#Cervical lacerations

[ijcimr]

Combined cervical laceration and bladder rupture: a case report of an unusual complication of precipitated labor by Dr Fatemeh Darsareh in International Journal of Clinical Images and Medical Reviews 

Abstract

Cases of bladder rupture have been rarely reported following vaginal childbirth. To the best of our knowledge, however, no cases of combined cervical laceration and bladder rupture have been reported to date. We present the first case of a 31-year-old woman with gestational diabetes who suffered a combined cervical laceration and bladder rupture after childbirth. Precipitated labor caused by oxytocin induction resulted in vaginal and cervical lacerations. The bladder rupture was confirmed by cystography. A team of obstetricians and urologists performed the laparotomy. The patient was kept under observation for two weeks before being discharged with no serious complications.

Keywords: Bladder rupture; Cervical lacerations; Precipitated labor; Childbirth trauma; Case report.

Introduction

Spontaneous bladder rupture following normal vaginal delivery is a surgical postpartum emergency. Previous cesarean section, vacuum/forceps-assisted vaginal deliveries, and distended bladder compressed by engaged head in birth canal are all risk factors for bladder injuries in healthy parturient women 1. Cases of bladder rupture, accompanied by uterine rupture, have been rarely reported following vaginal birth after cesarean section 2. To the best of our knowledge, however, no cases of combined cervical laceration and bladder rupture have been reported to date. We present the first case of spontaneous bladder rupture with cervical laceration after a precipitated vaginal delivery.

Case Presentation

A 31-year-old, G2P1L0D1, woman with gestational diabetes, was admitted to our maternity ward at 38 weeks of pregnancy for elective induction of labor to terminate her pregnancy.  She had a history of preterm birth and was a known case of minor thalassemia. The induction of labor began at 5:00 a.m. with oxytocin, and contractions began approximately two hours later. Table 1 depicts the progress of labor. During her labor, the patient urinated once. Finally, at 10:40 a.m., she gave birth to a baby boy weighing 3700 grams with an Apgar score of 7/9.  Excessive vaginal bleeding was observed following placental expulsion. The examination revealed an extensive laceration in the vagina and cervix that was repaired by the obstetrician and midwife. The patient was catheterized and was being closely monitored. A urologist was consulted due to the oliguria and hematuria (100 cc output with gross hematuria within 5 hours of childbirth). Cystography, as recommended by the urologist, revealed the bladder rupture. The patient was prepared for a laparotomy immediately. The laparotomy was performed by a team of obstetricians and urologists. Several hematomas were discovered in the uterine body and the broad ligament that the team decided not to manipulate because it did not grow during the surgery. A bladder rupture was found at the dome of bladder that was repaired in two layers. One pack cell unit and two FFP units were transfused. A peritoneal drain was placed posterior to the bladder and the skin incision was closed in layers. The patient was observed for two weeks. The result of the ultrasound revealed the shrinking of the hematoma. The blood and renal tests were normal. The catheter was removed after 2 weeks and the patient was discharged.

Table 1: The progress of labor

Discussion

Precipitate labor is defined as the expulsion of the fetus within three hours of the start of contractions. Few studies have found that precipitated labor is harmful to both the mother and the newborn. Precipitated labor, which is most commonly associated with placental abruption and induction of labor, is a significant risk factor for maternal complications 3. Maternal morbidities reported included extensive birth canal lacerations, uterine rupture, placenta retention, the need for revision of uterine cavity, post-partum hemorrhage, and blood transfusions 3,4. The lower urinary tract's anatomic proximity to the reproductive tract predisposes it to iatrogenic injury during obstetric procedures. The bladder and lower ureter are two of the most commonly involved organs. Because the dome of the bladder is the weakest area, most bladder ruptures occur through the peritoneal cavity 5. In our case, in addition to deep vaginal tears and extensive cervical laceration, bladder rupture occurred, but the diagnosis was delayed by a few hours. Given the nonspecific clinical features of bladder rupture, the diagnosis should be approached with caution. Oliguria and gross hematuria after a traumatic childbirth increase the likelihood of bladder rupture. In such cases, a cystogram is thought to be the best method for early detection.

In our case the patient had induced labour with oxytocin. The use of oxytocin to induce labour can result in tachy-systole and thus shorter deliveries. So in our case we believe that the power of uterine contractions and quick descent of passenger (3700 grams fetus) were the main risk factors of precipitated labour and the complications accompanied with it. A distended bladder during labor, particularly in our case, where the fetus descended quickly, could also be a factor in bladder rupture. Although the patient urinated normally during labor, it was critical to ensure that the bladder was empty, especially during the active phase of labor, to avoid bladder damage.

CONCLUSIONS

Bladder and cervical rupture should be considered, after precipitated vaginal delivery. When there is gross hematuria, a urinary catheter should be inserted to monitor the hematuria and urine output. If the hematuria persists and other associated symptoms appear, cystography is a useful tool for determining the severity of the bladder injury and determining the cause.

Funding

This study received no specific funding from public, commercial, or not-for-profit funding agencies.

Conflict of Interest

Authors had no conflicts of interest to declare.

Patient consent

Obtained.

For more details: https://ijcimr.org/editorial-board/ 

[defiblover27]

Simulation

In the bustling corridors of the underfunded hospital, a faded flyer catches the eye of passersby, its corners curling with age. "Volunteers Needed for Trauma Training Exercise," it boldly proclaims, beckoning those with a sense of adventure or altruism to step forward and lend their aid.

Among those drawn to the call is a 24-year-old woman, her determination evident in the set of her jaw as she approaches the hospital's trauma director. They exchange a brief but earnest conversation, the young volunteer expressing her willingness to participate in the training exercise while voicing her concerns about her comfort level with certain procedures.

"I'm eager to help in any way I can," she explains, her voice tinged with a mix of nervousness and resolve. "But I'll admit, I'm a bit apprehensive about some of the more invasive procedures. I'm comfortable with basic first aid and CPR, but I'm not sure I'm ready for things like intubation or defibrillation."

The trauma director nods understandingly, his expression one of reassurance rather than judgment. "That's perfectly understandable," he replies, his tone gentle yet firm. "Your safety and comfort are our top priorities. We'll tailor the scenario to suit your preferences and ensure you're only asked to participate in tasks you feel comfortable with."

With a sense of relief washing over her, the young volunteer nods gratefully, grateful for the understanding and support offered by the trauma director. Together, they discuss her role in the upcoming training exercise, mapping out a scenario that challenges her skills without pushing her beyond her limits.

Preparing the volunteer for the trauma training exercise is a meticulous process, undertaken with care and attention to detail to ensure her safety and comfort throughout the simulation.

As she arrives at the hospital, the volunteer is greeted by a team of trained professionals who guide her through each step of the preparation process. They lead her to a private changing area, where a set of hospital scrubs awaits her. With gentle encouragement, they assist her in disrobing, providing her with disposable undergarments to wear beneath the scrubs for modesty and hygiene.

Once dressed, the volunteer takes a seat as a makeup artist meticulously applies special effects makeup to simulate the injuries she will portray during the exercise. With a steady hand and an artist's eye for detail, they create realistic bruises, lacerations, and abrasions, transforming the volunteer's appearance into that of a trauma patient in need of urgent medical attention.

As the makeup artist works their magic, other members of the preparation team gather the necessary equipment for the simulation. They retrieve a backboard from its storage location, laying it out on a nearby gurney in anticipation of the volunteer's arrival. Alongside the backboard, they arrange a cervical collar (C-collar) and an inflatable orange brace designed to stabilize her right leg.

With the makeup application complete, the volunteer is guided to the gurney, where she lies down with a sense of trepidation mingled with excitement. The preparation team surrounds her, their movements practiced and precise as they secure her to the backboard with straps, ensuring she remains stable and secure throughout the simulation.

Next, they carefully position the cervical collar around her neck, adjusting it to provide support without impeding her breathing or movement. With gentle yet firm hands, they slide the inflatable orange brace into place around her right leg, inflating it to the appropriate level to immobilize the limb and prevent further injury.

As the final touches are made, the volunteer takes a deep breath, steeling herself for the challenges that lie ahead. Though she may be nervous, she knows she is in capable hands, surrounded by a team of professionals dedicated to her well-being. With a nod of affirmation, she signals her readiness to begin, eager to play her part in the training exercise and contribute to the hospital's ongoing mission of saving lives.

The simulation begins with the trauma team gathered around the gurney, their expressions grave as they assess the condition of the patient lying before them. The young woman, named Emily, is 24 years old, her face drawn with pain as she struggles to maintain consciousness amidst the chaos of the emergency room.

Emily's injuries are extensive, the result of a harrowing car accident that left her trapped in the wreckage for hours before help arrived. She presents with multiple traumatic injuries, including a deep laceration on her forehead, contusions and bruising across her chest and abdomen, and a visibly deformed right leg.

As the medical team conducts their initial assessment, Emily groans softly, her voice barely above a whisper as she describes the events leading up to the accident. She recalls the screech of tires and the sickening crunch of metal as her car careened off the road, the world spinning in a dizzying blur before everything went dark.

Her breathing is shallow and labored, punctuated by gasps of pain as she struggles to draw air into her damaged lungs. A rapid pulse races beneath her clammy skin, a testament to the body's instinctive response to trauma as it fights to stay alive against overwhelming odds.

The trauma team works quickly and methodically, their movements a synchronized dance of urgency and precision as they address each of Emily's injuries in turn. They apply pressure to the gaping wound on her forehead, staunching the flow of blood with sterile dressings and medical tape.

Meanwhile, others attend to her chest and abdomen, palpating for signs of internal injury while monitoring her vital signs for any indication of deterioration. X-rays are ordered to assess the extent of her injuries, with the medical team bracing themselves for the possibility of life-threatening complications hidden beneath the surface.

Throughout the simulation, Emily remains conscious but disoriented, her grip on reality tenuous as she grapples with the enormity of what has happened. She reaches out for reassurance, her eyes searching the faces of the medical team for a glimmer of hope in the midst of her darkest hour.

As the simulation progresses, the trauma team springs into action with renewed determination, their focus unwavering as they fight to stabilize Emily's condition and save her life. Though the road ahead may be long and fraught with uncertainty, they refuse to give up hope, drawing strength from their collective commitment to excellence in the face of adversity.

As the simulation progresses, the trauma director approaches Emily with solemnity, his voice gentle yet firm as he explains the next phase of the exercise. "Emily," he begins, his tone tinged with empathy, "in just a moment, we'll be simulating a critical event. We'll need to simulate your heart stopping. We'll need to cut open your shirt to begin chest compressions, and we'll place an ambu bag over your mouth and nose. You should remain still and 'lifeless' during this process. You may choose to close your eyes or keep them open."

Emily nods in understanding, her heart pounding in her chest as she braces herself for what's to come. With a deep breath, she closes her eyes, surrendering herself to the immersive experience of the simulation.

The trauma team springs into action with practiced efficiency, their movements choreographed to perfection as they simulate the onset of cardiac arrest. With a swift motion, they cut open Emily's shirt, exposing her chest to the harsh glare of the overhead lights. A sense of vulnerability washes over her, but she remains steadfast in her commitment to the exercise.

Chest compressions begin in earnest, the rhythmic thud echoing through the trauma room as the medical team works tirelessly to restore circulation to Emily's failing heart. An ambu bag is placed over her mouth and nose, delivering precious oxygen to her struggling lungs with each squeeze of the bag.

Amidst the chaos, Emily lies perfectly still, her body limp and unresponsive as she embraces the role of a patient in cardiac arrest. Though her mind races with adrenaline-fueled anticipation, she remains focused on maintaining the illusion of lifelessness, drawing upon her training and instincts to convey the gravity of the situation.

As the simulation unfolds, Emily finds herself enveloped in a surreal sense of suspended animation, her senses heightened as she navigates the fine line between reality and simulation. With each passing moment, she grows more deeply immersed in the role, her commitment unwavering as she plays her part in the collective effort to save lives and improve patient outcomes.

In the tense silence of the trauma room, Emily waits with bated breath, her entire being poised on the precipice of uncertainty. Though the outcome remains uncertain, she knows she is surrounded by a team of dedicated professionals committed to her well-being, ready to spring into action at a moment's notice to ensure her safety and success in the simulation.

As the simulation progresses and Emily remains in her role, the trauma director approaches her once more, his demeanor compassionate yet resolute. "Emily," he says softly, "we need to simulate defibrillation and the removal of the rest of your clothing. Are you okay with that?"

Emily meets the trauma director's gaze with a steady nod, her determination shining through the mask of simulated injuries. "Yes," she replies, her voice steady despite the rising tide of nerves coursing through her veins. "I'm ready."

With Emily's consent secured, the trauma team prepares to take the simulation to the next level. The room hums with a sense of purpose as equipment is brought forth, including the defibrillator paddles and a privacy screen to shield Emily from prying eyes.

With practiced hands, the trauma team carefully removes the remainder of Emily's clothing, revealing her body in its entirety to the stark fluorescent lights of the trauma room. Emily feels a pang of vulnerability wash over her, but she remains steadfast in her commitment to the exercise, drawing strength from the knowledge that she is surrounded by a team of professionals dedicated to her well-being.

As the final pieces of clothing are set aside, the trauma director approaches Emily once more, his expression one of reassurance as he prepares her for the next phase of the simulation. "Emily," he says, his voice gentle yet authoritative, "we're going to simulate defibrillation now. You'll feel a brief shock, but it's perfectly safe. Are you ready?"

Emily nods, her heart racing with a mixture of anticipation and apprehension. "I'm ready," she affirms, her voice a whisper in the stillness of the trauma room.

With a sense of purpose, the trauma team positions the defibrillator paddles against Emily's bare chest, their gloved hands steady as they prepare to deliver the simulated shock. A hush falls over the room as the trauma director counts down, his voice a steady cadence in the tense silence.

"Clear," he calls out, his command echoing through the trauma room.

In the next instant, Emily feels a jolt of electricity course through her body, sending a shiver down her spine as her muscles twitch in response to the simulated shock. Though the sensation is fleeting, it leaves her breathless with adrenaline, her senses heightened as she remains poised on the brink of uncertainty.

As the simulation continues, Emily finds herself drawn deeper into the immersive experience, her commitment unwavering as she navigates the challenges presented by the training exercise. Though the road ahead may be fraught with obstacles, she knows she is surrounded by a team of dedicated professionals ready to guide her every step of the way, ensuring her safety and success in the simulation.

As the simulation progresses, the trauma team continues their relentless efforts to resuscitate Emily, their movements a blur of urgency as they alternate between chest compressions, defibrillations, and the administration of resuscitation drugs.

With each compression, Emily feels the pressure against her chest, a rhythmic reminder of the tireless dedication of the medical team fighting to bring her back from the brink. The defibrillator paddles crackle with energy as they deliver simulated shocks, each one sending a jolt of electricity coursing through her body in a desperate bid to restart her faltering heart.

Amidst the chaos, the trauma director calls out the duration of Emily's cardiac arrest, his voice a steady anchor in the storm of uncertainty. "Five minutes," he intones, his words a stark reminder of the precious seconds slipping away with each passing moment.

The medical team works with practiced efficiency, their movements synchronized as they administer resuscitation drugs in a last-ditch effort to revive Emily's failing heart. The air is thick with tension as they watch for any signs of response, their collective gaze fixed on the monitor displaying Emily's vital signs.

Minutes stretch into eternity as the trauma team refuses to yield to despair, their determination unwavering in the face of overwhelming odds. With each passing moment, Emily feels herself drawn deeper into the immersive experience of the simulation, her senses attuned to the ebb and flow of life and death unfolding around her.

Though the outcome remains uncertain, Emily knows she is in capable hands, surrounded by a team of dedicated professionals committed to her well-being. As she lies in the midst of the simulated cardiac arrest, she draws upon her training and instincts to convey the gravity of the situation, embracing her role with a sense of purpose and determination that belies the simulated injuries adorning her body.

In the stillness of the trauma room, Emily waits with bated breath, her entire being poised on the razor's edge of uncertainty. Though the road ahead may be fraught with obstacles, she remains steadfast in her commitment to the simulation, ready to face whatever challenges lie in store with courage and resilience.

As the simulation intensifies, a sense of unease washes over Emily, a peculiar sensation prickling at the edges of her consciousness. Though she tries to push aside the feeling, dismissing it as a product of the immersive experience, a growing sense of dread gnaws at the pit of her stomach.

Unbeknownst to Emily or the trauma team, a medical student, eager to prove themselves in their new environment, has made a critical error. In their haste to assist with the simulation, they mistakenly administered a vial of real epinephrine instead of the simulated medication, a grave oversight that goes unnoticed amidst the chaos of the trauma room.

As the potent drug courses through Emily's veins, she feels a surge of adrenaline flood her system, her heart racing with an intensity that surpasses the bounds of the simulation. A sense of disorientation washes over her, her senses overwhelmed by the sudden onslaught of physiological responses triggered by the real medication.

Despite the mounting alarm bells ringing in her mind, Emily says nothing, her voice lost amidst the cacophony of the trauma room as the medical team continues their efforts to resuscitate her. With each passing moment, her condition deteriorates, her heartbeat growing erratic as she teeters on the brink of true cardiac arrest.

In a cruel twist of fate, Emily's worst fears are realized as she plunges into the depths of a genuine cardiac arrest, her body succumbing to the deadly grip of arrhythmia. The trauma team, unaware of the unfolding crisis, presses on with their simulated interventions, their attention focused solely on the task at hand.

As Emily's consciousness fades into darkness, she realizes with a sinking heart that she is no longer a participant in a training exercise but a patient in desperate need of salvation. Though the realization comes too late to alter the course of events, she clings to a flicker of hope, praying for a miracle to save her from the abyss of death that looms ever closer with each passing second.

As the trauma director attempts to speak to Emily, a sense of urgency grips him as he notices her lack of response. His brow furrows with concern as he leans in closer, his voice tinged with desperation as he calls out her name. "Emily, can you hear me? Emily?"

There is no response, no flicker of recognition in Emily's glassy eyes as they stare blankly ahead. Panic begins to rise within the trauma director's chest as he realizes something is terribly wrong. With trembling hands, he reaches for Emily's wrist, his fingers searching for the reassuring throb of a pulse beneath her skin.

His heart sinks as he feels nothing but stillness, his worst fears confirmed in the absence of the vital sign he had hoped to find. In a state of shock, he checks for a pulse again, this time beneath the cervical collar, but the result remains the same—Emily is in cardiac arrest.

A sense of urgency washes over the trauma director as he springs into action, his training kicking in as he directs the medical team to shift their focus from simulation to reality. "She's in cardiac arrest!" he declares, his voice cutting through the chaos of the trauma room. "Start chest compressions, now!"

With practiced efficiency, the trauma team pivots to the new reality before them, their movements swift and sure as they initiate CPR in a desperate bid to revive Emily's failing heart. Each compression is a prayer whispered into the void, a plea for a miracle to breathe life back into the stillness that surrounds them.

As the trauma room buzzes with frenetic energy, the trauma director's mind races with a million questions, each one more pressing than the last. How could this have happened? What went wrong? But amidst the chaos, there is no time for answers, only action as they fight to save Emily's life against overwhelming odds.

In the midst of the turmoil, Emily lies motionless, her body a canvas for the frantic efforts of the medical team as they work tirelessly to bring her back from the brink. Though the road ahead may be fraught with uncertainty, they refuse to give up hope, drawing upon their training and expertise to navigate the stormy seas of cardiac arrest and guide Emily safely back to shore.

As the resuscitation attempts continue, the trauma room pulses with urgency, the rhythm of chest compressions driving the frantic tempo of the medical team's efforts to revive Emily. With each compression, her body sways from side to side, the force of the compressions causing her breasts to shake in a stark reminder of the gravity of the situation.

Amidst the chaos, the trauma team remains undeterred, their focus unwavering as they prepare to escalate their interventions in a desperate bid to save Emily's life. With a sense of grim determination, they gel the paddles and charge them with electricity, the anticipation hanging heavy in the air as they prepare to deliver a shock to Emily's bare chest.

In a moment fraught with tension, the paddles are placed on Emily's skin, their cold metal surface a stark contrast to the warmth of her flesh. With a silent prayer on their lips, the medical team braces themselves as they prepare to unleash the full force of the defibrillator in a last-ditch effort to restart Emily's faltering heart.

A heartbeat later, the trauma room is awash with blinding light and crackling energy as the paddles deliver their shock, coursing through Emily's body in a desperate bid to jolt her heart back into rhythm. The room holds its breath as the monitor displays the outcome, the fate of Emily's life hanging in the balance with each passing moment.

But despite their best efforts, the monitor remains stubbornly flatline, a grim testament to the stubbornness of death in the face of human intervention. With a heavy heart, the trauma team presses on, their resolve unshaken as they refuse to yield to despair.

In a final act of desperation, the medical team moves to intubate Emily, their hands steady as they guide the endotracheal tube into her airway, securing her breathing and allowing for the administration of life-saving medications

As the resuscitation efforts persist, the passage of time weighs heavily on the trauma room, each minute stretching into eternity as the medical team fights desperately to revive Emily. Over thirty agonizing minutes tick by, marked by the relentless rhythm of chest compressions and the mechanical whir of life-saving equipment.

Despite their tireless efforts, Emily's condition continues to deteriorate before their eyes. Her once rosy complexion fades to a pallid shade of gray, her skin growing cold to the touch as the chill of death creeps inexorably into the room. The gel from the defibrillator paddles glistens on her bare chest, a stark reminder of the futile battle being waged against the icy grip of mortality.

A bruise blossoms between Emily's breasts, a grim testament to the force of the chest compressions that have been administered in a desperate bid to restore her failing circulation. Her eyes remain wide open, staring blankly into the void as if searching for answers that will never come.

Sensing the gravity of the situation, the trauma team pauses momentarily, their hands hovering over Emily's motionless form as they perform a vital signs check. With a heavy heart, they prepare to confirm what they already fear to be true—that Emily is beyond saving, her journey on this mortal coil drawing to a tragic and untimely end.

A cardiac ultrasound reveals the harsh reality of Emily's condition, the images on the monitor painting a bleak portrait of irreversible cardiac damage. Her heart lies still within her chest, a silent sentinel to the finality of death's embrace.

[killed-by-choice]

Maria D. Gomez, 29 (USA 1976)

Maria D. Gomez was a young immigrant who moved from Mexico to America and was living in California at the time of her death. She underwent a legal abortion at Altantic Family Medical Clinic (actually an abortion facility) in Los Angeles County. The first-trimester suction abortion was begun in the early afternoon of May 4, 1976.

Maria bled to death in an hour and a half. The coroner report indicates that John Blodgett (who was likely the one to perform the fatal abortion) claimed that Maria bled to death from an "old" cervical cut. His claims were quickly disproven once the autopsy began.

Maria’s autopsy results were disturbing. Her uterus was badly gashed and lacerated. A quart of blood was pooled in her abdomen. Even more horrifying was that the severed head of Maria’s child was left inside of her.

The severe internal injuries hadn’t been sutured, but Maria’s vagina was packed with gauze. The abortion facility knew about the bleeding but couldn’t be bothered to identify and treat the cause.

LA County Coroner Report 76-5654

“California, County Birth and Death Records, 1800-1994”, database with images, Maria D Gomez, 1976.

California Death Index, 1940-1997 database, Maria D Gomez, 04 May 1976 Department of Public Health Services, Sacramento.

[tmntforeverinmyheart]

for the ask game, in your reptile rancher's au how about number 19 and 78? I'm really curious if Leo will make it out unscathed kike in the show and if there's something you haven't posted about yet

Hi thanks for the ask :)

19: do any characters get disabled during the story?

From the tractor accident Leo is left with a few injuries and disability’s. Because of his tough skin, and leatherback, the injuries were less severe than they would’ve been on a regular human.

However

Injuries: Lacerations and depression skull fracture, left a dent in the back of his head. Scarred over.

Lacerations to his left shoulder, scarred over

Lacerations to his leatherback, which cause a spinal cord injury to the cervical C7 and C8, thoracic T-1 to T-7, T-11 to T-12 And lumbar L-1 to L-3.

Disability’s: His nerves are only able to control some finger, hand and elbow movement. He struggles with control of his bowel and bladder (accidents are quite common but his family will never judge him for it)

He suffers chronic pain in his lower back. He wears compression sleeves on his legs and leg braces over top of those. He also uses a mobility aid to help him get around when he’s having a particularly hard pain day :(

He struggles with hip bending, flexing and knee bending.

He generally has a pretty good outlook on life even with his shortcomings. And he has an amazing support system.

78: tell us something you want to share about your au/ iteration?

Oroku saki is actually their creator and he has more mutants held captive. Whom are technically the turtles siblings.

How many mutants? Let’s just say that he used all the DNA that he squeezed out of the turtles before they were taken by Yoshi.

————————————————————————

Also I have 3 more videos apart of the tractor accident that I have yet to share, gonna do that now. Hope y’all like them :)

( I always try to put as much realism and research as I can so I don’t offend anyone currently struggling with the disabilities or mental disorders I give my characters. I try to be as respectful as I can. 🩵)

[blspracticalscenarios]

Explained - Secondary assessment: Trauma

Secondary assessment: Trauma

During a full-body trauma assessment, you are looking for 

Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling (DCAP-BTLS)

HEAD 

Scalp: Examine for any bleeding or DCAP-BTLS by palpating the skull

Ears: Look inside the ear for any blood or CSF, behind the ears for     Battle’s signs, palpate the mastoid process

Eyes: Palpate the orbital bones, look for raccoon eyes, determine pupil size and reaction with pen light

Facial areas: Palpate the mandible and maxilla

Oral: Look inside the mouth for any fluids or foreign objects

Nasal: Palpate the bridge of the nose and look inside for any fluid or foreign objects

NECK

Posterior: Palpate cervical spine for step-off

Anterior: Look for tracheal deviation 

Lateral: Look for jugular vein distention 

*Make sure to palpate the cervical spine prior to applying a  c-collar *

CHEST

Inspect: Look for flail chest, sucking chest wounds, unequal     respirations, etc.

Palpate: Clavicles, shoulders, sternum, ribs 

Auscultate: Lung sounds

ABDOMEN

Palpate: All four quadrants separately with flat palms in a rolling motion

Inspect: Do you note any pulsating masses/rebound tenderness/swelling?

PELVIS

Palpate: Push inwards then downwards, noting any instability

  *If  you feel any instability when you push inwards, DO NOT PUSH DOWN*

GENITALS

Verbalize: Checking genitalia with palm facing upward

EXTREMITIES

Palpate: Palpate the entire extremity from most proximal joints downwards. Use a cup-like motion with your hands to feel both the anterior and posterior sides.

Pulse: Radial/dorsalis pedis/posterior tibial

Motion: Test your patient’s ability to squeeze, push, pull, or wiggle fingers/toes

Sensation: Can the patient feel and differentiate between which hand/foot is being touched

POSTERIOR:

Palpate: The posterior spine looking for step-off, instabilities, or     deformities

*Make sure to palpate the spine prior to rolling a patient onto a backboard*

Management of secondary injuries: Bleeding control, splinting, full spinal immobilization, etc.

[arescuer]

Handling Injuries to the Skull, Spine, and Chest

By the end of this lesson, you'll be able to:

Identify five signs of a skull fracture.

Recognize six signs of a spinal injury.

Spot five signs of chest injuries.

Show how to evaluate and treat skull and spine injuries before reaching a hospital.

Demonstrate how to handle rib fractures, flail chest, and penetrating chest injuries before hospital care.

Introduction

Understanding and managing trauma injuries is crucial for emergency medical care. This guide covers the basics of handling injuries to the skull, spine, and chest, focusing on anatomy, recognizing injuries, and providing initial care.

Anatomical Overview and Importance

Skull and Brain: The skull, made of flat bones, protects the brain. It helps absorb impacts. The brain is cushioned by cerebrospinal fluid, which reduces the effect of trauma. Children’s skulls are more flexible but can be injured differently from adults.

Facial Bones: The face has many small bones, like the jawbone and upper jaw. These bones are crucial for facial expressions, talking, and eating. Facial injuries can affect these functions and may involve serious complications.

Spinal Column: The spine is made of 33 vertebrae and supports the body while protecting the spinal cord. It has different sections (cervical, thoracic, lumbar, sacral, coccygeal), with the neck and lower back being more prone to injury due to their movement.

Chest: The rib cage protects vital organs like the heart and lungs. Injuries here can be very serious because they affect breathing and other functions.

Identifying and Assessing Injuries

Skull Fractures: Signs include confusion, pain, and swelling. Fractures can be linear, depressed, diastatic, or basilar, each needing different care.

Brain Injuries: Concussions, caused by trauma, can lead to headaches and dizziness. More severe injuries include contusions and lacerations, needing urgent care.

Facial Injuries: These can be simple cuts or more severe fractures affecting breathing, vision, and speech.

Spinal Cord Injuries: Early signs like numbness or paralysis are critical. Immediate immobilization is necessary to prevent further damage.

Chest Injuries: These can include rib fractures, lung bruises, or more severe issues like a collapsed lung or fluid around the heart. Each requires specific treatment.

Pre-Hospital Management

Skull and Brain Injuries: Focus on stabilizing the patient and preventing further injury. Manage bleeding and protect the neck. Avoid applying pressure to fractures.

Facial Injuries: Ensure the airway is clear, control bleeding gently, and stabilize any loose parts.

Spinal Injuries: Use cervical collars and spine boards to keep the spine still. Transport carefully to avoid movement.

Chest Injuries: Manage rib fractures with pain relief and proper breathing. For flail chest, use a bulky dressing. Seal open wounds to prevent air from entering the chest cavity.

Skills Development

Practical Stations:

Manage chest injuries, including treating wounds and impaled objects.

Handle rib and flail chest injuries with proper bandaging.

Practice spinal injury management, including placing cervical collars and using backboards.

Competency Evaluation: You will be assessed on your ability to perform these skills safely and accurately.

Scenario-Based Training: Practice real-life scenarios to apply what you've learned in a practical setting.

Significance

This course provides essential skills for managing skull, spine, and chest injuries. It emphasizes quick thinking and accurate assessment in emergencies, helping you provide effective care and improve patient outcomes.

[theneurologist]

Cervical Neck Pain

Suffering from severe cervical neck pain can drive a lot of discomfort to most of the individuals and may hamper their regular activities. However, there are various diagnosis methods through which a doctor can determine the severity of your neck pain and accordingly treatment methods. The most crucial aspect to managing your cervical pain is following a correct neck posture and giving it proper rest. This blog piece will discuss the cervical neck pain condition and the best treatment options available to ease your pain.

Understanding Cervical Neck Pain

Basically, it is the pain resulting from osteoarthritis or cervical spine spondylolysis, causing changes to the discs, bones and joints, since they connect with the neck. The Cervical Neck Pain holds various levels of intensity- from moderate to severe and each comes with specific ways of treating it. The pain in the neck can pose uncomfortableness, since the neck provides flexibility and support to our entire body posture. There are many reasons for this pain, however, considering proper exercises and some prescribed medications can help you overcome your painful condition.

Possible Cervical Neck Pain Reasons

Listed below are the most usual reasons behind the Cervical Neck Pain that you are facing:

Injury

A laceration in your neck or the spine area immensely triggers the cervical pain conditions.

Not giving proper rest to neck

Some people are stuck with jobs that require strenuous movements every day that put stress on their spines, causing wear and wear and tear conditions. 

Dehydrated Spinal Discs

An individual may face dryness in the spine discs, creating pressure on them, causing chronic cervical neck pain conditions.

Herniated Discs

An individual usually suffers this when the discs of the spinal column develop cracks within, causing leakage of cushioning substance inside, putting pressure on the spinal cords and nerves. You must immediately see a medical expert in case you witness symptoms of cervical pain that may create numbness and pain to the arms.

Bone Spurs

When the bone expands in size, it presses against other spinal nerves and the spinal cord, causing severe cervical pain and this requires the person to immediately seek medical assistance.

Other Reasons- Not following the correct body posture, poor seating arrangements, incorrect mattress structure and much more.

Common Symptoms Include:

Tingling or weakness in the arms and feet as these parts directly link to cervical nerves.

Muscles spasms

Trouble walking or performing other everyday activities because of the inability to coordinate

Abnormal reflexes in legs and hands.

Neck stiffness

Aches in the lower back of the head

Diagnosis of Cervical Neck Pain

Mentioned below are some ways that a doctor may apply to diagnose the Cervical Neck Pain:

Physical test:

The medical expert may inspect the alignment of your neck and head to assess the range of motion of your neck which lets them analyze neck and supporting muscles to look for tenderness and indications of strain.

Imaging Tests:

The doctors may advise these tests to capture images of the cervical neck when they suspect you’ve suffered a serious injury or suffering from extreme pain that isn’t getting better.

Medical History:

While diagnosing your cervical pain, the specialist may ask you for details about any previous neck injuries that you suffered that might result in whiplash or herniated disks. Moreover, you must provide details regarding your work schedule and other activities causing strain to your neck. After taking all these details, the medical expert will diagnose the pain based on the pain you are experiencing and how long you’ll be facing the neck pain issue.

X-rays:

Being the most common diagnosis procedure, the doctors suggest X-rays to reveal issues in your bones or soft tissues, causing neck discomfort. The results could reveal problems with alignment of the cervical spine, fractures and slipped discs, along with the signs of arthritis.

The Magnetic Image Processing:

MRI is suggested to reveal problems in your spinal cord, bone marrow, nerves, and the soft tissue and even to diagnose any tumor or cyst in the body.

CT Scans:

The doctors usually suggest CT scans to diagnose cervical pain where MRI is not possible to reveal bone spurs or indicate bone loss.

Treatment Options

Mentioned below are some treatment options available for such conditions:

Medications: If the general painkillers don’t work, the doctors may recommend higher doses of medication to relax muscles in pain relief, while reducing inflammation.

Surgery: Usually the medical experts recommend homely remedies initially, however, in some cases, surgical procedures may prove good alternatives to treat cervical neck pain.

Steroid injections: A medical professional may inject steroid drugs near nerve roots or the muscles of the neck for a simple reason to alleviate neck discomfort.

Pain Management Home Remedies

Check out below:

Follow Exercise Routine: Practice exercises prescribed by your doctor to ease neck pain and increase mobility as avoiding these cause you to suffer a serious neck injury or a pinched nerve.

Alternate Cold and Heat: Inflammation can be reduced by using cold for example an Ice pack or placed in towel for a maximum of 15 minutes every day for in the initial 48 hours. After that, you can use the heat. Take a shower with a warm temperature or use a heating pad that is on the lowest setting.

Stress Reduction Techniques: Follow some stress management tricks, including meditation and mindfulness breath exercises to relax your tension situations that might cause neck pain.

Stop Smoke: Smoking can damage bone structure and increases the risk of the degenerative disc disease and delays healing.

Prevention Tips:

Practice good posture

Adjust your sleep position

Stay active

Don’t carry heavy weight on your shoulders

Exercise your upper back extensor muscles

Conclusion

Since we tried our best to cover every relatable aspect about Cervical Neck Pain for our readers, it is essential to note that visiting a trusted medical hospital for your treatment will maximize your process. Axon Health by Dr. Eshan offers top quality treatments for cervical pain by deeply analyzing and determining the root cause of your neck pain. Our well-trained professionals ensure that all the patients are treated appropriately in a comfortable period. Book an appointment with us today!

[writer59january13]

Legacy accompanied with inadequacy DESPAIR RING

uninvited GUESTS linkedin as the themes of mein kampf.

Despite countless factorial permutations & combinations, this cyber surfer avails left and right alm seeking succor Out Of Human Bondage invisibles shackles bind head, shoulders, knees and toes mom mee whiz sic cured courtesy grim reaper, boot metastatic cervical/ovarian carcinoma snatched such balm when tethered in utero umbilical connection, etched bromide, which hankering calm embryonic sensation this corporeal being lacks

constantly subjected to exams from the brutal school of hard knocks, which I bewail sets back and glom mine aim to revel in blissful contentment but circumstances decrees otherwise cursing this chap tubby haunted by veritable elfin grotto dwelling phantoms hovering over sweet clover - dials a mirage yes...iris sieve blurbs from gals and guys numb burred in the billions,

that span the World Wide Web, and exude premature ejaculatory ecstasy, puzzled if fie totally tubular trod a tedious trek along the boulevard of broken dreams, what happenstance oft finds thyself to flail amidst difficulty to maximize optimal opportunities searching for Holy Grail or whatever constitutes such lofty personal objective, perchance being hale and hearty of body, mind and spirit spurs the furies of fate tut test this primate

while he aims to gallop with mighty industrial vim and vigor leaving a virtual soundcloud of dust, though mindfulness helps to pass go, and chance avoid jail time, then maybe monopolized feedback offered to this toothless married quasi herbivore enjoying poetry stone soup, yet also subsisting on supplementary vitamin packed glue tin free NON GMO fruity tall tales for a male thirty six years shy sans Bing a centenarian,

which span of life best cut short with a nail (possibly nine inches) hammered into faux coffin, cuz this imp doth turn pale at the prospect to fill up a space of land best utilized by birds - such as quail Mongoose, or ibis (though aye ne'er saw one), where cremated ashes sail across some verdant plain under cerulean skies putting to rest every travail, which thoughts of dem eyes spells

relief since potential homelessness, pennilessness, and wretchedness, the main impetus explaining this rambling, shambling, and troubling spiel the warp and woof ova gauzy veil imperceptibly looms closer upon turrets of my digital sea faring gunwale and thus desperation finds pleading for monetary

and spiritual salvation.

Before mine danse

macabre doppelganger draws dagger

punctures the skein tight

as a yank key notched belt

housed within mine impenetrable

hermetically sealed invisible bubble

drapes with blackened Hades

hued habiliment therein dwelt

sinister saboteur mastermind

marauder of the Hubble

tattooing and piercing fiery

oculus rift presence unseen but felt

demands sacrifice to traverse

river Styx with unadulterated gelt,

which known phantasmagorical double

diabolical self amidst aftermath

from Armageddon rubble

astride charred global

ruins entire civilization melt

planetary paroxysm prognosticated

by Maya sages with 11th hour stubble

birthed Darth Vader nemesis

with evil upon earth he did pelt

annihilating, decimating, and hashtagging mankind,

the derelict species that fueled trouble

hence evil twin appointed

apocalyptic malevolence spelt desiccation, humiliation, and laceration

upon once verdant veldt

with mass crematorium

desecration left horrific blistering welt.

Countdown to Homo sapiens extinction

predicted millenniums in past

never occurred as predicted on December 21

two thousand and twelve after common era,

whereby catastrophic spark

detonating inferno incinerating blast

eradicating extant flora

and fauna bereft sans hegira

with no means to interrupt

the die since the dawn of civilization cast.

Impossible mission to escape ominous

predetermined fate of human rat race,

nor turn back hands of time

with origin of species on clock face

thus ticking closer to hour of doomsday

without faith to brace

allowing, enabling and providing Gaia

to redeem terrestrial space

vestiges of teeming billions

soon erased criminal minds without a trace

forcefully relinquishing simians

planetary stranglehold amazing grace

proffering tabula rasa

for another dominant species

to claim the place.

Sirens promulgate emergency

toward impending inescapable cataclysm

yet no place to run or hide lest

one boards a rocket light-years away

which makes suspense thrillers

birthed by countless dystopian authors

enviable plot to keep

total Earth's destruction at bay.

Matthew Scott Harris,

a lifetime America Online

Meme bur hastens to convey dire

crisis sparking to offer electric nom de plume

duyeer93, a papa who did sire

deux darling daughters,

yet for ages hive stung

with hurt early, whence fatherhood did fire

meow n childhood's end fostering people

strangers even fork

getting this communication,

per S0S sprinkled with auk shucks corny,

Egret - letting opportunities take flight aspire

now pleasures soft as gossamer feather bedding

down play hardened angst

riddled psyche, where ire

Ronny gully stubbornly thrives amidst adversity as father time spins gyre

row scope at greased lightning speed,

intimating with dead reckoning to hire

grim reaper, who whiz patient

as Job, and exemplary at ridding mire

and muck bogs down this dada robbing

existence with joie de vivre, where funeral pyre

doth flickr-beckoning GoDaddy, cuz

Juno I haint gonna hear angelic choir

or equivalent enlightenment re:

home sweet home, this atheist doggedly tire

so haim trying keep sea legs

one step ahead of tipping point

envision self pitched into abyss -

thus end of poetic wire.

[indigo102-blog]

Beep, beep, beep …

Ward one, Major Trauma. Bed one, the one closest to the nurse station. The highest dependency bed in the ward and department. Arrival time stated at 04.26 on Sunday 24th April. My wife must have just left. I have no recollection. All I know is what the records state. Arrival time 00.22, investigations performed: CT scan; X-ray; ECG; Clotting studies; Venous blood gas; Biochemistry; Haematology and oh and not forgetting Covid test. Wow and thank you to the NHS and Emergency department team!

As I previously suggested, I woke to find myself lying in Ward One. That is not strictly true. Every hour I was being woken up for observation: heart rate; temperature; blood pressure etc. If it was not me, it was another one of the other five patients that would now be my company. They were also under observation but most now migrated to every four hours. I would not make it to the every four hour observation stage for at least another twelve hours. If the machines attached to me were not beeping it was another patient. Everything beeps, beeping almost continuously night and day. Lights blindingly bright. Cannula in back of hand and intravenous drip attached, the rotation between pain killers, antibiotics and saline hydration began. Sporting a large plastic J-brace around my neck to stop any movement. Lying on my back motionless.

The diagnosis was real, the notes said it all: Closed fracture, nose, suspected, Closed fracture: cervical spine, confirmed, Traumatic subarachnoid haemorrhage, confirmed. The CT scan showed intracranial haemorrhage (bleed on brain), facial fractures (broken nose) and C5 and C7 fractures (broken neck in two places). The spinal team advised a MRI brachial plexus scan (nerve damage). The stark reality hit me, I was in a bad way.

From the moment of hospital admission and now I had no recollection. Time had disappeared.

That morning (24th April) I had been taken into theatre for surgery at 09.55, for a 47 minute operation, reconstruction of mouth, broken nose and multiple facial lacerations all repaired. Back to the ward. The nurses, hospital team and other five patients would be my company and motivation. We were in Covid lockdown. No visitors.

I made it my mission to ask and remember each and every one by name. If nothing else, I could say hello next time I saw them. This was no mean feat. There were a lot of people and I mean a lot. The slow days ahead had begun …

[tamikuklasblog]

Rescue/Foster – Needs Placement by 8/9 11am

AALIYAH

Dallas Animal Services

A1054131

Age: 4 years old

Spayed Female

Weight: 12 pounds

Heartworm Negative

Available 8/9

Aaliyah was brought to our shelter after being attacked by another dog. She is needing a rescue or foster home to rest in while she recovers from her injuries.

Vet Exam 8/3/23-reluctant to rise, but becomes very active with attempted handling. there is a small region of puncture wounds along he cranioventral aspect of the neck/intermandibular region. there is an approx 12-14cm line of sutures along the left caudal cervical shoulder region that does not appear superficially inflamed.

Vet Exam 8/5/23-the cervical swelling is markedly improved and there is no inflammation associated with margin of left lateral neck laceration closure. ambulating reasonably well. no abnormal eliminations and good appetite.

Email dasrescue@dallas.gov

[mirandamckenni1]

Liked on YouTube: Y'all Have UNHINGED Vagina Questions || https://www.youtube.com/watch?v=fDYJytzYsgs || Want to support science & connect with us? Join the MDJ community: https://www.youtube.com/channel/UCrPhcbDwqWRc-3tteE2BS6g/join I asked for your most bizarre gynecology questions in my Chat GPT video and you went above and beyond. From Mucinex for to conceive to menstrual blood testing with a sprinkle of extra-terrestrial vaginal probes and glitter lube....you have truly the most unimaginable questions I've ever been asked. And we haven't even gotten to the part about cockroaches (sorry, I'm not in charge). Watch More Videos! Chat GPT’s Medical Advice is SHOCKING: https://www.youtube.com/watch?v=cNX6gG96nBs&t=695s Animal Water Births (inc Sand Tiger Sharks): https://youtu.be/gEOOxRn0RT0 Wild Births (inc Marsupials): https://youtu.be/KqKKr4ICQC4 Mega Multiples: https://youtu.be/8QWEb9S1O4s REFERENCES: Guaifensin & Fertility: https://ift.tt/OuTLlsM https://ift.tt/lMGwEVA https://ift.tt/tTWefmX Cervical Lacerations: https://ift.tt/fwocvBT https://ift.tt/57IpOXN Marsupial Birth: https://ift.tt/IGUj2Bw https://ift.tt/g6oma5c https://ift.tt/nw4HO0A FOLLOW ME ON SOCIAL: Instagram: https://ift.tt/mAV5zw0 Twitter: https://www.twitter.com/mamadoctorjones TikTok: https://ift.tt/ApGwyOT ** The information in this video is intended to serve as educational information and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/advanced practice provider. ** +++++++++++++++++++++++++++++++++++++++++++++++++++++

[thefriedmannfirm01]

Best Columbus Truck Accident Lawyers & Law Firms

Motor vehicle accidents of all kinds happen across the country, ranging from compact cars to larger, commercial vehicles like trucks. These accidents can leave individuals with life-altering injuries such as losing the ability to function on a daily basis and sometimes even resulting in death.

According to the Federal Motor Carrier Safety Administration (FMSCA), there were a total of 4,479 fatal crashes and 114,000 injury crashes reported in 2019 that involved buses and large trucks. The aftermath of a truck accident is a stressful time for anyone, especially as you try to focus on recovering from your injuries.

Following a truck accident, you may have a number of different questions about what to do next – from how you can seek compensation for your injuries to what kind of rights you have following the accident. This is where connecting with a truck accident lawyer in Columbus, Ohio from The Friedmann Firm can make a difference. We are here to help you post-accident as you seek compensation owed to you.

Why Do I Need a Truck Accident Lawyer? Seeking the help of a Columbus truck accident attorney will allow you to focus on your recovery, knowing that your case is in experienced hands. Personal injury cases are often complicated, especially when it comes to handling the often numerous details of a case.

Our team of serious truck accident attorneys in Columbus, Ohio has a thorough understanding of the laws and regulations that might apply to your case. We can handle all of the details of your case, including preparing all relevant legal documents, investigating the accident, and negotiating between insurance companies.

You can count on the Friedmann Firm truck accident lawyers to handle your case with an aggressive approach.

Common Truck Accident Injuries There are a number of different types of injuries that can result from a truck accident. Some of the most common injuries include:

Traumatic brain injuries (TBI) Wrongful death Spinal cord injuries Broken bones and fractures Back pain including strains and sprains Whiplash injuries Cuts and lacerations Crush injuries Cervical, thoracic, and lumbar spine injuries Scarring and burns Post-traumatic stress disorder (PTSD) and other mental illnesses Nerve injuries and damage including numbness and radiculopathy Injuries you sustain following an accident will also fall into one of two categories: catastrophic and non-catastrophic. Like other details that arise in the aftermath of an accident, these two categories can be important to understand as you move to file a personal injury claim.

Catastrophic injuries are typically defined as injuries that leave a person with life-changing or long-term injuries. They will often require extensive, long-term treatment and can impact someone’s ability to work and live on a daily basis. Treatment may include surgeries, hospitalization, and lifetime care.

Catastrophic injuries can include:

Spinal cord injuries Brain and head injuries, including TBIs Severe scarring and burning Loss of limbs or amputation Injuries that result in death Non-catastrophic injuries are the kinds of injuries that someone is expected to fully recover from. Non-catastrophic injuries can still be severe, but they are not injuries that someone will need lifetime care for.

Non-catastrophic injuries can include:

Whiplash injuries Broken bones and fractures Cuts and lacerations Some sprains and strains Concussions What Are Some of the Most Common Causes of Truck Accidents? There are a number of different reasons that truck accidents occur. Some of the most common causes of truck accidents include:

Driver error Driver fatigue Distracted driving Failure to obey traffic signals and posted traffic laws Poor training Large blind spots Alcohol and/or drug use Vehicle Issues Overweight trailers Loads that aren’t secured properly Regulatory violations Brake problems Tire problems Failure to follow the truck’s recommended maintenance schedule Weather There are a number of states and federal-level regulations and laws that truck drivers and the companies they work for or drive for need to comply with in order to operate. We understand the often complex regulations and laws related to truck accidents.

Alongside common causes of truck accidents, we also want to note that some accidents may involve more than just a large truck and passenger vehicle. According to the National Highway Traffic Safety Administration (NHTSA),

If you have been involved in a large truck accident, please contact The Friedmann Firm. You can schedule a free consultation with one of our Columbus semi-truck accident lawyers who will be able to offer you legal advice and representation.

Frequently Asked Questions What Should I Do After a Truck Accident? In the immediate aftermath of a truck accident, there are a few different steps you should take.

Seek medical attention as soon as possible. Be sure to keep a record of any medical attention, both at the scene of the accident and afterward. This includes keeping track of medical reports and bills, as this information will be useful as you file a personal injury claim. Be sure to collect contact information from witnesses including names, phone numbers, and email addresses. Take photos of the accident if you are able to. Photos can serve as important evidence when you file a personal injury claim. Speak with an experienced Columbus truck crash attorney before accepting any kind of settlement offer. The truck driver’s insurance may move to quickly offer you a settlement, but we can help ensure that you receive the full amount of compensation owed to you. Is There a Deadline for Filing a Claim? Section 2305.10 of the Ohio Revised Code sets the statute of limitations on filing a personal injury claim at two years. Within two years of your accident, you’ll need to consider filing a claim before the deadline. This content has been taken from - https://www.thefriedmannfirm.com/columbus/truck-accident-lawyer-columbus-ohio/

[killed-by-choice]

Christine Mora, 18 (USA 1994)

Christine Mora was a high school senior. She was 17 weeks pregnant when she underwent an abortion at Doctors’ Surgical Center in Cypress, California — an FPA (Family Planning Associates) location. FPA facilities have been linked to a long history of death and malpractice. She had no idea when she walked through those doors that she would never reach her 19th birthday or graduate from high school.

The abortion was done in only three minutes, which was a careless lack of patience for such a hazardous operation. Christine was left unattended afterwards and suffered a fall. Thomas Grubbs, the abortionist responsible for the girl’s 3-minute mutilation, was called to check on her.

He never should have left Christine unattended. By this time, her speech was slurred and she couldn’t respond to any questions in a way that made sense. An ambulance rushed the dying teenager to the hospital, where her father was called and informed about the abortion and his daughter’s condition.

Christine deteriorated for 8 days in the ICU before dying. Her 18-month-old was left a motherless only child. The heartbroken family was furious when the results of the autopsy came back and they saw what Grubbs had done to Christine.

The autopsy showed septicemia and hemorrhage in the brain, along with multiple cervical lacerations. It also revealed that Christine had a congenital heart defect called a foramen ovale, in which a connection between the two sides of her heart had not closed at birth as it was supposed to do. However, her heart defect did not cause her death.

Her family filed a wrongful death suit. The expert reviewing the case for Christine’s family said that the “treatment” provided to Christine at the FPA facility “fell below applicable standard” and that the “breach of standard care was the direct cause of Miss Mora’s death.” In particular, he faulted them because Grubbs had never examined Christine prior to the abortion (he’d had no contact with her at all before beginning her abortion) and because “The anesthesia record says that Dr. Bruggs did the entire extraction procedure in three minutes,” which was what caused the cervical lacerations. The lacerations had caused an amniotic fluid embolism, killing Christine.

The abortionist eventually settled out of court with confidentiality on the exact amount of the settlement included as part of the agreement.

FPA was also responsible for the deaths of Denise Holmes, 16-year-old Patricia Chacon, Mary Pena, Josefina Garcia, 17-year-old Laniece Dorsey, Susan Levy, Joyce Ortenzio, 19-year-old Tami Suematsu, 13-year-old Deanna Bell, Emmeko Reed, 16-year-old Nakia Jorden, Kimberly K. Neil and Kenniah Epps.

If it wasn’t for the abortion, Christine and her baby would still be alive.

California Certificate of Death # 94-180853

Orange County Coroner’s Report 94-06863-AB

California Death Index, 1940-1997 database, Christine Mora, 08 Nov 1994; Department of Public Health Services, Sacramento.

Mega-Abortionist Settles in a Hurry, San Diego News Notes May 1997

[whatimdoing-here]

"bleeding quite briskly"

Oh cool lol.

[arescuer]

Management of Injuries to the Skull, Spinal Column, and Chest

Introduction

Emergency medical care plays a crucial role in trauma situations. This course on the Management of Injuries to the Skull, Spinal Column, and Chest is designed to provide first responders and medical professionals with essential knowledge and skills for handling these critical injuries. The course covers anatomical insights, injury identification, and pre-hospital management techniques.

Anatomical Overview and the Importance of Understanding Injury Mechanics

The Skull and Brain: Protection and Vulnerability

Structure of the Skull: The human skull is a bony framework that safeguards the brain. It absorbs and disperses external impacts to protect the brain.

Cerebrospinal Fluid (CSF): This fluid surrounds the brain, providing additional cushioning.

Pediatric vs. Adult Skull: Children's skulls have unfused cranial bones, offering flexibility but making them susceptible to distinct injury patterns.

Facial Bones: Complexity and Complications

Facial Structure: The face consists of numerous small bones, including the mandible and maxilla, which are vital for facial functions.

Injury Impact: Facial injuries can involve complex trauma affecting airways and sensory organs.

The Spinal Column: A Vital Yet Vulnerable Structure

Spinal Anatomy: The spinal column comprises 33 vertebrae divided into cervical, thoracic, lumbar, sacral, and coccygeal regions, supporting the body and housing the spinal cord.

Function and Risk: The spine's mobility varies, with the cervical and lumbar regions being particularly prone to injury.

The Chest: A Shield for Vital Organs

Thoracic Cage: The rib cage protects vital organs such as the heart and lungs while allowing for necessary flexibility.

Physiological Significance: Chest injuries can impact both organ function and respiratory mechanics, making prompt management critical.

Identifying and Assessing Injuries

Skull Fractures: Signs, Symptoms, and Severity

Identification: Look for altered mental status, pain, tenderness, and physical signs like bruising or swelling.

Types: Skull fractures include linear, depressed, diastatic, and basilar, each requiring specific management.

Brain Injuries: From Concussions to Contusions

Concussions: Mild traumatic brain injuries can cause symptoms ranging from headaches to severe cognitive issues.

Severe TBIs: Contusions, lacerations, and diffuse axonal injuries may lead to long-term neurological effects.

Facial Injuries: More Than Just Superficial Wounds

Complexity: Facial trauma can affect breathing, vision, and eating. It can range from minor cuts to complex fractures involving the orbital bones, maxilla, or mandible.

Spinal Cord Injuries: A Delicate Balance

Assessment Challenges: Spinal injuries may not show immediate symptoms. Look for numbness, tingling, or paralysis, and ensure immediate immobilization.

Chest Trauma: Recognizing and Responding

Types of Injuries: Includes rib fractures, lung contusions, pneumothorax, and cardiac tamponade. Each requires tailored management techniques.

Pre-Hospital Management of Traumatic Injuries

Managing Skull and Brain Injuries

Initial Response: Stabilize the patient and prevent further injury. Control bleeding and protect the neck if spinal injuries are suspected.

Skull Fractures: Avoid pressure on injury sites. If cerebrospinal fluid leaks, cover with a sterile dressing without applying pressure.

Brain Injury: Ensure airway openness, adequate oxygenation, and monitor for increased intracranial pressure.

Handling Facial Injuries

Airway Management: Ensure the airway is clear. Watch for obstructions from blood, swelling, or broken teeth.

Bleeding Control: Apply gentle pressure to control bleeding and stabilize loose teeth or jaw fragments.

Spinal Injury Protocols

Immobilization: Use cervical collars and spine boards to prevent further movement and damage.

Transportation: Move patients carefully, maintaining spine alignment.

Chest Injury Interventions

Rib Fractures: Manage pain and ensure effective breathing. Avoid wrapping tightly as it may impair respiration.

Flail Chest: Stabilize with a bulky dressing and monitor for respiratory distress.

Open Chest Wounds: Seal with an occlusive dressing to prevent air entry into the pleural space.

Skills Development and Assessment

Practical Skills Stations

Station 1: Managing chest injuries, including penetrating wounds and impaled objects.

Station 2: Techniques for rib and flail chest injuries, focusing on bandaging and stabilization.

Stations 3 and 4: Spinal injury management, including cervical collar placement and patient immobilization.

Evaluation of Competencies

Assessment Criteria: Evaluate based on skill performance, safety, accuracy, and efficiency.

Performance Metrics: Includes a checklist covering PPE usage and specific injury management techniques.

Scenario-Based Training

Real-World Application: Hands-on exercises simulate real-life scenarios to integrate theoretical knowledge with practical skills.

Significance of This Training

The Management of Injuries to the Skull, Spinal Column, and Chest course is vital for equipping first responders and medical professionals with the expertise needed to handle critical trauma cases effectively. This training emphasizes not only technical skills but also the importance of quick thinking, accurate assessment, and calm decision-making. Completing this course will enhance participants' ability to deliver life-saving interventions and improve patient outcomes in traumatic injury situations.

[wordsnstuff]

Resources for Writing Injuries

Patreon || Ko-Fi || Masterlist || Work In Progress

–

Head Injuries

General Information | More

Hematoma

Hemorrhage

Concussion

Edema

Skull Fracture

Diffuse Axonal Injury

Neck

General Information

Neck sprain

Herniated Disk

Pinched Nerve

Cervical Fracture

Broken Neck

Chest (Thoracic)

General Information

Aortic disruption

Blunt cardiac injury

Cardiac tamponade

Flail chest

Hemothorax

Pneumothorax (traumatic pneumothorax, open pneumothorax, and tension pneumothorax)

Pulmonary contusion

Broken Ribs

Broken Collarbone

Abdominal

General Information

Blunt trauma

Penetrating injuries (see also, gunshot wound & stab wound sections)

Broken Spine

Lung Trauma

Heart (Blunt Cardiac Injury)

Bladder Trauma

Spleen Trauma

Intestinal Trauma

Liver Trauma

Pancreas Trauma

Kidney Trauma

Arms/Hands/Legs/Feet

General Information | More

Fractures

Dislocations

Sprains

Strains

Muscle Overuse

Muscle Bruise

Bone Bruise

Carpal tunnel syndrome

Tendon pain

Bruises

Injuries to ligaments

Injuries to tendons

Crushed Hand

Crushed Foot

Broken Hand

Broken Foot

Broken Ankle

Broken Wrist

Broken Arm

Shoulder Trauma

Broken elbow

Broken Knee

Broken Finger

Broken Toe

Face

General Information

Broken Nose

Corneal Abrasion

Chemical Eye Burns

Subconjunctival Hemorrhages (Eye Bleeding)

Facial Trauma

Broken/Dislocated jaw

Fractured Cheekbone

Skin & Bleeding

General Information (Skin Injuries) | More (Arteries)

femoral artery (inner thigh)

thoracic aorta (chest & heart)

abdominal aorta (abdomen)

brachial artery (upper arm)

radial artery (hand & forearm)

common carotid artery (neck)

aorta (heart & abdomen)

axillary artery (underarm)

popliteal artery (knee & outer thigh)

anterior tibial artery (shin & ankle)

posterior tibial artery (calf & heel)

arteria dorsalis pedis (foot)

Cuts/Lacerations

Scrapes

Abrasions (Floor burns)

Bruises

Gunshot Wounds

General Information

In the Head

In the Neck

In the Shoulders

In the Chest

In the Abdomen

In the Legs/Arms

In the Hands

In The Feet

Stab Wounds

General Information

In the Head

In the Neck

In the Chest

In the Abdomen

In the Legs/Arms

General Resources

Guide to Story Researching

A Writer’s Thesaurus

Words To Describe Body Types and How They Move

Words To Describe…

Writing Intense Scenes

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Masterlist | WIP Blog

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