Paziana Karolina, Fields J Matthew, Rotte Masashi, Au Arthur, Ku Bon
Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Wilderness Environ Med. 2012 Dec;23(4):343-8. doi: 10.1016/j.wem.2012.04.006. Epub 2012 Jul 25.
Retained foreign objects account for as much as 2% of soft tissue injuries sustained in the wilderness. Subcutaneously embedded fragments are often missed during the initial medical evaluation and may result in morbidity secondary to delayed removal. Although the utility of ultrasonography in the emergency department for the detection of retained objects is established, the potential use of point-of-care ultrasound to aid with foreign body removal in the field has not been well described. We present 2 case reports that demonstrate the value of ultrasonography in detecting and successfully removing foreign bodies sustained in the wilderness, and outline a procedural technique that minimizes morbidity and uses equipment available in wilderness medical field kits. We propose that with the advent of portable and handheld ultrasound units, foreign body removal in the field has become feasible and may decrease the morbidity of soft tissue injuries, particularly in austere and wilderness environments with limited access to immediate medical care.
在野外遭受的软组织损伤中,留存异物占比高达2%。皮下嵌入的碎片在初始医学评估时常常被漏诊,可能会因移除延迟而导致发病。尽管超声检查在急诊科用于检测留存异物的效用已得到证实,但现场即时超声在野外辅助取出异物方面的潜在用途尚未得到充分描述。我们报告2例病例,展示了超声检查在检测和成功取出野外留存异物方面的价值,并概述了一种可将发病率降至最低且使用野外医疗急救包中现有设备的操作技术。我们认为,随着便携式和手持式超声设备的出现,在野外取出异物已变得可行,且可能会降低软组织损伤的发病率,尤其是在难以获得即时医疗救治的偏远和野外环境中。