; therefore, it is important for physicians who practice nasogastric intubation to be aware of this potential complication, and to be familiar with an approach to early diagnosis. CLINICAL FEATURES We present a case of perforat...