Multiple trauma in the achondroplastic dwarf: An emergency medicine physician perspective case report and literature review

David M. Dvorak, Robert A. Rusnak, Jacques Morcos

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Although uncommon, the achondroplastic dwarf (AD) may become the victim of multiple trauma, presenting special challenges for the emergency department (ED) physician. Traditional management of airway, breathing, circulation, and neurological disability is altered by the unique anatomic features of achondroplasia. Despite facial abnormalities observed in the AD, orotracheal and nasotracheal intubation are usually accomplished without particular difficulty; however, abnormalities of the base of the skull and cervical spine make hyperextension of the neck especially hazardous in these patients. The lungs are functionally normal, although vital capacity is decreased and thoracic case abnormalities and abdominal obesity impair lung expansion. Vascular access in the AD is difficult. Peripheral access is difficult because of excessive subcutaneous fat, whereas central venous access is complicated by neck, chest wall, and spinal abnormalities that obscure commonly used anatomic landmarks. Major neurological syndromes observed in ADs are hydrocephalus, cervical medullary compression, and thoracolumbar stenosis. The ED physician should recognize these syndromes, their potential to produce neurological disability, and their unique implications for trauma.

Original languageEnglish
Pages (from-to)390-395
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume11
Issue number4
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Emergency Medicine
Multiple Trauma
Hospital Emergency Service
Neck
Achondroplasia
Anatomic Landmarks
Physicians
Lung
Airway Management
Abdominal Obesity
Subcutaneous Fat
Vital Capacity
Skull Base
Thoracic Wall
Hydrocephalus
Intubation
Blood Vessels
Pathologic Constriction
Respiration
Spine

Keywords

  • Achondroplasia
  • dwarfism
  • massive epidural hematoma
  • trauma management

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Multiple trauma in the achondroplastic dwarf : An emergency medicine physician perspective case report and literature review. / Dvorak, David M.; Rusnak, Robert A.; Morcos, Jacques.

In: American Journal of Emergency Medicine, Vol. 11, No. 4, 01.01.1993, p. 390-395.

Research output: Contribution to journalArticle

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