There is probably not a year that goes by when injuries or deaths do not occur at incidents involving crowds. The internet resource of Still provides an insight into over 160 such incidents that have occurred between 1902 and December 2014 [1]. Examples of incidents covered at this site as well as within the published literature or accessible on Internet based resources include those involving football stadia, underground stations, gymnasia, nightclubs, access tunnels, religious and music festivals, as well as riverfronts, bridges and railway stations [2–22]. Although the cause of the incident may be suggested to be the action of the crowd, the crowd is often not the underlying cause. Rather it is the inappropriate utilisation of space and the failure of the organisers of the event or location to provide a safe environment for the crowd.

Death in Crowds

Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature.

/pdf/a-rare-and-serious-syndrome-that-requires-attention-in-h82mclfqdg.pdf

A Rare and Serious Syndrome That Requires Attention in Emergency Service: Traumatic Asphyxia

Background: Recently, there has been an increase in prescription drug abuse and related fatalities. Although opioid analgesics are commonly implicated, there have been significant increases in the prevalence of benzodiazepine exposures and overdoses.Objective: To describe national trends in pediatric benzodiazepine exposures from 2000 to 2015.Methods: A retrospective database analysis was conducted. Data regarding benzodiazepine exposures in children ages 0 to <18 years reported to participating United States poison centers from January 2000 through December 2015 were obtained from the National Poison Data System. Population data were obtained from the US Census Bureau to determine annual population estimates. Data were analyzed using chi-square tests.Results: A total of 296,838 pediatric benzodiazepine exposures were identified during the study period. The rate of pediatric benzodiazepine exposure increased 54% between 2000 and 2015. The severity of medical outcomes also increased, as did the prevalence of co-ingestion of multiple drugs, especially in children ages 12 to <18 years. Nearly half of all reported exposures in 2015 were documented as intentional abuse, misuse, or attempted suicide, reflecting a change from prior years. The most commonly identified pediatric benzodiazepines of exposures were alprazolam, clonazepam, and lorazepam.Conclusions: The rate and severity of reported pediatric benzodiazepine exposure is increasing over time. Adolescent exposures are of specific concern, as co-ingestion and intentional abuse were found to be more common in this group. Medical providers and caretakers should be cognizant of this growing epidemic to avoid preventable harm to adolescents, young children, and infants.

Child and adolescent benzodiazepine exposure and overdose in the United States: 16 years of poison center data

Traumatic asphyxia is a rare syndrome in which the thoracoabdominal region is exposed to pressure and it presents with cervicofacial cyanosis and oedema, subconjunctival haemorrhage, and petechial haemorrhage in the face, neck and upper part of chest. In this report we present a 28 year old male patient whose whole body except the head and neck stayed under soil for about 30 minutes as an example case in order to review traumatic asphyxia syndrome.

/pdf/review-of-traumatic-asphyxia-syndrome-with-a-case-504ramh3ry.pdf

Review of Traumatic Asphyxia Syndrome with a Case Presentation

Utility of Bedside Urine Toxicology Screening Test in Emergency Department: A Retrospective Study

Introduction: Septic pulmonary embolism (SPE) is a pulmonary infarction and infection that is caused by pulmonary embolization from an infected fibrin thrombus that occludes the pulmonary arteries. SPE is a rare subtype of pulmonary embolism clinically characterized by fever, respiratory distress, and pulmonary infiltrates seen on radiological imaging. In the chest computed tomography of SPE, multiple air cysts; wedge-shaped opacities in the periphery of the lungs; multiple diffuse, small opacities mimicking bronchopneumonia; bilateral nodules; and cavitary nodules in the lungs can be seen. Case Report: A 34-week-old male patient presented to our emergency department with complaints of chest and back pain, shortness of breath, and coughing up bloody sputum. The patient was addicted to heroin for 10 years and was a smoker for 15 years. In his chest x-ray, multiple diffuse opacities were present in both lungs. Thoracic computed tomography revealed multiple hyperdense nodular lesions in both lung parenchyma. Since these findings were consistent with SPE, the patient was hospitalized in the intensive care unit for further treatment. Conclusion: The initial clinical and radiological features are often not specific to the disorder, and therefore, it is difficult to make the diagnosis. In patients with predisposing factors, if symptoms and radiological findings are compatible with SPE, the diagnosis should be kept in mind. In this article, we present the case of a 34-year-old male patient who was an intravenous drug addict and was diagnosed with SPE.

/pdf/septic-pulmonary-embolism-in-a-patient-who-was-an-4fpbszg1z0.pdf

Septic Pulmonary Embolism in a Patient Who Was an Intravenous Drug Addict

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Review of Traumatic Asphyxia Syndrome with a Case Presentation

Utility of Bedside Urine Toxicology Screening Test in Emergency Department: A Retrospective Study

Septic Pulmonary Embolism in a Patient Who Was an Intravenous Drug Addict