Brachial plexus injuries, also known as Erb’s Palsy, are injuries to the nerves in the shoulder area that usually occur at birth. These injuries, which affect the movement of a child’s shoulder, arm and hand, happen when the infant’s shoulders get stuck in the birth canal after the head emerges (shoulder dystocia), requiring techniques to free the child from the cervix which do not use traction. If excessive force is used, these measures may lead to significant injury for both mother and child. The pulling of the baby’s head stretches and injures the nerves in the shoulder that is impacted. This collection of nerves is called the brachial plexus or Erb’s Point, which is located in the upper trunk. In most cases these nerves are only stretched, and usually recover spontaneously within 3-4 months. Sometimes, as the nerves try to heal themselves, scar tissue is formed along the nerve that disrupts signals to the muscles. In other instances, the nerves are so severely injured that they are torn from the spine (avulsed), or they may be ruptured at a different place along the nerve. These situations result in varying degrees of paralysis of the arm and shoulder, and if surgical intervention is not conducted in a timely fashion, this paralysis may be permanent.
Brachial plexus injury may result in various degrees of weakness. The part of the arm that is involved directly correlates to the nerves that may be damaged in the upper trunk (generally C5, C6), middle trunk (generally C7) or lower trunk (Klumpke’s Palsy generally C8, T1). Babies with this type of injury will have limp arms by their sides, with forearms turned inward and wrists bent. The affected babies cannot lift their arm, and may also have droopy eyelids (Horner’s Syndrome) on the side that was injured.
In most cases, brachial plexus injuries are preventable, and it is important for the mother to receive regular prenatal care with dietary vigilance. High blood sugars over-nourish babies and make them gain weight faster than normal, and larger babies are more likely to get stuck in the birth canal. This is why diabetic mothers or mothers with gestational diabetes are more likely to have these high risk deliveries. Advanced planning with your physician during your pregnancy will help to anticipate a difficult delivery.
The manner in which the baby is delivered may also be a cause of Erb’s Palsy, even if there are no prenatal signs. The factors include excessive traction, fundal (stomach) pressure, limited or no episiotomy, and failure to use the appropriate maneuver to free the baby’s shoulder.
Some prenatal risk factors are:
· Mothers with a small pelvis
· Previous history of shoulder dystocia
· Prolonged labors· Induced labors· Breech deliveries
· Fetal malposition· Mothers with diabetes or gestational diabetes
As a result, a caesarean section may be indicated, but may not always be the first choice of your health care provider. Caesarean sections have their own inherent complications, such as:
·Hemorrhage· Infection
· Pulmonary embolism
· Adhesions· Intestinal obstruction
· Bladder injury
· Uterine rupture
· Higher incidence of ectopic pregnancies (future) and· Placenta praevia
An informed decision is the best decision for your health and the health of your unborn child.
For more information on helping children with brachial plexus injuries, please refer to the following resources:
National Rehabilitation Information Center (NARIC)
4200 Forbes Blvd
Suite 202
Lanham, MD 20706-4829
www.naric.com
Tel: 301-459-5900
United Brachial Plexus Network
k
1610 Kent Street Kent, OH 44240
www.ubpn.org
Tel: 1-866-877-7004
Many brachial plexus injuries are the result of medical malpractice and require the services of an attorney.
For more information about brachial plexus litigation practice, please visit either a legal attorney website specializing in brachial plexus injuries or an Erb's Palsy information website.
Article Source: http://EzineArticles.com/?expert=Tara_Pingle
Friday, July 13, 2007
Emergency Room Errors
Emergency Rooms, or ER's, at hospitals all over the country are the most stressful worksites in the healthcare profession. The standard of care in United States hospitals is high quality. Doctors, nurses, surgeons, and all other healthcare professionals take pride in this. However, the fact remains that malpractice occurs in the medical profession and today's hospitals need to improve the care provided in their Emergency Departments.
Errors in hospital Emergency Rooms are a common occurrence infrequently talked about and rarely reported to the media. That is why you don't hear about these types of cases on the news. Understaffed hospitals, ill-equipped emergency rooms, and poorly trained staff may lead to fatal errors when dealing with patients requiring emergency treatment. Let's face it - when you arrive at your local hospital ER you know absolutely nothing about who will be taking care of you and there is no time to research the competency and track record of the ER staff.
There are many ways that errors or malpractice may occur in Emergency Rooms. The following is a partial list of some of the Emergency Room medical negligence cases we have handled:
Medication Errors
Prescription Errors
Failing to diagnose impending heart attacks and strokes
Diagnosis Errors
Errors in interpreting x-rays, CT scans, and MRI studies
Discharging patients who are critically ill
Over 225,000 people die from medical malpractice related injuries in a single year and nearly half of these deaths are from emergency room errors.
The following is a partial list of the more common medical errors which arise in the Emergency Department:
Failing to administer prophylactic antibiotics in patients with open fractures. An open fracture is one in which the bone has broken through the skin, and as such, these fractures present an increased likelihood of infection. The best outcome for these patients is dependent upon prevention of infection and obtaining a quick union of the fracture. Prophylactic antibiotics reduce the risk of infection and should be given as soon as possible.
Failing to diagnose compartment syndrome in patients with tibial fractures. The tibia is the larger of the two bones of the lower leg and is the weight-bearing bone of the shin. A compartment syndrome is a serious complication which occurs when the pressure in a closed fascial compartment rises sufficiently high to cause nerve and tissue injuries. Without timely diagnosis and treatment, compartment syndrome can cause permanent loss of use or function in the involved extremity (legs or arms). The clinical signs of compartment syndrome include pain out of proportion to the injury, pain on passive range of motion, and loss of distal pulses. Immediate consultation with a surgeon is the preferred course of treatment.
Failing to treat a perirectal abscess in a diabetic patient as an emergency. Patients who are diabetic present many unique challenges to their health care providers. A perirectal or perianal abscess is a pool of pus that forms next to the anus, often causing considerable tenderness and swelling in that area and pain on sitting down and on defecating. These abscesses or infections have a tendency to rapidly progress to deeper, more serious infections in diabetic patients. The abscess can develop into Fournier's gangrene, a life-threatening infections with a reported mortality rate of 9% - 43%. Again, prompt consultation with a surgeon is the preferred course of action.
Failing to provide the proper airway for patients with facial or skull fractures. Establishing and securing an airway is one of the first steps addressed by all Emergency Departments. There are several ways to accomplish this goal but the main techniques are tracheal intubation (either oral or nasal), bag and mask, or a surgical procedure known as a cricothyroidotomy. Emergency physicians should almost never attempt a nasal tracheal intubation in patients with facial or skull fractures due to the possibility of passing the tube into the cranial vault and thereby cause even more serious injuries.
Failing to admit unstable patients or patients with unclear diagnoses to the hospital. Remember, the Emergency Room doctor's first responsibility is to stabilize the patient and then make appropriate decisions about the patient's continuing care needs. Most ER doctors do not have admitting privileges at the hospital - they must contact the patient's regular doctor or the hospital admitting doctor for permission to admit the patient directly from the ER into the hospital. Almost everyone has a story about a friend or family member who was discharged from the Emergency Room returned to their home and within hours or a couple of days suffered a disastrous outcome. Make sure your friend or family member is stable, and with a plan of treatment, before discharge from the ER.
If you or anyone you know has experienced an emergency room error, or any other kind of medical malpractice, please contact us. We are here to help.
T. Daniel Frith, III is an attorney with Frith Law Firm in Roanoke, Virginia. He concentrates his practice on medical malpractice, nursing home abuse, nursing home neglect, lead paint poisoning, and business torts. You may view his complete profile at http://www.frithlawfirm.com/frith.htm and the firm’s home page http://www.frithlawfirm.com
Article Source: http://EzineArticles.com/?expert=Dan_Frith
Errors in hospital Emergency Rooms are a common occurrence infrequently talked about and rarely reported to the media. That is why you don't hear about these types of cases on the news. Understaffed hospitals, ill-equipped emergency rooms, and poorly trained staff may lead to fatal errors when dealing with patients requiring emergency treatment. Let's face it - when you arrive at your local hospital ER you know absolutely nothing about who will be taking care of you and there is no time to research the competency and track record of the ER staff.
There are many ways that errors or malpractice may occur in Emergency Rooms. The following is a partial list of some of the Emergency Room medical negligence cases we have handled:
Medication Errors
Prescription Errors
Failing to diagnose impending heart attacks and strokes
Diagnosis Errors
Errors in interpreting x-rays, CT scans, and MRI studies
Discharging patients who are critically ill
Over 225,000 people die from medical malpractice related injuries in a single year and nearly half of these deaths are from emergency room errors.
The following is a partial list of the more common medical errors which arise in the Emergency Department:
Failing to administer prophylactic antibiotics in patients with open fractures. An open fracture is one in which the bone has broken through the skin, and as such, these fractures present an increased likelihood of infection. The best outcome for these patients is dependent upon prevention of infection and obtaining a quick union of the fracture. Prophylactic antibiotics reduce the risk of infection and should be given as soon as possible.
Failing to diagnose compartment syndrome in patients with tibial fractures. The tibia is the larger of the two bones of the lower leg and is the weight-bearing bone of the shin. A compartment syndrome is a serious complication which occurs when the pressure in a closed fascial compartment rises sufficiently high to cause nerve and tissue injuries. Without timely diagnosis and treatment, compartment syndrome can cause permanent loss of use or function in the involved extremity (legs or arms). The clinical signs of compartment syndrome include pain out of proportion to the injury, pain on passive range of motion, and loss of distal pulses. Immediate consultation with a surgeon is the preferred course of treatment.
Failing to treat a perirectal abscess in a diabetic patient as an emergency. Patients who are diabetic present many unique challenges to their health care providers. A perirectal or perianal abscess is a pool of pus that forms next to the anus, often causing considerable tenderness and swelling in that area and pain on sitting down and on defecating. These abscesses or infections have a tendency to rapidly progress to deeper, more serious infections in diabetic patients. The abscess can develop into Fournier's gangrene, a life-threatening infections with a reported mortality rate of 9% - 43%. Again, prompt consultation with a surgeon is the preferred course of action.
Failing to provide the proper airway for patients with facial or skull fractures. Establishing and securing an airway is one of the first steps addressed by all Emergency Departments. There are several ways to accomplish this goal but the main techniques are tracheal intubation (either oral or nasal), bag and mask, or a surgical procedure known as a cricothyroidotomy. Emergency physicians should almost never attempt a nasal tracheal intubation in patients with facial or skull fractures due to the possibility of passing the tube into the cranial vault and thereby cause even more serious injuries.
Failing to admit unstable patients or patients with unclear diagnoses to the hospital. Remember, the Emergency Room doctor's first responsibility is to stabilize the patient and then make appropriate decisions about the patient's continuing care needs. Most ER doctors do not have admitting privileges at the hospital - they must contact the patient's regular doctor or the hospital admitting doctor for permission to admit the patient directly from the ER into the hospital. Almost everyone has a story about a friend or family member who was discharged from the Emergency Room returned to their home and within hours or a couple of days suffered a disastrous outcome. Make sure your friend or family member is stable, and with a plan of treatment, before discharge from the ER.
If you or anyone you know has experienced an emergency room error, or any other kind of medical malpractice, please contact us. We are here to help.
T. Daniel Frith, III is an attorney with Frith Law Firm in Roanoke, Virginia. He concentrates his practice on medical malpractice, nursing home abuse, nursing home neglect, lead paint poisoning, and business torts. You may view his complete profile at http://www.frithlawfirm.com/frith.htm and the firm’s home page http://www.frithlawfirm.com
Article Source: http://EzineArticles.com/?expert=Dan_Frith
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