One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatra...One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatran despite recurrent falls. Due to a ground-level-fall, he suffered from subarachnoidal and intraparenchymal hemorrhages, subdural hematoma and brain edema with a midline shift. Despite osteoelast/c trepanation and hematoma-evacuation he remained comatose and died seven days later without regaining consciousness. Most probably, decreased dabigatran clearance due to increased age might have contributed to the fatal course. We suggest withholding anticoagulant therapy in patients with unexplained falls. If anticoagulant therapy is deemed necessary, vitamin-K-antagonists with their potential for laboratory monitoring and reversal of anticoagulant activity should be preferred.展开更多
A coal burst occurred on 15 April, 2014 at the Austar Coal Mine, located west of Newcastle, NSW,Australia. The burst resulted in fatal injuries to two men working as part of the mining crew at the development face. At...A coal burst occurred on 15 April, 2014 at the Austar Coal Mine, located west of Newcastle, NSW,Australia. The burst resulted in fatal injuries to two men working as part of the mining crew at the development face. At the time, a continuous miner was being used to mine a longwall development gate road through heavily structured coal, at a depth of approximately 550 m. A number of pre-cursor bumps had occurred on previous shifts, emanating from the coal ribs of the roadway, in proximity to the coal face.This paper reviews the geological, geotechnical and mining conditions and circumstances leading up to the coal burst event; and presents and discusses the available evidence and possible interpretations relating to the geomechanical behaviour mechanisms that may have been critical factors in this incident. The paper also discusses some key technical and operational considerations of ground support systems and mining practices and strategies needed for operating in such conditions in the future.展开更多
文摘One disadvantage of direct anticoagulant drug is the lack of an antidote, which may become relevant in patients with traumatic brain in- jury. A 77-years old man with atrial fibrillation and syncope received dabigatran despite recurrent falls. Due to a ground-level-fall, he suffered from subarachnoidal and intraparenchymal hemorrhages, subdural hematoma and brain edema with a midline shift. Despite osteoelast/c trepanation and hematoma-evacuation he remained comatose and died seven days later without regaining consciousness. Most probably, decreased dabigatran clearance due to increased age might have contributed to the fatal course. We suggest withholding anticoagulant therapy in patients with unexplained falls. If anticoagulant therapy is deemed necessary, vitamin-K-antagonists with their potential for laboratory monitoring and reversal of anticoagulant activity should be preferred.
文摘A coal burst occurred on 15 April, 2014 at the Austar Coal Mine, located west of Newcastle, NSW,Australia. The burst resulted in fatal injuries to two men working as part of the mining crew at the development face. At the time, a continuous miner was being used to mine a longwall development gate road through heavily structured coal, at a depth of approximately 550 m. A number of pre-cursor bumps had occurred on previous shifts, emanating from the coal ribs of the roadway, in proximity to the coal face.This paper reviews the geological, geotechnical and mining conditions and circumstances leading up to the coal burst event; and presents and discusses the available evidence and possible interpretations relating to the geomechanical behaviour mechanisms that may have been critical factors in this incident. The paper also discusses some key technical and operational considerations of ground support systems and mining practices and strategies needed for operating in such conditions in the future.
