Rib fracture fixation as a tool for extubation in a resource-poor environment

An elderly female with multiple comorbidities was involved in a pedestrian vehicle accident and sustained blunt chest trauma, arriving at a resource-poor hospital in rural South Africa. She had multiple bilateral rib fractures with a unilateral flail segment that caused her to develop respiratory fa...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2019-02, Vol.12 (2), p.bcr-2018-227518
Main Authors: Dickson-Lowe, Richard Alexander, Buitendag, Johannes Jacobus Petrus, Jolayemi, Olamide Oluwafunsho, Oosthuizen, George
Format: Article
Language:English
Subjects:
Abdomen
Accidents, Traffic
Airway Extubation
Cardiac arrhythmia
Case reports
Female
Flail Chest - complications
Flail Chest - surgery
Fracture Fixation, Internal
Fractures
Health Resources
Hospitals
Humans
Injuries
Intensive care
Intubation, Intratracheal
Middle Aged
Novel Treatment (New Drug/Intervention
Established Drug/Procedure in New Situation)
Ostomy
Pain
Patients
Pedestrians
Pneumonia
Respiration
Respiration, Artificial - methods
Respiratory failure
Respiratory Insufficiency - etiology
Respiratory Insufficiency - therapy
Rib cage
Rib Fractures - complications
Rib Fractures - surgery
South Africa
Streptococcus infections
Surgeons
Systematic review
Trauma
Ventilators
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:An elderly female with multiple comorbidities was involved in a pedestrian vehicle accident and sustained blunt chest trauma, arriving at a resource-poor hospital in rural South Africa. She had multiple bilateral rib fractures with a unilateral flail segment that caused her to develop respiratory failure. She was intubated and sent to the intensive care unit (ICU) for ventilation. She developed hospital and ventilator acquired pneumonia. She subsequently had hypoxic arrests on two separate occasions and two failed extubations. Despite inadequate access to provisions, this patient was taken to theatre for rib fracture fixation as an attempt to improve her lung function and get her off the ventilator. She was extubated two days after the procedure and discharged from ICU 4 days thereafter. On her follow-up, she reported that she had returned to normal daily living and tasks.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-227518