Suicidal nonfatal impalement injury of the thorax

Cartwright, Anthony J; Taams, Karel O; Unsworth-White, MJ; Mahmood, Nilofer; Murphy, Peter M

doi:10.1016/s0003-4975(00)02471-1

Cited by 16 publications

(25 citation statements)

References 4 publications

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“…Anesthesia in such cases is often challenging due to the abnormal position of the patient, need for strict immobilization, requirement of single lung ventilation is other issue. 4 , 9 , 10 Our patient however could lie supine but required a change of endotracheal tube to double lumen at later stage after exploration, for repair of lung injury. Although the intraoperative change of the endotracheal tube is potentially a hazardous procedure and should be avoided unless, as in the present case, intubation was easy and so further conversion into double lumen tube was not expected to be difficult.…”

Section: Discussionmentioning

confidence: 92%

“…No attempt should be made to remove the impaled object blindly and removal should only be done under direct vision after seeing the object and the structures injured in the thorax. 3 , 9 , 10 , 12 , 13 , 14 In this patient, after anterolateral thoracotomy, the right pleural cavity was opened and the bar was clearly identified and its path and injured structures visualized.…”

Section: Discussionmentioning

confidence: 93%

“…Patients who reached the hospital should be considered for immediate surgical exploration by a team of specialists, usually including a cardiothoracic surgeon, anesthetist, gastrointestinal surgeon, orthopedic surgeon and plastic surgeon. 10 …”

Section: Discussionmentioning

confidence: 99%

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Thoracic impalement injury: A survivor with large metallic object in-situ

Afzal

Armughan

Javed

et al. 2018

Chinese Journal of Traumatology

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Impalement injuries, is a severe form of trauma, which are not common in civilian life. These injuries rarely occurs in major accidents. Abdomen, chest, limbs and perineum are often involved due to their large surface area. Thoracic impalement injury is usually a fatal injury, due to location of major vessels and heart in the thoracic cavity. These injuries are horrifying to site, but the patients who are lucky enough to make it to hospital, usually survive. Chances of survival are larger in right sided impalement injuries while central injuries are always died at the scene.Our patient, 25 years old male, was brought to the emergency room (ER) with large impaled metallic bar (about 2.5 feet long) in situ, in right sided chest. The patient was immediately shifted to operation room (OR) and was operated, his recovery was uneventful without any sequelae.Such patients should be treated and resuscitated according to advanced trauma life support (ATLS) protocols and operated without any delay for further investigations. Such operations are carried out by the most experienced surgeon team available. The impaled objects should not be processed if not necessary to avoid major hemorrhage and damage to vital structures, until the patient is in operation room. Large size and unusual position of impaled objects, makes the job difficult for surgeons/anesthetists.Although horrifying at scene, patients with thoracic impalement injuries are mostly young and healthy, and those who survive the pre-hospital phase are potentially manageable with proper resuscitation. Usually these patients make recovery without any further complications.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 93%

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Thoracic impalement injury: A survivor with large metallic object in-situ

Afzal

Armughan

Javed

et al. 2018

Chinese Journal of Traumatology

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“…We are presenting seven cases over a period of five years, however Edwin et al in Accra, Ghana presented three cases over a period of same five years[3]. Cartwright and colleagues reported of mortality rates of about 40% in general population and almost 70% in those with cardiac involvement[4]. Young age and isolated pulmonary injuries have been found to account for favourable prognosis[2].…”

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confidence: 95%

Management of Thoracic Impalement Injury in Ghana: A Five-Year Experience at the Komfo Anokye Teaching Hospital

Okyere¹,

Brenu²,

Okyere³

2019

WJCS

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Impalement injuries are rare and among the most spectacular and dramatic traumatic injuries especially of the chest. The survival of a patient with a thoracic impalement injury can be extremely rare. Herein we present and discuss our successes of the management of 7 rare cases of thoracic impalement injuries over a 5-year period from January 2014 to June 2019 at the Komfo Anokye Teaching Hospital, Kumasi in Ghana. We discuss the presentation, diagnosis, treatment and outcomes of the seven cases encountered.

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“…Development of prevention strategies via altered roadway or fence design, modified fence materials or placement, etc., are needed, but first the problem needs to become recognized and an understanding of the injury mechanisms must be obtained. Few published reports exist (2–6) and none can answer the questions that arise.…”

mentioning

confidence: 99%

Plank Fence Penetration into Automobiles—Implications for Prevention Initiatives*

Procter

Bernard

Ginn

et al. 2010

Journal of Forensic Sciences

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The wooden plank fence presents a deadly but unrecognized hazard to motorists. We hypothesize that fence plank injury is prevalent and results in significant morbidity and mortality. Databases of the University of Kentucky's Level I Trauma Center and the Fayette County Coroner were retrospectively analyzed over a 12-year period (1995-2006). One hundred and twenty-eight subjects were involved in vehicle contact with wooden plank fences. One hundred and twenty-three subjects were evaluated at the Emergency Department of our trauma center; 35 (27%) had a patient-plank interaction (PPI). Men (30/35) were more frequently involved (86%), and average age was 32.8 years. Thirty-two (91%) were drivers; 14/35 (40%) died from PPI-related injuries. The most common cause of death was blunt head trauma in 13 of these 14 fatally injured subjects (93%). This study provides new data underscoring the frequency, lethality, and economic consequences of this injury mechanism. Further research is needed to quantify the national prevalence of this problem and develop injury-mitigating strategies pertaining to roadway or fence design.

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Suicidal nonfatal impalement injury of the thorax

Cited by 16 publications

References 4 publications

Thoracic impalement injury: A survivor with large metallic object in-situ

Thoracic impalement injury: A survivor with large metallic object in-situ

Management of Thoracic Impalement Injury in Ghana: A Five-Year Experience at the Komfo Anokye Teaching Hospital

Plank Fence Penetration into Automobiles—Implications for Prevention Initiatives*

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