The use of recombinant activated factor VII in a patient with penetrating chest trauma and ongoing pulmonary hemorrhage.

A case is described where recombinant activated factor VII was used to control pulmonary hemorrhage in a patient who had sustained a high-velocity gunshot wound to the chest, in the deployed medical setting, allowing onward transfer of the patient to the United Kingdom for further management.

Comparison of four subarachnoid solutions in a needle-through-needle technique for elective caesarean section.

We have used both spinal and extradural anaesthesia with a 26-gauge, long spinal needle through a 16-gauge Tuohy needle for elective Caesarean section. Four different subarachnoid solutions of bupivacaine were compared: 0.5% heavy bupivacaine alone, or with adrenaline, fentanyl or adrenaline and fentanyl.

Laryngeal oedema from a neck haematoma. A complication of internal jugular vein cannulation.

Laryngeal oedema occurred after formation of a neck haematoma after attempted internal jugular vein cannulation. This resulted in complete respiratory obstruction and respiratory arrest and it was impossible to ventilate her lungs manually or intubate her trachea. Oxygenation of the patient was only possible using transtracheal ventilation.

Continuous brachial plexus blockade. A technique that uses an axillary catheter to allow successful skin grafting.

An 82-year-old woman sustained a full thickness burn of her hand. A technique for producing anaesthesia of the brachial plexus via an indwelling catheter is described. Confirmation of the catheter position was obtained by X ray.

Survival in adults after cardiac arrest due to drowning.

Some remarkable cases of full neurological recovery after cardiac arrest following immersion incidents have been intermittently reported in the journals over the years. These have largely been in children or teenagers who have fallen into extremely cold water. We report here two older adults who recovered completely after a period of cardiac arrest in cold water.