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door to ct time in trauma patients

Kuo-Chen Huang, Yan-Ren Lin, Yuan-Jhen Syue, Chia-Te Kung, I-Min Chiu, Chao-Jui Li
BACKGROUND: There are fewer female emergency physicians (EPs) than male ones. This study attempted to analyze the differences in clinical practice between female and male EPs in the emergency department (ED). MATERIALS AND METHODS: A retrospective, 1-year cohort study was conducted across 4 EDs in the largest healthcare system in Taiwan. A total of 199,757 adult patients without trauma treated by 76 EPs (9 females and 67 males) were included in the study. The clinical practice of female and male EPs was compared...
March 2018: American Journal of the Medical Sciences
Philippe De Vloo, Stefaan Nijs, Sandra Verelst, Johannes van Loon, Bart Depreitere
OBJECTIVE: According to level 2 evidence, earlier evacuation of acute subdural or epidural hematomas necessitating surgery is associated with better outcome. Hence, guidelines recommend performing these procedures "immediately". Literature on extent and causes of pre- and intra-hospital intervals in trauma patients requiring emergent craniotomies is almost completely lacking. Studies delineating and refining the interval before thrombolytic agent administration in ischemic stroke have dramatically reduced the "door-to-needle time"...
March 13, 2018: World Neurosurgery
Mischa Braun, Wolf Ulrich Schmidt, Martin Möckel, Michael Römer, Christoph J Ploner, Tobias Lindner
BACKGROUND: Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. METHODS: We implemented a new interdisciplinary standard operating procedure (SOP) for patients presenting with non-traumatic coma of unknown origin. It includes a new in-house triage process, a new alert call, a new composition of the clinical response team and a new management algorithm (altogether termed "coma alarm")...
April 27, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Jon W Schrock, Marija Lum
OBJECTIVE: Target stroke guidelines recommend a door-to-needle time of ≤60 minutes for acute ischemic stroke (AIS) patients treated with intravenous (IV) tissue-type plasminogen activator (tPA). We sought to analyze all diagnostic steps involved in the acute evaluation and treatment of AIS with IV tPA and to look for causes of delay in door to needle time (DNT). METHODS: A review of AIS patients treated in the emergency department with IV tPA. Times comparing intervals from door to head computed tomography (CT), CT result, electrocardiogram (ECG), chest radiograph, and IV tPA treatment...
November 2014: American Journal of Emergency Medicine
Ehrin J Armstrong, Ameya R Kulkarni, Kurt S Hoffmayer, Prashant D Bhave, John S MacGregor, Priscilla Hsue, John C Stein, Scott Kinlay, Peter Ganz, James M McCabe
Patients presenting with suspected ST-segment elevation myocardial infarction (STEMI) may have important alternative diagnoses (e.g., aortic dissection, pulmonary emboli) or safety concerns for STEMI management (e.g., head trauma). Computed tomographic (CT) scanning may help in identifying these alternative diagnoses but may also needlessly delay primary percutaneous coronary intervention (PCI). We analyzed the ACTIVATE-SF Registry, which consists of consecutive patients with a clinical diagnosis of STEMI admitted to the emergency departments of 2 urban hospitals...
August 1, 2012: American Journal of Cardiology
Ryan M Neinstein, John H Phillips, Christopher R Forrest
INTRODUCTION: Trauma to the pediatric orbit may produce a unique fracture in which entrapment of the periorbital tissue and/or inferior rectus muscle may occur due to a "trap-door" effect of the compliant orbital floor. This study was designed to assess the outcome following the surgical management of orbital trapdoor fractures in children and to examine alterations in the morphology of the inferior rectus (IR) muscle. METHODOLOGY: Outcome assessment on patients undergoing surgery at the Hospital For Sick Children, Toronto with symptomatic orbital floor trapdoor fractures over a 10-year period and a CT-based morphometric analysis of the inferior rectus muscle were performed...
July 2012: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Marcin Kos, Daniel Brusco, Werner Engelke
UNLABELLED: Orbital fractures are one of the most frequent consequences following midfacial trauma. If not treated they can lead to serious optical complications as: double vision (diplopia), restriction of ocular motility, eyeball sinking (enophthalmos). Autogenic bone grafts although still wide and effectively used for reconstruction of the fractured orbital walls present some disadvantages. This is morbidity of the donor site, unforeseen resorption, time-consuming procedure and longer postoperative care...
2006: Polimery W Medycynie
K Satomi, J Ogawa, Y Ishii, K Hirabayashi
BACKGROUND CONTEXT: Laminoplasty has been reported to achieve good operative results for treatment of cervical stenotic myelopathy. However, long-term results and prognostic factors have not been well documented. Among postoperative complications, weakness of the shoulder girdle muscles has been reported as a particular complication of laminoplasty, but the cause is still poorly understood. PURPOSE: Our aim was to clarify the short-term complications and long-term operative results after unilateral open-door laminoplasty and to identify the predictors for operative outcome...
January 2001: Spine Journal: Official Journal of the North American Spine Society
A Seichi, K Takeshita, I Ohishi, H Kawaguchi, T Akune, Y Anamizu, T Kitagawa, K Nakamura
STUDY DESIGN: A retrospective study of the long-term results from double-door laminoplasty (Kurokawa's method) for patients with myelopathy caused by ossification of the posterior longitudinal ligament and cervical spondylosis was performed. OBJECTIVE: To know whether the short-term results from double-door laminoplasty were maintained over a 10-year period and, if not, the cause of late deterioration. SUMMARY OF BACKGROUND DATA: There are few long-term follow-up studies on the outcome of laminoplasty for cervical stenotic myelopathy...
March 1, 2001: Spine
W Hartel, J W Weidringer, L Lampl, K H Bock
Between 50 to 60% of all polytraumatized patients have a thoracic injury with a mortality of 30 to 60%. The first diagnostic steps involving symptoms such as in- or expiratory pain, emphysema of the skin, flail chest or sipping noise lead via clinical examination to first and often definitive therapeutic procedures, i.e. intubation, artificial respiration and insertion of chest tube. X-ray of the chest, computed tomography as well as ultrasonic screening and monitoring of arterial blood gases are important in in-door technical diagnosis...
1990: Langenbecks Archiv Für Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft Für Chirurgie
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