Biomedical subjects

E C Smoot

Publications and source records attributed to E C Smoot.

61 records · Page 4Linked to original sources

PubMedDate not supplied

Development of septic arthritis by hematogenous seeding in a pediatric patient with burns.

We describe a pediatric patient with burns who experienced a septic hip joint from hematogenous seeding by sustained Staphylococcus aureus bacteremia. A search for a central vascular focus of the bacteremia included the use of an indium scan, which localized purulence within the left hip joint. The physical findings, radiographic findings, and subsequent aspiration of the hip joint were diagnostic for a septic arthritis. This case alerts the physician that the pediatric hip is a potential site for infection in the presence of bacteremia. Once infected, the joint may become a secondary source of an ongoing bacteremia. The diagnostic work-up and treatment for a septic hip have been discussed. This occult site of infection is easy to overlook because a painful hip joint in the pediatric patient with burns may be confused for painful burn wounds. The prerequisites to joint infections in this population were all present: bacteremia, intercurrent illness, unique vascular anatomy, and an impaired immune response.

Arthritis, Infectious↗

PubMedDate not supplied

Five percent mafenide acetate solution in the treatment of thermal injuries.

A 5% mafenide acetate solution was used in the treatment of 669 patients with thermal injuries. This solution was used as the initial topical antibacterial agent in the treatment of the acute burn wound in 276 patients. It was initiated during the intermediate and chronic phases of burn wound therapy in 393 patients. Acid-base derangements did not occur. Discontinuation of therapy because of the patient's pain was necessary in fewer than 1% (17 of 669) of all patients treated. The incidence of rash and pruritus was extremely low. Effective antibacterial activity was achieved. This solution appears to be an effective, safe, and versatile antibacterial agent that produces minimal side effects and is useful in all phases of burn wound management.

Adult↗

PubMedDate not supplied

Photographing the patient with burns for medical documentation.

Photographs of a burn injury provide an objective description of the patient's disease course and may be important in the medicolegal documentation of child abuse or other criminal and civil actions. Accurate and reproducible photographs require careful composition and choice of equipment. Standardized clinical positioning is described with recommendations for timing of serial photographs.

Burns↗

PubMedDate not supplied

Overwhelming postsplenectomy sepsis in a patient with burns: a case report and a rational approach to treatment.

Overwhelming postsplenectomy sepsis is a dreaded sequel of splenectomy. The rate of overwhelming sepsis in children after splenectomy for trauma is reported to be 10 to 30 times that of the general population. Episodes of pneumonia, septicemia, and meningitis in adults after a splenectomy are 166 times more common than in the general population. The care of a patient with burns and asplenia presents many unique management challenges to the burn physician. Awareness of the development of overwhelming postsplenectomy sepsis and its most common infecting organisms is crucial. The specific immunologic deficiencies of reduced immunoglobulin production and cell-mediated immunity that exist in patients after a splenectomy may be compounded by burn injury. Specific treatment recommendations for patients with burns and asplenia are lacking. We report a fatal case of overwhelming sepsis in a patient with asplenia and with an 8% total body surface area partial-thickness burn, and we review the pathogenesis of overwhelming postsplenectomy sepsis. We focus on treatment recommendations regarding the use of prophylactic antimicrobials, intravenous immunoglobulin replacement therapy, and pneumococcal polyvalent vaccine to standardize the care of the patient with burns and asplenia and reduce infectious morbidity and deaths.

Adult↗

PubMedDate not supplied

Propane gas dangers and strategies for prevention of injuries.

Although the overall incidence of thermal injuries continues to decrease, the incidence of certain types of burns is alarmingly high. Approximately 3000 propane fires and explosions are reported yearly. More than 9% of these cases result in bodily injury, and the mortality rate is more than 7% of the injured. Most of the accidents are felt to be the result of a lack of knowledge among the general public in regard to the use of liquid petroleum (LP) gas, which is a low-cost and widely used fuel source. A series of accidents that resulted in several injuries in the midsouth area heightened our awareness of the problems associated with LP-gas storage, transportation, and use. A review of the incidence of use and injury, warning systems, product liability status, and prevention strategies are reported to help educate health care providers and increase public awareness of the problems associated with propane gas.

Accident Prevention↗

PubMedDate not supplied

Modified use of extremity tourniquets for burn wound debridement.

A modified technique of tourniquet use for sequential burn wound debridement is described. With partial exsanguination of the extremity, intermittent release and rapid reinflation of the tourniquet will allow the surgeon to assess the adequacy of debridement and to decrease reactive hyperemia and blood loss during the excision. This controlled method to decrease blood loss in the upper extremities during debridement, in combination with epinephrine soaks and compressive wraps, can be mastered so that transfusion is not necessary during excisions of less than 12% total body surface area. Visible hemostasis is assessed with this method before final application of skin grafts to optimize skin graft revascularization and minimize wound hematomas.

Arm↗

PubMedDate not supplied

Latex allergy anaphylaxis in a spina bifida patient with a pressure ulcer.

At a Memphis, Tenn., children's hospital, latex-free surgery is mandated for patients with spina bifida or for those who have had multiple surgeries to correct congenital urinary anomalies. Even in the absence of a positive clinical history, both categories of patients are presumed to have a latex allergy or sensitivity. This case report illustrates the severe anaphylactic reaction that may occur with exposure to latex gloves or glove powder that transfers the antigen. The increasing incidence of latex rubber allergy for patients and health care workers is reviewed. Screening for patients at risk for allergy is outlined. These allergic patients can undergo safe operations if precautions are undertaken to avoid latex exposure. Precautions must also be initiated and enforced throughout the hospital for treatment of the patient in the pre- and post-operative period.

Adolescent↗