Management of Airways through Rapid Tracheostomy in a Severely Burnt Patient Attended to via Helicopter.

In Catanzaro, Italy, an adult male with severe burns all over his body and in a state of coma was promptly rescued by the medical team at the air ambulance service (HEMS), who provided airway safety through laryngeal mask placement (LMA). The patient was subsequently transferred to the nearest Hub center, where an emergency tracheostomy was performed to ensure better airway management during the flight to the nearest available major burn center. This is the first documented case at regional level of a patient undergoing rapid tracheostomy through an imminent transfer with air ambulance.

The Use of Exogenous Lung Surfactant (Poractant Alfa) in Acute Respiratory Failure by Drowning.

Drowning is an acute respiratory failure as a result from immersion or submersion of the airways in a liquid medium (predominantly water). Inhalation of water causes severe lung damage due to the destruction of pulmonary surfactant, resulting in decreased lung elasticity, alveolar collapse, alteration of ventilation-perfusion ratio, intrapulmonary blood shunting, hypoxia, acute lung injury, and Acute Respiratory Distress Syndrome (ARDS). Poractant alfa (Curosurf®), a natural surfactant effective in the treatment of newborn respiratory distress, has been used in various forms of ARDS, but in drowning syndromes, experience is still poor.

Use of Ceftolozane/Tazobactam in a Case of Septic Shock by Puerperal Sepsis.

Multiresistant bacteria infections cause widespread morbidity and mortality and lead to an increase in expenses for hospital stays and complications. We describe the case of a 27-year-old patient with puerperal sepsis after cesarean section due to Escherichia coli complicated by multiresistant Klebsiella ESBL-producing superinfection with septic shock and multiple organ dysfunction syndrome, successfully treated with ceftolozane/tazobactam.

Early intensive treatment to prevent kidney failure in post-traumatic rhabdomyolysis: Case report.

Traumatic rhabdomyolysis is a clinical and biological syndrome secondary to lysis of striated muscle fibers resulting in extended musculoskeletal damage. An acute muscle damage causes the release of constituent elements of the sarcoplasmic reticulum, such as muscle enzymes, potassium, and myoglobin in plasma circulation; these conditions are at great risk of dangerous systemic complications for life such as hypovolemic shock, hyperkalemia, and acute kidney injury. We describe the case of a patient who suffered a severe musculoskeletal and vascular trauma with elevated creatine kinase values and myoglobinemia treated early with coupled plasma filtration adsorption in order to prevent kidney damage, associated with volume replacement, loop diuretics, and correction of metabolic acidosis.

The Use of Coupled Plasma Filtration Adsorption in Traumatic Rhabdomyolysis.

Severe musculoskeletal injuries induce the release of sarcoplasmic elements such as muscle enzymes, potassium, and myoglobin in the systemic circulation. The circulating myoglobin damages the glomerulus and renal tubules. Conventional haemodialysis is not able to remove myoglobin, due to its high molecular weight (17,8 kilodaltons [kDa]).

Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution.

The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides.