Papers by Joshua Lightfoot
Dear Editor, Patients with acute behavioural disturbances are a common occurrence in EDs. Previou... more Dear Editor, Patients with acute behavioural disturbances are a common occurrence in EDs. Previous studies in Australian EDs have shown that over 1% of presentations require security staff intervention and the majority of clinical staff are exposed to some form of violence at least weekly. The management of this cohort of patients is complex, often requiring the involvement of a large number of medical, nursing and security staff. The addition of the possible presence of high consequence infectious diseases such as Coronavirus 2019 (COVID-2019) to non-compliant, behavioural disturbed patients poses a unique threat to staff, other patients and members of the public. Current discussion and planning for ED management of COVID-19 patients has almost entirely been in relation to either the compliant or the severely unwell patient. However, it is unlikely that the proportion of patients with acute behavioural disturbance will be significantly different within the COVID-19 population. Inde...
Karger Kompass Pneumologie
Hintergrund: In der Literatur werden nur wenige Fälle von multiplen Bronchusstenosen beschrieben,... more Hintergrund: In der Literatur werden nur wenige Fälle von multiplen Bronchusstenosen beschrieben, und keiner von vergleichbarer Schwere wie der unsere. Dieser Fall ist von Relevanz aufgrund seiner Seltenheit, der zu gewinnenden pathophysiologischen Erkenntnisse, der erfolgreich angewandten interventionell-pneumologischen Behandlungsstrategien, und seiner möglichen Beispielrolle für eine seltene Indikation für eine Hochrisiko-Lungentransplantation. Vorstellung des Falls: Bei einem 47-jährigen Mann traten multiple rezidivierende netzartige Bronchusstenosen auf, 5 Wochen nachdem er eine Episode schwerer Tracheobronchitis durchgemacht hatte, die vermutlich durch eine chemische Inhalationsverletzung verursacht worden war und zunächst zum vollständigen
BMC Pulmonary Medicine
Background: There are few cases of multiple bronchial stenoses reported in the literature and non... more Background: There are few cases of multiple bronchial stenoses reported in the literature and none of the severity described here. The case is relevant due to its rareness, the pathophysiological insights derived, the successful interventional pulmonology strategies demonstrated, and as an example of a rare indication for high-risk lung transplantation. Case presentation: A 47-year-old man developed multiple recurrent bronchial web-like stenoses five weeks after an episode of severe tracheo-bronchitis presumed secondary to a chemical inhalation injury which initially caused complete bilateral lung collapse necessitating veno-venous extracorporeal membrane oxygenation. The stenoses completely effaced bronchi in many locations causing severe type II respiratory failure requiring mechanical ventilation and bronchoscopic puncture / dilatation then ultimately bilateral lung transplantation. Conclusion: This very rare case highlights the morbid sequelae that can arise after catastrophic tracheobronchitis which now, in the era of extracorporeal membrane oxygenation, may be survivable in the short-term.
Emergency Medicine Australasia
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Papers by Joshua Lightfoot