1887
Volume 2022 Number 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

: The diaphragm is a musculotendinous structure providing a significant drive for respiration and lung expansion during inspiration. The other muscles aiding in ventilation are intercostal, abdominal, and accessory muscles, including sternocleidomastoid and scalene.1 Direct neck trauma, either blunt or penetrating, potentially can contribute to diaphragmatic paralysis related to phrenic nerve palsy.2 The use of ultrasound to confirm diaphragmatic paralysis is growing and becoming an alternative to conventional investigations, including fluoroscopy which is a gold standard.3: A middle-aged man was found lying on the road with neck and upper back pain following a frontal collision with a bus. He was a restrained car driver at the time of the impact and was eventually brought by ambulance to the Emergency Department (ED). He had no breathing difficulty although, in the chest x-ray, the right hemidiaphragm was found to be raised (Figure 1). Bedside ultrasound showed no right hemidiaphragm movement assessed in B-Mode (Figure 2). In M-Mode, it showed a flat excursion and minimal change in thickness of the right hemidiaphragm compared to the left. He was managed conservatively with a cervical collar, analgesia, and admitted to the trauma ward for observation and discharged on day 5 with the diagnosis of transient right-sided diaphragmatic paralysis recovered fully as evident with reduced height differential between hemidiaphragm on repeat chest x-ray done one day before discharge, and C1 transverse process and C7 right lamina fracture. The use of bedside ultrasound is critical in suspected traumatic diaphragmatic paralysis during a secondary or tertiary survey to avoid high-risk transfers and the prevention of secondary injuries. : Bedside ultrasound has characteristics that make it an ideal tool to use in ED to improve patient safety and optimize resource utilization. Hence; its use is highly recommended. However, further research is needed to determine its effectiveness in traumatic patients for diaphragm paralysis.

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2022-01-15
2022-05-17
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References

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  • Article Type: Conference Abstract
Keyword(s): Bedside UltrasoundDiaphragmParalysisPatient assessment and Trauma
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