Fd Madzimbamuto1, T Madamombe. 1. Department of Anaesthetics and Critical Care Medicine, University of Zimbabwe, College of Medicine, Harare, Zimbabwe.
Abstract
OBJECTIVES: To present a series of cases of survivors and non-survivors of traumatic asphyxia from a single mass casualty incident in Zimbabwe and a review of the literature. DESIGN: Descriptive case review. SETTING: Parirenyatwa Hospital is a tertiary referral 1 000 bed teaching hospital in Zimbabwe. RESULTS: Survivors (n = 4) displayed the classic signs of traumatic asphyxia of conjunctival haemmorhages, petechial blue-purple discoloration of head and neck and neurological findings of confusion or unconsciousness and convulsions. Non-survivors (n = 12) showed more varied signs but all showed petechiae and with a history of being crushed. On-site resuscitation and triage was absent, reducing the chance of identifying potential survivors at the scene. CONCLUSION: The outcome in traumatic asphyxia is improved by rapid restoration of ventilation and circulation. The epidemiology of traumatic asphyxia in Zimbabwe is unknown but the conditions predisposing to it are present. Closer integration between hospital and pre-hospital services will permit better management of major trauma patients and mass casualty events.
OBJECTIVES: To present a series of cases of survivors and non-survivors of traumatic asphyxia from a single mass casualty incident in Zimbabwe and a review of the literature. DESIGN: Descriptive case review. SETTING: Parirenyatwa Hospital is a tertiary referral 1 000 bed teaching hospital in Zimbabwe. RESULTS: Survivors (n = 4) displayed the classic signs of traumatic asphyxia of conjunctival haemmorhages, petechial blue-purple discoloration of head and neck and neurological findings of confusion or unconsciousness and convulsions. Non-survivors (n = 12) showed more varied signs but all showed petechiae and with a history of being crushed. On-site resuscitation and triage was absent, reducing the chance of identifying potential survivors at the scene. CONCLUSION: The outcome in traumatic asphyxia is improved by rapid restoration of ventilation and circulation. The epidemiology of traumatic asphyxia in Zimbabwe is unknown but the conditions predisposing to it are present. Closer integration between hospital and pre-hospital services will permit better management of major traumapatients and mass casualty events.