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首页> 外文期刊>Wilderness & environmental medicine >A 51-Year-Old Woman Crushed by an Elephant Trunk
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A 51-Year-Old Woman Crushed by an Elephant Trunk

机译：一名51岁的老太太被大象树干撞碎

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Wild and exotic animal attacks are not common in the United States. Animal-related injuries in the United States are usually caused by dog bites, followed by cattle and horse injuries. Exotic animal attacks can occur when the animals are provoked, depressed, or housed improperly by owners. We report the case of a 51-year-old woman who sustained multiple systemic traumatic injuries after she was pinned to a fence by an elephant's trunk. Upon arrival in the emergency department, she was hypothermic with a temperature of 35.1 degrees C (95.1 degrees F), hypotensive to 94/60 mm Hg after 5 L crystalloid, tachycardic at 108 beats/min, and intubated with oxygen saturation of 100%. Tranexamic acid was administered in addition to starting a massive transfusion protocol. Injuries included bilateral multiple rib fractures, left abdominal wall degloving injury, right pneumothorax, right hemothorax, left chest wall puncture wound, grade IV splenic laceration, 3 grade III liver lacerations, retroperitoneal hematoma, and degloving injuries to bilateral posterior thighs requiring more than 30 operations. Why should an emergency physician be aware of this? Several factors need to be considered when evaluating animal-related injuries, including type, age, and sex of the animal. Multisystem traumatic injuries should be assumed when a large animal is involved. Prehospital care and transport time are vital to a patient's survival in both urban and rural settings. During the initial resuscitation, administering antibiotics tailored to the specific animal can greatly decrease risk of infection and morbidity. Additionally, tetanus immunoglobulin, tetanus toxoid, and rabies immunoglobulin and vaccine may be needed, unless the victim has been previously vaccinated.
机译：野生和外来动物袭击在美国并不常见。在美国，与动物有关的伤害通常是被狗咬伤，然后是牛和马受伤。当动物被主人不适当地激怒，压抑或圈养时，可能会发生外来动物袭击。我们报道了一名51岁妇女在被大象的树干钉在栅栏上后遭受多处系统性外伤的案例。到达急诊室后，她进行了体温过低的温度测试，温度为35.1摄氏度（95.1华氏度），在5升晶体后降压至94/60毫米汞柱，以108次/分钟的速度进行心动过速，并以100％的氧饱和度进行插管。除了开始大量输血方案外，还施用了氨甲环酸。受伤包括双侧多发肋骨骨折，左腹壁脱垂伤，右气胸，右血胸，左胸壁穿刺伤，IV级脾裂伤，3级III级肝裂伤，腹膜后血肿以及双侧后大腿脱垂伤需要30多个操作。急诊医师为什么要意识到这一点？在评估与动物有关的伤害时，需要考虑几个因素，包括动物的类型，年龄和性别。当涉及大型动物时，应假定多系统创伤。院前护理和运输时间对于城市和农村地区患者的生存至关重要。在最初的复苏过程中，施用针对特定动物的抗生素可以大大降低感染和发病的风险。此外，可能需要破伤风免疫球蛋白，破伤风类毒素和狂犬病免疫球蛋白及疫苗，除非受害者事先已经接种过疫苗。

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