Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature

We report a case of fatal pulmonary embolism (PE) following exsanguinations of lower limb in orthopedic surgery. A 30-year-old man was posted for fixation of a tibial plateau fracture on the seventh day after injury. Subarchnoid block was performed. Esmarch bandage was used for exsanguination of the...

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Main Authors: Sameer Desai, P G Prashantha, S V Torgal, R Rao
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2013-01-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:http://www.saudija.org/article.asp?issn=1658-354X;year=2013;volume=7;issue=3;spage=331;epage=335;aulast=Desai
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author Sameer Desai
P G Prashantha
S V Torgal
R Rao
author_facet Sameer Desai
P G Prashantha
S V Torgal
R Rao
author_sort Sameer Desai
collection DOAJ
description We report a case of fatal pulmonary embolism (PE) following exsanguinations of lower limb in orthopedic surgery. A 30-year-old man was posted for fixation of a tibial plateau fracture on the seventh day after injury. Subarchnoid block was performed. Esmarch bandage was used for exsanguination of the limb and tourniquet was inflated. Within three minutes after tourniquet inflation, the patient became unconscious hypotensive, and collapsed. Resuscitation was instituted and spontaneous circulation restored. Right ventricular strain pattern on transthoracic echocardiography, increased levels of D-dimer, and Doppler examination of the lowerlimb confirmed deep venous thrombosis of right femoral vessels and PE. In spite of thrombolytic therapy with streptokinase and heparin, the patient died on the ninth day after the event. Cases of PE secondary to the use of Esmarch bandage and tourniquet are reviewed here to identify the risk groups and management of PE.
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spelling doaj.art-12802c4ed61040ee9ac47c738eaac2092022-12-21T22:08:20ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2013-01-017333133510.4103/1658-354X.115325Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literatureSameer DesaiP G PrashanthaS V TorgalR RaoWe report a case of fatal pulmonary embolism (PE) following exsanguinations of lower limb in orthopedic surgery. A 30-year-old man was posted for fixation of a tibial plateau fracture on the seventh day after injury. Subarchnoid block was performed. Esmarch bandage was used for exsanguination of the limb and tourniquet was inflated. Within three minutes after tourniquet inflation, the patient became unconscious hypotensive, and collapsed. Resuscitation was instituted and spontaneous circulation restored. Right ventricular strain pattern on transthoracic echocardiography, increased levels of D-dimer, and Doppler examination of the lowerlimb confirmed deep venous thrombosis of right femoral vessels and PE. In spite of thrombolytic therapy with streptokinase and heparin, the patient died on the ninth day after the event. Cases of PE secondary to the use of Esmarch bandage and tourniquet are reviewed here to identify the risk groups and management of PE.http://www.saudija.org/article.asp?issn=1658-354X;year=2013;volume=7;issue=3;spage=331;epage=335;aulast=DesaiEsmarch bandagelower limb fracturespulmonary embolismtourniquet
spellingShingle Sameer Desai
P G Prashantha
S V Torgal
R Rao
Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature
Saudi Journal of Anaesthesia
Esmarch bandage
lower limb fractures
pulmonary embolism
tourniquet
title Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature
title_full Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature
title_fullStr Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature
title_full_unstemmed Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature
title_short Fatal pulmonary embolism subsequent to the use of Esmarch bandage and tourniquet: A case report and review of literature
title_sort fatal pulmonary embolism subsequent to the use of esmarch bandage and tourniquet a case report and review of literature
topic Esmarch bandage
lower limb fractures
pulmonary embolism
tourniquet
url http://www.saudija.org/article.asp?issn=1658-354X;year=2013;volume=7;issue=3;spage=331;epage=335;aulast=Desai
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