Last posts on foley2024-03-29T09:17:32+01:00All Rights Reserved blogSpirithttps://www.hautetfort.com/https://www.hautetfort.com/explore/posts/tag/foley/atom.xmlMédecine tactiquehttp://citerahiadesgenettes.hautetfort.com/about.htmlSonde de foley: Au moins 2 et pas pour un sondagetag:citerahiadesgenettes.hautetfort.com,2013-07-06:51160772013-07-06T21:03:00+02:002013-07-06T21:03:00+02:00 Improved mortality from penetrating neck and maxillofacial trauma using...
<p style="text-align: center;"><span style="font-family: arial, helvetica, sans-serif;"><strong><span style="font-size: medium;">Improved mortality from penetrating neck and maxillofacial trauma using Foley catheter balloon tamponade in combat</span></strong></span></p><p style="text-align: center;"><a href="http://journals.lww.com/jtrauma/Abstract/publishahead/Improved_mortality_from_penetrating_neck_and.99868.aspx" target="_blank"><em><span style="font-size: small;"><span style="font-family: arial, helvetica, sans-serif;">Weppner </span><span style="font-family: arial, helvetica, sans-serif;">J. J Trauma </span><span style="font-family: arial, helvetica, sans-serif;">Acute Care Surg. 2013;75: 00Y00</span></span></em></a></p><p style="text-align: justify;"><span style="font-size: small;"><strong style="font-size: small;"><span style="font-family: arial, helvetica, sans-serif;"><span>BACKGROUND:</span></span></strong></span></p><p style="text-align: justify;"><span style="font-size: small;"><span style="font-family: arial, helvetica, sans-serif;"><span style="font-family: arial, helvetica, sans-serif;">The military medical community has promoted use of Foley catheter balloon tamponade in the initial management of vascular </span></span><span style="font-family: arial, helvetica, sans-serif;">injury owing to neck or maxillofacial trauma. The aim of the study was to compare outcomes </span><span style="font-family: arial, helvetica, sans-serif;">with Foley catheter tamponade </span><span style="font-family: arial, helvetica, sans-serif;">with those obtained with traditional use of external pressure.</span></span></p><p style="text-align: justify;"><span style="font-size: small;"><strong><span style="font-family: arial, helvetica, sans-serif;"><span style="font-family: arial, helvetica, sans-serif;">METHODS:</span></span></strong></span></p><p style="text-align: justify;"><span style="font-size: small;"><span style="font-family: arial, helvetica, sans-serif;"><span style="font-family: arial, helvetica, sans-serif;">This retrospective cohort study evaluated all cases of persistent bleeding caused by penetrating neck or maxillofacial trauma </span></span><span style="font-family: arial, helvetica, sans-serif;">received at one forward aid station between December 2009 and October 2011. Cohorts included those who were treated with </span><span style="font-family: arial, helvetica, sans-serif;">Foley catheter tamponade and those managed with external pressure. Which treatment option was applied depended solely on t</span><span style="font-family: arial, helvetica, sans-serif;">he availability of Foley catheters at the time. The effectiveness of each technique in controlling initial and delayed hemorrhage </span></span><span style="font-family: arial, helvetica, sans-serif; font-size: small;">is described, and the impact on mortality is analyzed using the Student’s t test and Fisher’s exact test.</span></p><p style="text-align: left;"><strong><span style="font-family: arial, helvetica, sans-serif; font-size: small;"><span style="font-family: arial, helvetica, sans-serif;">RESULTS:</span></span></strong></p><p style="text-align: justify;"><span style="font-family: arial, helvetica, sans-serif; font-size: small;"><span style="font-family: arial, helvetica, sans-serif;">Seventy-seven subjects met the inclusion criteria with 42 subjects in the Foley group and 35 subjects in the external pressure </span></span><span style="font-family: arial, helvetica, sans-serif; font-size: small;">group. A statistically significant difference was found between the groups regarding delayed failure, experienced by three </span><span style="font-family: arial, helvetica, sans-serif; font-size: small;">patients (7%) in the Foley group and nine patients (26%) in the external pressure group ( p G 0.05). <em><span style="background-color: #ffff99;"><strong>The difference in mortality, </strong></span></em></span><span style="font-size: small;"><em><span style="background-color: #ffff99;"><strong><span style="font-family: arial, helvetica, sans-serif;">5% (two patients) in the Foley tamponade group and 23% (eight patients) in the external pressure group, was statistically </span></strong></span></em></span><span style="font-family: arial, helvetica, sans-serif; font-size: small;"><em><span style="background-color: #ffff99; font-size: medium;"><strong><span style="font-size: small;">significan</span>t</strong></span></em> ( p G 0.05).</span></p><p style="text-align: left;"><strong><span style="font-family: arial, helvetica, sans-serif; font-size: small;"><span style="font-family: arial, helvetica, sans-serif;">CONCLUSION:</span></span></strong></p><p style="text-align: justify;"><span style="font-size: small;"><span style="font-family: arial, helvetica, sans-serif;"><span style="font-family: arial, helvetica, sans-serif;">For penetrating neck and maxillofacial injuries in a combat environme</span></span><span style="font-family: arial, helvetica, sans-serif;"><span style="font-family: arial, helvetica, sans-serif;">nt, </span></span><span style="font-family: arial, helvetica, sans-serif;"><span style="font-family: arial, helvetica, sans-serif;"><em><span style="background-color: #ffff99;"><strong>Foley catheter balloon tamponade significantly </strong></span></em></span></span><span style="font-family: arial, helvetica, sans-serif;"><em><span style="background-color: #ffff99;"><strong>reduced mortality when compared with direct pressure techniques</strong></span></em> through its effect on preventing delayed bleeding.</span></span></p><p style="text-align: center;"><em><span style="font-size: small;"><span style="font-family: arial, helvetica, sans-serif;">--------------------------------------------------------------------</span></span></em><span style="text-align: left;"> </span></p><p style="text-align: justify;"><a href="http://citerahiadesgenettes.hautetfort.com/media/00/00/2121141090.2.jpeg" target="_blank"><img id="media-4173306" style="float: right; margin: 0.2em 0 1.4em 0.7em;" title="" src="http://citerahiadesgenettes.hautetfort.com/media/00/00/420709474.2.jpeg" alt="cou,foley" /></a><span style="font-size: small; font-family: arial, helvetica, sans-serif;">The Foley catheter tamponade is relatively simple and very easy to perform rapidly. Before its insertion in the cases examined in this study, a hemorrhaging wound was identified in the neck ormaxillofacial area, and a hemostat was applied to the distal endof an 18 Fr Foley catheter (30 cm3). <strong><span style="background-color: #ffff99;">The catheter was then introduced with a finger into the wound and directed along the wound track to the estimated or palpated source of bleeding, after which the Foley balloon was inflated with sterile water until the bleeding stopped or moderate resistance </span></strong></span><strong style="font-family: arial, helvetica, sans-serif; font-size: small;"><span style="background-color: #ffff99;">felt. </span></strong><span style="font-family: arial, helvetica, sans-serif; font-size: small;">If this technique did not stop the hemorrhage and either a deep wound or large defect was present in the bleeding vessel, it was considered that the balloon may have only been able to provide distal control. In such cases, a second catheter was introduced into the wound and inflated to provide more proximal control.</span></p><p style="text-align: justify;"><span style="font-size: small; font-family: arial, helvetica, sans-serif;"><a href="http://citerahiadesgenettes.hautetfort.com/media/02/01/183952109.jpeg" target="_blank"><img id="media-4173270" style="float: right; margin: 0.2em 0 1.4em 0.7em;" title="" src="http://citerahiadesgenettes.hautetfort.com/media/02/01/68596954.jpeg" alt="Foley4.jpeg" /></a></span></p><p style="text-align: justify;"><span style="font-family: arial, helvetica, sans-serif; font-size: small;">When treating Zone I injuries of the supraclavicular fossa, the catheter was introduced as far as possible past the defect in the vessel, allowing the balloon to be inflated before being pulled back firmly and then held in place with a hemostat. Doing so compressed the injured vessel onto the first rib and clavicle, which was intended to tamponade bleeding into the chest. If external hemorrhage continued following insertion of the Foley catheter, a second catheter may have been inserted to control bleeding</span></p>
Médecine tactiquehttp://citerahiadesgenettes.hautetfort.com/about.htmlLa sonde de foley: Pour l'hémostasetag:citerahiadesgenettes.hautetfort.com,2011-09-02:37623772011-09-02T08:42:00+02:002011-09-02T08:42:00+02:00 Une sonde de foley est utile non pour réaliser un sondage urinaire sur le...
<p>Une sonde de foley est utile non pour réaliser un sondage urinaire sur le terrain mais comme moyen d'hémostase.</p><p> L'emploi de sonde à ballonet pour rélaiser un tamponnement de lésions hémorragiques est une <a href="http://journals.lww.com/jtrauma/Abstract/2011/02000/A_Decade_s_Experience_With_Balloon_Catheter.11.aspx" target="_blank">réalité</a>.</p><p style="text-align: justify;"> </p><p style="text-align: justify;">Ces techniques peuvent trouver un champ d'application au combat notamment pour l<a href="http://www.ramcjournal.com/2009/dec09/tai3.pdf" target="_blank">a prise en charge des traummatisés jonctionnels.</a></p><p style="text-align: center;"> </p><p><strong>Premier exemple</strong>: Un saignement d'origine thoracique.</p><p> </p><p style="text-align: center;"><a href="http://citerahiadesgenettes.hautetfort.com/media/02/01/3349246986.JPG" target="_blank"><img id="media-3181202" style="margin: 0.7em 0pt;" title="" src="http://citerahiadesgenettes.hautetfort.com/media/02/01/2246138545.JPG" alt="Ffoley Thorax.JPG" /></a></p><p style="text-align: center;">Balloon Foley catheter compression as a treatment for intercostal vessel bleeding. Chao BF et all Injury, Int. J. Care Injured 42 (2011) 958–959</p><p style="text-align: left;"><strong>Autres exemples</strong>:</p><p style="text-align: left;"><a href="http://www.lava.med.br/mestrado/vascular/2003/Artigos_14_modulo_Trauma_vascular_Poli/trauma_axilar_e_subclavia.pdf" target="_blank">Les plaies sous-clavières</a></p><p style="text-align: center;"><a href="http://citerahiadesgenettes.hautetfort.com/media/00/01/407697318.JPG" target="_blank"><img id="media-3181215" style="margin: 0.7em 0pt;" title="" src="http://citerahiadesgenettes.hautetfort.com/media/00/01/3429237125.JPG" alt="Foley Sous Clav.JPG" /></a></p><p style="text-align: left;"> </p><p style="text-align: left;"> </p><p style="text-align: left;">Les <a href="http://www.ncbi.nlm.nih.gov/pubmed/16830215" target="_blank">plaies cervicales</a>,</p><p style="text-align: center;"><a href="http://citerahiadesgenettes.hautetfort.com/media/01/02/2048492963.jpg" target="_blank"><img id="media-3182157" style="margin: 0.7em 0pt;" title="" src="http://citerahiadesgenettes.hautetfort.com/media/01/02/2495279043.jpg" alt="neckfoley.jpg" /></a></p><p style="text-align: left;">les plaies inguinales,</p><p style="text-align: left;">les épistaxis</p>