Traumatic asphyxia

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Traumatic asphyxia
Classification and external resources
Specialty emergency medicine
ICD-10 T719
ICD-9-CM 994.7

Traumatic asphyxia, or Perthe's syndrome, is a medical emergency caused by an intense compression of the thoracic cavity, causing venous back-flow from the right side of the heart into the veins of the neck and the brain.[1]

Causes[edit]

Traumatic asphyxia occurs when a powerful compressive force is applied to the thoracic cavity. This is most often seen in motor vehicle accidents, as well as industrial and farming accidents. However, it can present anytime a significant pressure is applied to the thorax.

Signs and symptoms[edit]

Traumatic asphyxia is characterized by cyanosis in the upper extremities, neck, and head as well as petechiae in the conjunctiva. Patients can also display jugular venous distention and facial edema.[2] Associated injuries include pulmonary contusion, myocardial contusion, hemo/pneumothorax, and broken ribs.[3][4]

Pathophysiology[edit]

The sudden impact on the thorax causes an increase in intrathoracic pressure.[3] In order for traumatic asphyxia to occur, a Valsalva maneuver is required when the traumatic force is applied.[5] Exhalation against the closed glottis along with the traumatic event causes air that cannot escape from the thoracic cavity. Instead, the air causes increased venous back-pressure, which is transferred back to through the right atrium, to the superior vena cava and to the head and neck veins and capillaries.[3]

Prognosis[edit]

For individuals who survive the initial crush injury, survival rates are high for traumatic asphyxia.[3][5][6]

See also[edit]

References[edit]

  1. ^ Marx, John (2013). Rosen's Emergency Medicine - Concepts and Clinical Practice. Philadelphia: Saunders. p. 435. ISBN 978-1455706051. 
  2. ^ Aehlert, Barbara J. (2010). Paramedic Practice Today: Above and Beyond. p. 472. ISBN 978-0-323-08537-3. 
  3. ^ a b c d Eken, Cenker; Yıgıt, Ozlem (2009). "Traumatic asphyxia: A rare syndrome in trauma patients". International Journal of Emergency Medicine. 2 (4): 255–6. doi:10.1007/s12245-009-0115-x. PMC 2840592free to read. PMID 20436897. 
  4. ^ Lee, Ming-Chung; Wong, Sing-Sieng; Chu, Jaw-Ji; Chang, Jen-Ping; Lin, Pyng-Jing; Shieh, Ming-Jang; Chang, Chau-Hsiung (1991). "Traumatic asphyxia". The Annals of Thoracic Surgery. 51 (1): 86–8. doi:10.1016/0003-4975(91)90456-Z. PMID 1985583. 
  5. ^ a b Barakat, M; Belkhadir, Z.H; Belkrezia, R; Faroudy, M; Ababou, A; Lazreq, C; Sbihi, A (2004). "Syndrome d'asphyxie traumatique ou syndrome de Perthes. À propos de six cas" [Traumatic asphyxia or Perthe's syndrome. Six cas reports]. Annales Françaises d'Anesthésie et de Réanimation (in French). 23 (1): 59–62. doi:10.1016/j.annfar.2003.10.011. PMID 14980325. 
  6. ^ Bledsoe, Bryan E.; Berkeley, Ross. P.; Markus, Troy (2010). "Know the Signs and Symptoms of Traumatic Asphyxia". JEMS.