Background: Kerosene is one of the most widely used sources of energy in developing countries. Modes of accidental exposure include inhalation, ingestion and through skin or eye contact. There have been few cases reported in literature where kerosene was injected intravenously and subcutaneously with differing outcomes ranging from mild irritation to serious necrotizing fasciitis. It remains challenging to predict the outcome of patients who inject kerosene via non-venous route as it is difficult to establish the accuracy of tissue layer affected by the injection
Objective: To establish methods of management available in the rare presentation of attempted suicide by self-injection of kerosene.
Design: An analysis of Case Studies
Setting: Training
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Most reported cases are in Arab countries (KSA, Jordan, Iraq) (15 cases) [2-6]. Iraq is the highest of Arab countries (11 cases) [4]. The difficulty arises in management as cases are unique to each exposure in terms of dose injected, site of intended versus actual injection and quantification of the exact dose of exposure. The lethal dose of kerosene for 70 kg adult is 100 ml [7]. Only 12.9% (4 cases) had reported the exact dose of kerosene that was used. Routes of kerosene exposure included: intradermal, subcutaneous and intravenous. Superficial skin contact with kerosene may cause dryness scaling and dermatitis [8]. Injection of kerosene presents with a more severe clinical presentation in the form of local unspecified inflammation, aggregation of neutrophils and soft tissue necrosis. This was demonstrated in two histopathology specimens of debrided necrotic tissue in two reported cases [2,3]. Intradermal injection has been reported in 32% of cases (10 cases) [4]. All treated medically as a case of panniculitis and skin ulceration. Patients recovered without complications except one who has developed injection site fibrosis and contracture in the wrist and
Most persons who later attempt suicide have given some indication of being at risk, of having ideation or intent related to suicide. The suicide rate among physicians and nurses is higher than in the general population; their special knowledge of pharmacology and physiology can make attempts more likely to be lethal. Most people who complete suicide have made at least one previous attempt, and a history of prior attempts is one of the strongest predictors of future risk. Some attempts may appear unlikely to have succeeded from the outset, because the means was one of low lethality (e.g., choking oneself with socks wrapped around the neck) or because circumstances would have led to
Nancy was an 80 year-old woman who was cooking dinner for her and her grandson. When the unthinkable happened, the long sleeved shirt that she was wearing caught fire. She yelled for help! Her grandson came to her rescue and helped her. 911 were called immediately. When the paramedics arrived on the scene, they evaluated Nancy and took her to the hospital due to her injuries. She sustained burns to the anterior and posterior right upper arm as well as the anterior and posterior thorax. Parts of her skin were black and charred and some parts of her skin had blisters. She was admitted into the hospital where doctors did further testing and treatment to her burns. Due to Nancy’s burns, her skin was severely affected.
Fumes in heavily oiled area can also affect the community and there is widespread concern that some workers are not being given sufficient safety equipment, including respirators — and volunteers, who may not have as much training or experience as hired workers, could be in the greatest danger. So far, more than 400 oil-exposure
Great post. I like the points you outlined about assessment of Mr. J. You started with maintaining ABC’s to checking lower extremities pulses to ensure that it is not cut off by the tight constrictive band of the eschar. ECG should be monitored at least the first 24 hours because Mr. J is prone to cardiac arrest due to high electrical voltage injury. Fluid resuscitation with 14 or 16 gauge preferably through unburned tissue, and infusion of lactated Ringer’s solution will help to prevent shock. Assessment of vital signs and pain is very important, the nurse should also assess for history of tetanus immunization because burn wounds are prone to tetanus. Mr.’s brief medical history is important in case he has any allergies, current medical
Toxicology-Toxic - may be fatal if swallowed or inhaled. Corrosive, causes burns. Harmful by inhalation and through skin absorption.
The tree Melinda is assigned in art class symbolizes her and how she changes dramatically, for better or worse, throughout the book. In the near beginning Melinda draws trees that have been struck by lighting, the trees are dark, broken down and weary to symbolize how Melinda is feeling at this point. A great example of this is when Melinda says “For a solid week, ever since the pep rally, I’ve been painting watercolors of trees that have been hit by lightning. I try to paint them so they are nearly dead, but not totally. Mr. Freeman doesn’t say a word to me about them. He just raises his eyebrow. One picture is so dark you can barely see the tree at all” (Anderson 30). This symbolizes how she is going through a period in her life where she
In response to the burning sensation, your immune system jumps into action, launching the body's natural defense — its inflammatory response — to fight injury and infection. As a result, your lips, tongue, and insides of your cheeks may become swollen. The longer you're exposed to the irritant at its full concentration, the more swelling you will experience.
Surgical smoke is generated during the cutting or coagulation of tissue by a wide variety of devices including laser, vessel sealing devices and electro cautery. Quantity of smoke generated is variable based on the amount of tissue, open or closed procedure, device utilized and functional temperature of the device. The contents of the smoke generated contain numerable volatile organic compounds. Several carcinogenic particles have been isolated in surgical smoke. Both viral and bacterial components have been identified in smoke particles. The size of particles in surgical smoke is predominantly smaller than 2.5µM. Inhaled small particles have known negative health effects. Smoke temperature was not identified as an evaluated vector of risk in the literature. The literature does not definitively link surgical smoke exposure to injury or disease. Preventing workplace exposure to tobacco smoke has reduced mortality. Operating room personnel are likely at risk from chronic exposure to toxins, small particle inhalation and possible infectious transmissions from smoke. Smoke evacuation systems can provide
Chemical suicides became prevalent in the United States around 2008. Since then, the number of suicides has been rising faster as the years go by. These forms of
Burn injuries are a commonly seen in the United States. The most common mechanism of injury is a fire or flame, followed by scald, contact, electrical, and chemical burns. The majority of burns occur at a home or residence (ABA, 2017). Primary care providers should be informed of the most current evidence-based practice guidelines when caring for burn wounds. For decades, the first-line treatment of partial thickness burn wounds has been and continues to be, silver sulfadiazine (SSD) cream (Zacharevskij et al, 2017).
According to the Centers for Disease Control and Prevention (CDC) suicide is the tenth leading cause of death in the United States (US) as of the 2015 Suicide Facts at a Glance Report. In 2013 there were 41,149 suicides in the US which calculates to a rate of 12.6 per 100,000 or 113 suicides each day or one every 13 minutes (Centers of Disease Control and Prevention [CDC], 2015). Emergency departments are often a resource for those seeking assistance for suicidal ideations. This paper will discuss many aspect of suicide including; contributing factors, scope of the problem, populations affected, significance, and approaches used to address the issue.
“Suicide occurs when a person ends their life. It is the 11th leading cause of death among Americans. But suicide deaths are only part of the problem. More people survive suicide attempts than actually die. They are often seriously injured and need medical care” (Suicide, 2010). It is important to know the risk factors involved as well as ways to prevent suicide form occurring. As case managers, or any health care professional, it is equally important for us to know what the signs may be in order to properly address them and it is also very beneficial to know HOW to address such a sensitive issue. We have to know that not every suicidal case will be prevented but knowing it will definitely lessen the cases of those that do decide to commit
I felt intense warmth around my bed frame. Just as I was about to open my eyes I sensed a strong surge of pain that overwhelmed my body, as I looked down at my legs, I saw a sea of orange flames devouring my bed sheets. It was in that moment that I realized that my house was on fire, and my legs were burned. This is an example of how most Americans experience home fires. In fact, residential properties have the most fire related “deaths (76.5%), fire injuries (78.0%) and fire dollar loss (55.0%)” in the United States (United States Fire Administration, 2013). The most popular injuries related to fires are burn wounds. Burn wounds can be categorized into three different levels: first degree, second degree, and third degree burns.
A study conducted by Cheek, Nestor & Liu (2015) found Injection drug use was positively associated with suicide attempts, but not suicide ideation or suicide plans. This study also can be explained by the Interpersonal Theory of Suicide, which stated you needed to remove the fear of death to go from ideation to attempter (Joiner, 2005). In this study injection drug use removed the fear of death. Also injection drug use was associated with the suicide attempts among suicide planners (Cheek, Nestor & Liu, 2015). Which further supports the concept that substance use can remove the fear of dying and can take an individual from suicide ideation to suicide
On November 27, 1971, in Portland, Oregon, a man claiming to be “Dan Cooper” bought a ticket for Northwest-Orient Airlines Flight 305 to Seattle, Washington. Dressed in a sharp dark suit with a pearl tiepin, this forty-five year-old man was about six feet tall with black hair (Abacha and Gilmore 233). No one would suspect him of going down in American history as the only man to ever escape capture after hijacking a U.S. plane (Warchol 1).