It is considered quite safe to use these shells for dispersing ma

It is considered quite safe to use these shells for dispersing masses. However, we encountered very serious types of injures, which had been caused by tear gas shells and were similar to those induced by other war weapons. Vascular buy Fasudil injury presents a great challenge to the emergency treatment team, because such injuries require urgent intervention to prevent loss of life

or limb. Moreover, they are challenging since sometimes they present only with subtle or occult symptoms or signs. Historically, most patients who sustained serious arterial injury did Inhibitors,research,lifescience,medical not survive long enough to reach medical care provider. Those who made to a medical care provider generally had minor wounds. With advancement in the health care Inhibitors,research,lifescience,medical system and urbanisation of population, many seriously injured patients, even those with very serious vascular injuries such as carotid vascular injury, now arrive in the hospital and are salvaged.1,2 The Present study was undertaken to analyse the pattern, presentation, management and outcome of vascular injuries induced by tear gas shells. Materials and Methods The study was performed prospectively recruiting patients with vascular injury due to tear gas shells admitted to Sher-i-Kashmir Institute of Medical Sciences, Srinagar Kashmir, India from 1st January

2008 to 31st December 2009. There were widespread Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical public demonstrations against the government during this period. Tear gas shells were used to disperse the mob during these demonstrations (figure 1). Very serious type of injuries did occur by these tear gas shells. A total of 202 patients injured by tear gas shells were presented to Emergency Department of the Hospital. Out of these numbers, 18 patients had vascular injury. Patients with vascular trauma

caused by reasons other than tear gas shell were excluded from the study. Patients were initially resuscitated in the Emergency Department and a thorough clinical examination was done. All of the patients had severe signs of vascular injuries with extensive soft tissue damages. All of the patients were given third generation Inhibitors,research,lifescience,medical cephalosporins and aminoglycosides at the time of induction of anaesthesia. The injured vessels were exposed after controlling for proximal and distal bleeding. The extent of each injury was from assessed. The patients were revascularised using reverse saphenous vein graft. Thorough debridements of soft tissues were done. Heparin was instilled locally in every patient, and each patient also received anticoagulation therapy postoperatively in the form of clopidogrel and aspirin to decrease the chance of postoperative thrombus formation. Liberal fasciotomy was performed in most of the patients whenever deemed necessary on clinical assessment. All fractures were fixed before vascular repair while temporary vascularity was restored before fracture fixation.

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