1.Evolving Frontiers in Severe Polytrauma Management – Refining the Essential Principles
Kam Chak Wah ; Choi Wai Man ; Wong Janet Yuen Ha ; Vincent Lai ; Wong Kit Shing John
Malaysian Journal of Medical Sciences 2013;20(1):1-12
This editorial aims to refine the severe polytrauma management principles. While keeping ABCDE priorities, the termination of futile resuscitation and the early use of tourniquet to stop exsanguinating limb bleeding are crucial. Difficult-airway-management (DAM) is by a structured 5-level approach. The computerised tomography (CT) scanner is the tunnel to death for hemodynamically unstable patients. Focused Abdominal Sonography for Trauma–Ultrasonography (FAST USG) has replaced diagnostic peritoneal lavage (DPL) and is expanding to USG life support. Direct whole-body multidetector-row computed tomography (MDCT) expedites diagnosis & treatment. Non-operative management is a viable option in rapid responders in shock. Damage control resuscitation comprising of permissive hypotension, hemostatic resuscitation & damage control surgery (DCS) help prevent the lethal triad of trauma. Massive transfusion protocol reduces mortality and decreases the blood requirement. DCS attains rapid correction of the deranged physiology. Mortality reduction in major pelvic disruption requires a multi-disciplinary protocol, the novel pre-peritoneal pelvic packing and the angio-embolization. When operation is the definitive treatment for injury, prevention is best therapy.
2.Clostridium difficile infection outbreak in a male rehabilitation ward, Hong Kong (China), 2011
Tsz-sum Lam ; Man-ting Yuk ; Ngai-chong Tsang ; Man-ha Wong ; Shuk-kwan Chuang
Western Pacific Surveillance and Response 2012;3(4):59-60
Clostridium difficile is an anaerobic, gram-positive bacterium, capable of sporulation when environmental conditions no longer support its growth. The sporulation capacity enables the organism to persist in the environment for extended periods of time. Clostridium difficile is the main pathogen accountable for antibiotic-associated colitis and for 15% to 25% of cases of nosocomial antibiotic-associated diarrhoea. Major risk factors such as increased severity of underlying illness, increased age, prior antimicrobial use and gastric acid suppressors have been identified for Clostridium difficile.
3.Bacille-Calmette-Guérin vaccine-associated suppurative lymphadenitis in Hong Kong Special Administrative Region (China), 2004 to 2012
Lam Tsz-sum ; Leung Yiu-Hong ; Tsang Hoi-ling ; Choi Kin-wing ; Wong Tin-yau ; Wong Man-ha ; Chuang Shuk-kwan
Western Pacific Surveillance and Response 2013;4(1):39-40