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https://www.readbyqxmd.com/read/28225743/damage-control-resuscitation-in-patients-with-severe-traumatic-hemorrhage-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#1
Jeremy W Cannon, Mansoor A Khan, Ali S Raja, Mitchell J Cohen, John J Como, Bryan A Cotton, Joseph J Dubose, Erin E Fox, Kenji Inaba, Carlos J Rodriguez, John B Holcomb, Juan C Duchesne
BACKGROUND: The resuscitation of severely injured bleeding patients has evolved into a multi-modal strategy termed damage control resuscitation (DCR). This guideline evaluates several aspects of DCR including the role of massive transfusion (MT) protocols, the optimal target ratio of plasma (PLAS) and platelets (PLT) to red blood cells (RBC) during DCR, and the role of recombinant activated factor VII (rVIIa) and tranexamic acid (TXA). METHODS: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a subcommittee of the Practice Management Guidelines (PMG) Section of EAST conducted a systematic review using MEDLINE and EMBASE...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28215195/tetanus-a-potential-public-health-threat-in-times-of-disaster
#2
Paige Finkelstein, Laura Teisch, Casey J Allen, Gabriel Ruiz
BACKGROUND: Tetanus is a potentially fatal condition that is rare in urban environments but is seen in developing countries and post-natural-disaster. Therefore, the purpose of this report was to review the epidemiology, pathogenesis, and management of tetanus in the trauma patient. METHODS: A thorough literature review was conducted to look for the most current and thorough guidelines on the prophylaxis and treatment of tetanus. PUBMED (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), MEDLINE (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), and Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom) databases were searched for articles in English, published from 2005 to 2015, using the keywords "Tetanus," "Trauma/Surgery," and "Disaster...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#3
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28193544/current-approach-to-liver-traumas
#4
Levent Kaptanoglu, Necmi Kurt, Hasan Ediz Sikar
INTRODUCTION: Liver injuries remain major obstacle for successful treatment, due to size and location of the liver. Requirement for surgery should be determined by clinical factors, most notably hemodynamical state. In this present study we tried to declare our approach to liver traumas. We also tried to emphasize the importance of conservative treatment, since surgeries for liver traumas carry high mortality rates. PRESENTATION OF CASE: Patients admitted to the Department of Emergency Surgery at Kartal Research and Education Hospital, due to liver trauma were retrospectively analyzed between 2003 and 2013...
February 11, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28192378/analysis-and-management-of-complications-in-a-cohort-of-1-065-minimally-invasive-cochlear-implantations
#5
Yi Jiang, Ping Gu, Beicheng Li, Xue Gao, Baochun Sun, Yueshuai Song, Guojian Wang, Yongyi Yuan, Cuicui Wang, Miao Liu, Dongyi Han, Pu Dai
OBJECTIVES: To analyze complications associated with minimally invasive cochlear implantation by comparing data from different centers, to discuss major reasons for complications, and to refine implantation techniques to decrease them. PATIENTS: Patients who underwent cochlear implantation at our center by the same surgeon (the corresponding author of this article) from March 2006 to March 2015 were enrolled. INTERVENTION: First, a retrospective analysis of the complications associated with minimally invasive cochlear implantation at our center was performed...
March 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28190515/early-experience-with-a-split-bolus-single-pass-ct-protocol-in-paediatric-trauma
#6
V J Leung, M Grima, N Khan, H R Jones
AIM: To determine the adequacy of the split-bolus computed tomography (CT) technique in terms of vascular enhancement and solid-organ injury assessment in paediatric trauma. MATERIALS AND METHODS: A retrospective review was undertaken of all split-bolus trauma CT examinations performed in patients <16 years during the period from 1 January 2015 to 31 January 2016. Twelve examinations were performed in this time on patients with an age range of 2-15 years (mean 10...
February 9, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28188036/outcomes-of-an-accelerated-care-pathway-for-pediatric-blunt-solid-organ-injuries-in-a-public-healthcare-system
#7
Oluwatomilayo Daodu, Mary Brindle, Carlos R Alvarez-Allende, Lisette Lockyer, Bryce Weber, Steven R Lopushinsky
PURPOSE: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed. METHODS: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015. Patients were subdivided into pre- and post-protocol groups. Length of hospital stay (LOS) and failure of non-operative treatment were the primary outcomes of interest...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#8
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186700/retrospective-study-of-mortality-in-asiatic-lions-panthera-leo-persica-in-the-european-breeding-population-between-2000-and-2014
#9
Olivia Metz, Jonathan Williams, Rikke Kruse Nielsen, Nic Masters
Although the European population of Asiatic lions (Panthera leo persica) has been managed under the European Endangered Species Program (EEP) since 1990, little is known about the health status of the population. This study was designed to characterize mortality for this population through examination of the studbook and other records on 392 Asiatic lions living in the EEP between 2000 and 2014. A total of 270 animals died during the period with 80% of them being under 1 year old. The mortality rate for under 1 year olds was 54%, while the odds of survival of cubs within a litter increased if the dam had had litters previously...
January 2017: Zoo Biology
https://www.readbyqxmd.com/read/28184955/-tranexamic-acid-in-the-german-emergency-medical-service-a%C3%A2-national-survey
#10
V Zickenrott, I Greb, A Henkelmann, F Balzer, S Casu, L Kaufner, C von Heymann, K Zacharowski, C F Weber
BACKGROUND: Trauma-induced coagulopathy, one of the leading causes of trauma-related death, is detected in about one of four trauma patients upon hospital admission. The current European Management of Major Bleeding and Coagulopathy Following Trauma guidelines, published in 2013, recommend that tranexamic acid (TXA) be administered as early as possible to inhibit hyperfibrinolysis (grade of recommendation (GoR 1A)). Furthermore, it is suggested that protocols for the management of patients with bleeding or showing signs of bleeding include the administration of the first dose of TXA at the site of injury or during transportation to hospital (GoR 2C)...
February 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28181114/injury-to-the-male-external-genitalia-a-comprehensive-review
#11
REVIEW
James Furr, Daniel Culkin
While rare, trauma and injury to the male external genitalia can result in significant consequences regarding function, appearance, psychological effects, and overall quality of life. Due to the relative paucity of literature regarding male external genitalia injuries, few standardized protocols exist. This review aims to outline common clinical causes of male external genitalia injuries by both anatomic location and etiology. Initial stabilization, long-term reconstruction, and coverage options are discussed in detail...
February 8, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28166840/app-based-serious-gaming-for-training-of-chest-tube-insertion-study-protocol-for-a-randomized-controlled-trial
#12
Mirco Friedrich, Christian Bergdolt, Patrick Haubruck, Thomas Bruckner, Karl-Friedrich Kowalewski, Beat Peter Müller-Stich, Michael C Tanner, Felix Nickel
BACKGROUND: Chest tube insertion is a standard intervention for management of various injuries of the thorax. Quick and accurate execution facilitates efficient therapy without further complications. Here, we propose a new training concept comprised of e-learning elements as well as continuous rating using an objective structured assessment of technical skills (OSATS) tool. The study protocol is presented for a randomized trial to evaluate e-learning with app-based serious gaming for chest drain insertion...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28165797/strategies-of-enhancing-bone-regenerate-formation-in-distraction-osteogenesis
#13
Mohammad Mesfer Alzahrani, Emad Anam, Saad M AlQahtani, Asim M Makhdom, Reggie C Hamdy
Distraction osteogenesis (DO) is a commonly used technique in multiple orthopaedic specialties, including trauma, oncology and pediatrics. This technique aims to produce new bone formation in the distraction gap in a controlled manner. The issue with this technique has been the high risk of complications, one of which is poor regenerate formation during the distraction process. Although several factors (including patient and operative factors) and techniques (including surgical, mechanical and pharmacological) have been described to ensure successful regenerate formation during the process of DO, these factors are sometimes difficult to control clinically...
February 6, 2017: Connective Tissue Research
https://www.readbyqxmd.com/read/28151829/haemotherapy-algorithm-for-the-management-of-trauma-induced-coagulopathy-an-australian-perspective
#14
James Winearls, Biswadev Mitra, Michael C Reade
PURPOSE OF REVIEW: Recent advances in the understanding of the pathophysiological processes associated with traumatic haemorrhage and trauma-induced coagulopathy have resulted in improved outcomes for seriously injured trauma patients. However, a significant number of trauma patients still die from haemorrhage. This article reviews the various transfusion strategies utilized in the management of traumatic haemorrhage and describes the major haemorrhage protocol (MHP) strategy employed by an Australian trauma centre...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28131117/identification-and-management-of-obstetric-hemorrhage
#15
REVIEW
Emily J Baird
Obstetric hemorrhage remains the leading cause of maternal death and severe morbidity worldwide. Although uterine atony is the most common cause of peripartum bleeding, abnormal placentation, coagulation disorders, and genital tract trauma contribute to adverse maternal outcomes. Given the inability to reliably predict patients at high risk for obstetric hemorrhage, all parturients should be considered susceptible, and extreme vigilance must be exercised in the assessment of blood loss and hemodynamic stability during the peripartum period...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28101655/percutaneous-vertebral-augmentation-in-fragility-fractures-indications-and-limitations
#16
O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
January 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28099390/to-nearly-come-full-circle-nonoperative-management-of-high-grade-iv-v-blunt-splenic-trauma-is-safe-utilizing-a-protocol-with-routine-angioembolization
#17
Indermeet S Bhullar, Joseph J Tepas, Daniel Siragusa, Todd Loper, Andrew Kerwin, Eric R Frykberg
INTRODUCTION: Nonoperative management (NOM) of hemodynamically stable high grade (IV-V) blunt splenic trauma (BST) remains controversial given the high failure rates (19%) that persist despite angioembolization (AE) protocols. The NOM protocol was modified in 2011 to include mandatory AE of all grade (IV-V) injuries without CB along with selective AE of grade (I-V) with CB. The purpose of this study was to determine if this new AE protocol significantly lowered the failure rates for grade (IV-V) injuries allowing for safe observation without surgery and if the exclusion of grade III injuries allowed for the prevention of unnecessary angiograms without affecting the overall failure rates...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28096576/role-of-edaravone-in-managemant-of-septic-peritonitis
#18
Ghada Fouad Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP). MATERIAL AND METHODS: This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28092169/national-athletic-trainers-association-position-statement-management-of-acute-skin-trauma
#19
Joel W Beam, Bernadette Buckley, William R Holcomb, Mario Ciocca
OBJECTIVE:   To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. BACKGROUND:   Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications...
December 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#20
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
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