BACKGROUND:Tension pneumothorax(TPX) is an uncommon but life-threatening condition.It is important that this uncommon presentation,managed by needle decompression,is practised by paramedics using a range of educationa...BACKGROUND:Tension pneumothorax(TPX) is an uncommon but life-threatening condition.It is important that this uncommon presentation,managed by needle decompression,is practised by paramedics using a range of educationally sound and realistic mannequins.The objective of this study is to identify if the chest wall thickness(CWT) of training mannequins used for chest decompression is an anatomically accurate representation of a human chest.METHODS:This is a two-part study.A review of the literature was conducted to identify chest wall thickness in humans and measurement of chest wall thickness on two commonly used mannequins.The literature search was conducted using the Cochrane Central Register of Controlled Trials,MEDLINE,CINAHL,and EMBASE databases from their beginning until the end of May 2012.Key words included chest wall thickness,tension pneumothorax,pneumothorax,thoracostomy,needle thoracostomy,decompression,and needle test.Studies were included if they reported chest wall thickness.RESULTS:For the literature review,4 461 articles were located with 9 meeting the inclusion criteria.Chest wall thickness in adults varied between 1.3 cm and 9.3 cm at the area of the second intercostal space mid clavicular line.The Laerdal? manikin in the area of the second intercostal space mid clavicular line,right side of the chest was 1.1 cm thick with the left 1.5 cm.The MPL manikin in the same area or on the right side of the chest was 1.4 cm thick but on the left 1.0 cm.CONCLUSION:Mannequin chests are not an accurate representation of the human chest when used for decompressing a tension pneumothorax and therefore may not provide a realistic experience.展开更多
After analyzing 15 clinical case, 2 of which is especially representative, about perforating injury at the areaintegrates thoracic and abdominal cavities in our hospital from Jan. 1988 to Aug. 2001, the writers have s...After analyzing 15 clinical case, 2 of which is especially representative, about perforating injury at the areaintegrates thoracic and abdominal cavities in our hospital from Jan. 1988 to Aug. 2001, the writers have summarized some therapyon it. First, to avoid delaying surgery operation , those who are injured at that area seriously should be treated with surgeryoperations immediately without X ray and supersonic checks. Second, the positive check results of suspect patients should behelpful for diagnosis, however the negative ones also could not be excluded of the diagnosis clues. The writers think that theconcomitant observation results with the development of illness are most significant. Third, the emphasis of treatments for thoseinjuries should be paid on abdomen. Explore the abdomen is necessary for the situations that abdominal substantial organs bleedand vacuum organs break, thoracic close drainage is sufficient for treating most thoracic trauma cases. It has been improved to beconvenient to check the thoracic cavities by cutting off the diaphragma temporarily if necessary. Fourth, as it was reported that asmany as 97 per cent of patients will have visceral injury dues to abdominal gunshot wound, all gunshot wounds be done with anexploratory laparotomy without hesitation. Fifth, resuscitating of patients as soon as possible is the key to decrease the mortalityand complications. Sixth, acute pancreas injury should be treated as acute pancreatitis.展开更多
为了研究在制动紧急制动系统(AEB)作用下,集成主动预紧式安全带(Integrated Active Pre-tensioning Seatbelt,IAPS)主动预紧对事故中乘员胸部伤害产生的影响,针对某款车型进行了2次模拟AEB制动功能的滑台试验。试验中,滑台由64 km/h通...为了研究在制动紧急制动系统(AEB)作用下,集成主动预紧式安全带(Integrated Active Pre-tensioning Seatbelt,IAPS)主动预紧对事故中乘员胸部伤害产生的影响,针对某款车型进行了2次模拟AEB制动功能的滑台试验。试验中,滑台由64 km/h通过模拟AEB制动降至50 km/h后进行正面碰撞。2次试验中,一次用普通安全带,一次用IAPS。研究结果表明:碰撞前,AEB制动导致乘员发生前移及上躯干前倾,而IAPS能够使乘员保持原有姿态。但躯干前倾,安全带碰撞中预紧会对乘员肩部产生向下按压作用,IAPS作用后导致事故中安全带按压作用丧失,碰撞后期乘员胸部前扑幅度加大,胸部刚度下降。在AEB制动下,IAPS作用改变安全带肩带合力作用方向,在当前试验条件下,存在加重乘员胸部伤害风险。展开更多
文摘BACKGROUND:Tension pneumothorax(TPX) is an uncommon but life-threatening condition.It is important that this uncommon presentation,managed by needle decompression,is practised by paramedics using a range of educationally sound and realistic mannequins.The objective of this study is to identify if the chest wall thickness(CWT) of training mannequins used for chest decompression is an anatomically accurate representation of a human chest.METHODS:This is a two-part study.A review of the literature was conducted to identify chest wall thickness in humans and measurement of chest wall thickness on two commonly used mannequins.The literature search was conducted using the Cochrane Central Register of Controlled Trials,MEDLINE,CINAHL,and EMBASE databases from their beginning until the end of May 2012.Key words included chest wall thickness,tension pneumothorax,pneumothorax,thoracostomy,needle thoracostomy,decompression,and needle test.Studies were included if they reported chest wall thickness.RESULTS:For the literature review,4 461 articles were located with 9 meeting the inclusion criteria.Chest wall thickness in adults varied between 1.3 cm and 9.3 cm at the area of the second intercostal space mid clavicular line.The Laerdal? manikin in the area of the second intercostal space mid clavicular line,right side of the chest was 1.1 cm thick with the left 1.5 cm.The MPL manikin in the same area or on the right side of the chest was 1.4 cm thick but on the left 1.0 cm.CONCLUSION:Mannequin chests are not an accurate representation of the human chest when used for decompressing a tension pneumothorax and therefore may not provide a realistic experience.
文摘After analyzing 15 clinical case, 2 of which is especially representative, about perforating injury at the areaintegrates thoracic and abdominal cavities in our hospital from Jan. 1988 to Aug. 2001, the writers have summarized some therapyon it. First, to avoid delaying surgery operation , those who are injured at that area seriously should be treated with surgeryoperations immediately without X ray and supersonic checks. Second, the positive check results of suspect patients should behelpful for diagnosis, however the negative ones also could not be excluded of the diagnosis clues. The writers think that theconcomitant observation results with the development of illness are most significant. Third, the emphasis of treatments for thoseinjuries should be paid on abdomen. Explore the abdomen is necessary for the situations that abdominal substantial organs bleedand vacuum organs break, thoracic close drainage is sufficient for treating most thoracic trauma cases. It has been improved to beconvenient to check the thoracic cavities by cutting off the diaphragma temporarily if necessary. Fourth, as it was reported that asmany as 97 per cent of patients will have visceral injury dues to abdominal gunshot wound, all gunshot wounds be done with anexploratory laparotomy without hesitation. Fifth, resuscitating of patients as soon as possible is the key to decrease the mortalityand complications. Sixth, acute pancreas injury should be treated as acute pancreatitis.
