On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting

Olayinka Olumide Ajiboye; Julian Ojebo

doi:doi:10.11648/j.ijacm.20241202.15

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On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting

Olayinka Olumide Ajiboye^*

, Julian Ojebo

Published in International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 2)

Received: 29 April 2024 Accepted: 16 July 2024 Published: 20 August 2024

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Abstract

Road traffic accidents has been reported to be on the increase, leaving patients with diverse orthopaedic injuries as well as traumatic brain injury. The accidents and emergencies unit continues to struggle during resuscitation and offer inadequate analgesia to these patients who also may be in shock or not fully resuscitated, owing to fear of worsening the haemodynamics, or the respiratory suppression from opioids, most trauma physicians refrain from using strong opioids. Intravenous access in the polytraumatized patients is usually challenging, even more so in obese patients, putting them to greater morbidity or mortality according to some published articles. This case report expresses the importance of prompt management, multi-disciplinary care of an obese polytraumatized patient, which led to shorter hospital stay and reduction in morbidity and mortality. A multi-disciplinary approach with quick involvement of the Anaesthetists made a big difference in establishing venous access promptly to commence resuscitation, preventing onset of morbidity such as acute kidney injury due to hypovolaemia. On arrival blocks, a technique developed by anesthesiologist Ravindra and plastic and hand surgeon Raja is a situation where the skilled Anaesthetist blocks different regions in order to offer patient excellent analgesia without compromising the haemodynamic or respiratory drive is important to note and emphasize.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 12, Issue 2)
DOI	10.11648/j.ijacm.20241202.15
Page(s)	89-92
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Polytraumatized Patients, On Arrival Blocks, Supraclavicular Block, Obesity, Internal Jugular Vein

References

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[2]	Tobiloba Oyejide Alex Omotosho, Jainaba Sey-Sawo, Oluwatomilayo Felicity Omotosho, Yahya Njie Knowledge and attitudes of nurses towards pain management at Edward Francis Small Teaching Hospital, Banjul. International Journal of Africa Nursing Sciences. 2023. 18(1): 100534. https://doi.org/10.1016/j.ijans.2023.100534
[3]	Motov SM, Khan AN. Problems and barriers of pain management in the emergency department: Are we ever going to get better? J Pain Res. 2008 Dec 9; 2: 5-11.
[4]	Muthelo L, Seimela HM, Mbombi MO, Malema R, Phukubye A, Tladi L. Challenges for Optimum Cardiopulmonary Resuscitation in the Emergency Departments of Limpopo Province: A Qualitative Study. Healthcare (Basel). 2023 Jan 4; 11(2): 158. https://doi.org/10.3390/healthcare11020158
[5]	Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015 Jul; 33(7): 673-89. https://doi.org/10.1007/s40273-014-0243-x
[6]	Aissam Elmhiregh, Abdulaziz F Ahmed, Abdul Majid Dabboussi, Ghalib O Ahmed, Husham Abdelrahman, Talal Ibrahim. The impact of obesity on polytraumatized patients with operatively treated fractures. Injury, Volume 53, Issue 7, 2022, Pages 2519-2523.
[7]	Nelson J, Billeter AT, Seifert B, Neuhaus V, Trentz O, Hofer CK, Turina M. Obese trauma patients are at increased risk of early hypovolemic shock: a retrospective cohort analysis of 1,084 severely injured patients. Crit Care. 2012 May 8; 16(3): R77. https://doi.org/10.1186/cc11334
[8]	Obesity and Overweight. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=For%20adults%2C%20WHO%20defines%20overweight,than%20or%20equal%20to%2030 (accessed Jul. 12, 2024)
[9]	Sabapathy SR, Venkateswaran G, Boopathi V, Subramanian JB. "On Arrival Block"-Management of Upper Extremity Trauma with Resuscitation in the Operating Room. Plast Reconstr Surg Glob Open. 2020 Oct 29; 8(10): e3191. https://doi.org/10.1097/GOX.0000000000003191
[10]	G V, Krishna Prasad. (2020). Utilities of Peripheral Nerve Blocks beyond the Operating Room: A Narrative Review. Academia Anesthesiologica International. 5. https://doi.org/10.21276/aan.2020.5.1.24
[11]	Gadsden J, Warlick A. Regional anesthesia for the trauma patient: improving patient outcomes. Local Reg Anesth. 2015 Aug 12; 8: 45-55. https://doi.org/10.2147/LRA.S55322
[12]	G V, Krishna Prasad & Khanna, Sangeeta & Sharma, Vipin. (2020). Peripheral nerve blocks in trauma patients: Recent updates and improving patient outcomes: A narrative review. Indian Journal of Pain. 34. 8. https://doi.org/10.4103/ijpn.ijpn_70_19
[13]	McGreevy K, Bottros MM, Raja SN. Preventing Chronic Pain following Acute Pain: Risk Factors, Preventive Strategies, and their Efficacy. Eur J Pain Suppl. 2011 Nov 11; 5(2): 365-372. https://doi.org/10.1016/j.eujps.2011.08.013
[14]	Raymond Sinatra, Causes and Consequences of Inadequate Management of Acute Pain, Pain Medicine, Volume 11, Issue 12, December 2010, Pages 1859–1871, https://doi.org/10.1111/j.1526-4637.2010.00983.x
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APA Style

Ajiboye, O. O., Ojebo, J. (2024). On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting. International Journal of Anesthesia and Clinical Medicine, 12(2), 89-92. https://doi.org/10.11648/j.ijacm.20241202.15

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ACS Style

Ajiboye, O. O.; Ojebo, J. On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting. Int. J. Anesth. Clin. Med. 2024, 12(2), 89-92. doi: 10.11648/j.ijacm.20241202.15

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AMA Style

Ajiboye OO, Ojebo J. On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting. Int J Anesth Clin Med. 2024;12(2):89-92. doi: 10.11648/j.ijacm.20241202.15

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@article{10.11648/j.ijacm.20241202.15,
  author = {Olayinka Olumide Ajiboye and Julian Ojebo},
  title = {On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting
},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {12},
  number = {2},
  pages = {89-92},
  doi = {10.11648/j.ijacm.20241202.15},
  url = {https://doi.org/10.11648/j.ijacm.20241202.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20241202.15},
  abstract = {Road traffic accidents has been reported to be on the increase, leaving patients with diverse orthopaedic injuries as well as traumatic brain injury. The accidents and emergencies unit continues to struggle during resuscitation and offer inadequate analgesia to these patients who also may be in shock or not fully resuscitated, owing to fear of worsening the haemodynamics, or the respiratory suppression from opioids, most trauma physicians refrain from using strong opioids. Intravenous access in the polytraumatized patients is usually challenging, even more so in obese patients, putting them to greater morbidity or mortality according to some published articles. This case report expresses the importance of prompt management, multi-disciplinary care of an obese polytraumatized patient, which led to shorter hospital stay and reduction in morbidity and mortality. A multi-disciplinary approach with quick involvement of the Anaesthetists made a big difference in establishing venous access promptly to commence resuscitation, preventing onset of morbidity such as acute kidney injury due to hypovolaemia. On arrival blocks, a technique developed by anesthesiologist Ravindra and plastic and hand surgeon Raja is a situation where the skilled Anaesthetist blocks different regions in order to offer patient excellent analgesia without compromising the haemodynamic or respiratory drive is important to note and emphasize.
},
 year = {2024}
}

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TY  - JOUR
T1  - On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting

AU  - Olayinka Olumide Ajiboye
AU  - Julian Ojebo
Y1  - 2024/08/20
PY  - 2024
N1  - https://doi.org/10.11648/j.ijacm.20241202.15
DO  - 10.11648/j.ijacm.20241202.15
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
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EP  - 92
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20241202.15
AB  - Road traffic accidents has been reported to be on the increase, leaving patients with diverse orthopaedic injuries as well as traumatic brain injury. The accidents and emergencies unit continues to struggle during resuscitation and offer inadequate analgesia to these patients who also may be in shock or not fully resuscitated, owing to fear of worsening the haemodynamics, or the respiratory suppression from opioids, most trauma physicians refrain from using strong opioids. Intravenous access in the polytraumatized patients is usually challenging, even more so in obese patients, putting them to greater morbidity or mortality according to some published articles. This case report expresses the importance of prompt management, multi-disciplinary care of an obese polytraumatized patient, which led to shorter hospital stay and reduction in morbidity and mortality. A multi-disciplinary approach with quick involvement of the Anaesthetists made a big difference in establishing venous access promptly to commence resuscitation, preventing onset of morbidity such as acute kidney injury due to hypovolaemia. On arrival blocks, a technique developed by anesthesiologist Ravindra and plastic and hand surgeon Raja is a situation where the skilled Anaesthetist blocks different regions in order to offer patient excellent analgesia without compromising the haemodynamic or respiratory drive is important to note and emphasize.

VL  - 12
IS  - 2
ER  -

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Author Information

Olayinka Olumide Ajiboye

Department of Anaesthesia, Garki Hospital, Abuja, Nigeria

Contact Email

http://orcid.org/0009-0005-4839-2239
Julian Ojebo

Department of Anaesthesia, Garki Hospital, Abuja, Nigeria

Contact Email

http://orcid.org/0009-0001-4436-5883

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APA Style

Ajiboye, O. O., Ojebo, J. (2024). On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting. International Journal of Anesthesia and Clinical Medicine, 12(2), 89-92. https://doi.org/10.11648/j.ijacm.20241202.15

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ACS Style

Ajiboye, O. O.; Ojebo, J. On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting. Int. J. Anesth. Clin. Med. 2024, 12(2), 89-92. doi: 10.11648/j.ijacm.20241202.15

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AMA Style

Ajiboye OO, Ojebo J. On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting. Int J Anesth Clin Med. 2024;12(2):89-92. doi: 10.11648/j.ijacm.20241202.15

Copy | Download

@article{10.11648/j.ijacm.20241202.15,
  author = {Olayinka Olumide Ajiboye and Julian Ojebo},
  title = {On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting
},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {12},
  number = {2},
  pages = {89-92},
  doi = {10.11648/j.ijacm.20241202.15},
  url = {https://doi.org/10.11648/j.ijacm.20241202.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20241202.15},
  abstract = {Road traffic accidents has been reported to be on the increase, leaving patients with diverse orthopaedic injuries as well as traumatic brain injury. The accidents and emergencies unit continues to struggle during resuscitation and offer inadequate analgesia to these patients who also may be in shock or not fully resuscitated, owing to fear of worsening the haemodynamics, or the respiratory suppression from opioids, most trauma physicians refrain from using strong opioids. Intravenous access in the polytraumatized patients is usually challenging, even more so in obese patients, putting them to greater morbidity or mortality according to some published articles. This case report expresses the importance of prompt management, multi-disciplinary care of an obese polytraumatized patient, which led to shorter hospital stay and reduction in morbidity and mortality. A multi-disciplinary approach with quick involvement of the Anaesthetists made a big difference in establishing venous access promptly to commence resuscitation, preventing onset of morbidity such as acute kidney injury due to hypovolaemia. On arrival blocks, a technique developed by anesthesiologist Ravindra and plastic and hand surgeon Raja is a situation where the skilled Anaesthetist blocks different regions in order to offer patient excellent analgesia without compromising the haemodynamic or respiratory drive is important to note and emphasize.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting

AU  - Olayinka Olumide Ajiboye
AU  - Julian Ojebo
Y1  - 2024/08/20
PY  - 2024
N1  - https://doi.org/10.11648/j.ijacm.20241202.15
DO  - 10.11648/j.ijacm.20241202.15
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 89
EP  - 92
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20241202.15
AB  - Road traffic accidents has been reported to be on the increase, leaving patients with diverse orthopaedic injuries as well as traumatic brain injury. The accidents and emergencies unit continues to struggle during resuscitation and offer inadequate analgesia to these patients who also may be in shock or not fully resuscitated, owing to fear of worsening the haemodynamics, or the respiratory suppression from opioids, most trauma physicians refrain from using strong opioids. Intravenous access in the polytraumatized patients is usually challenging, even more so in obese patients, putting them to greater morbidity or mortality according to some published articles. This case report expresses the importance of prompt management, multi-disciplinary care of an obese polytraumatized patient, which led to shorter hospital stay and reduction in morbidity and mortality. A multi-disciplinary approach with quick involvement of the Anaesthetists made a big difference in establishing venous access promptly to commence resuscitation, preventing onset of morbidity such as acute kidney injury due to hypovolaemia. On arrival blocks, a technique developed by anesthesiologist Ravindra and plastic and hand surgeon Raja is a situation where the skilled Anaesthetist blocks different regions in order to offer patient excellent analgesia without compromising the haemodynamic or respiratory drive is important to note and emphasize.

VL  - 12
IS  - 2
ER  -

Copy | Download