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https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#1
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#2
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28081306/tracheal-intubation-in-patients-immobilized-by-a-rigid-collar-a-comparison-of-glidescope-and-an-intubating-laryngeal-mask-airway
#3
Semih Özdil, Zehra İpek Arslan Aydın, Zehra Nur Baykara, Kamil Toker, Zeynep Mine Solak
BACKGROUND/AIM: Intubation must be rapidly performed with the utmost care in cervical trauma patients. We present the first comparison of GlideScope and an intubating laryngeal mask airway (ILMA) regarding insertion and intubation times, intubation success rates, mucosal damage, need for optimization maneuvers, effects on hemodynamic changes, and postoperative minor complications in a simulated cervical injury with a Philadelphia cervical collar. MATERIALS AND METHODS: Ethics committee approval and patient consent were obtained and 94 American Society of Anesthesiology physical status I or II patients were enrolled in this study...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28078473/traumatic-atlantoaxial-rotatory-fixation-in-an-adult-patient
#4
María A García-Pallero, Cristina V Torres, Juan Delgado-Fernández, R G Sola
INTRODUCTION: Atlantoaxial rotational fixation (AARF) is a rare entity in adults, with only a few cases reported in the English literature and often associated with a traumatic mechanism. It is an underdiagnosed condition that must be taken into account in the initial assessment of all craniocervical trauma. Both diagnostic and therapeutic delay may be a potential cause of severe neurological damage or even death of the patient. The therapeutic management is controversial given the difficulty of achieving optimum stability and permanent reduction...
January 11, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28073868/delayed-diagnosis-of-fractured-anterior-arch-of-the-atlas-in-a-young-child
#5
Sergio B Sesia, Friederike Prüfer, Michael Walther, Daniel Studer
A 2-year-old girl fell off a bunk bed onto a parquet floor. She immediately reported neck pain and presented with muscle spasm and limited motion of the cervical spine (C-spine). Plain X-rays of the C-spine showed no osseous lesion. Owing to persisting pain and limited motion in the neck, MRI of the C-spine was obtained which revealed intact ligaments and cervical spinal cord, as well as soft tissue swelling in front of the anterior arch of the atlas. Subsequent CT of the C-spine confirmed a complete, undisplaced fracture of the anterior arch of the atlas (Gehweiler type I fracture)...
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28053621/clinical-and-magnetic-resonance-imaging-features-of-compressive-cervical-myelopathy-with-traumatic-intervertebral-disc-herniation-in-cynomolgus-macaque-macaca-fascicularis
#6
Yun-Jung Choi, Hye-Jin Park, Chul-Ho Sohn, Kyeong Cheon Jung, Seong Hoe Park, Jae-Il Lee
Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord...
December 2016: Laboratory Animal Research
https://www.readbyqxmd.com/read/28041757/comparison-of-the-macintosh-laryngoscope-and-blind-intubation-via-the-igel-for-intubation-with-cervical-spine-immobilization-a-randomized-crossover-manikin-trial
#7
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Lukasz Szarpak, Michael Frass, Oliver Robak
INTRODUCTION: Endotracheal intubation (ETI) using a Macintosh laryngoscope (MAC) requires the head to be positioned in a modified Jackson position, slightly reclined and elevated. Intubation of trauma patients with an injured neck or spine is therefore difficult, since the neck usually cannot be turned or is already immobilized in order to prevent further injury. The iGEL supraglottic airway seems optimal for such conditions due to its blind insertion without the need of a modified Jackson position...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040237/-comparison-of-effectiveness-of-intubation-by-way-of-gum-elastic-bougie-and-intubating-laryngeal-mask-airway-in-endotracheal-intubation-of-patients-with-simulated-cervical-trauma
#8
Esra Yildiz Sut, Solmaz Gunal, Mehmet Akif Yazar, Bayazit Dikmen
PURPOSE: In this study, we evaluated the effectiveness of intubations by way of Gum Elastic Bougie and Intubating Laryngeal Mask Airway in endotracheal intubation of patients with simulated cervical trauma. METHOD: One hundred and thirty four patients were included in the study. All patients were placed cervical collar for a simulated cervical trauma. Patients were allocated randomly into three groups: Group NI (n=45) intubation with Macintosh laryngoscopy, Group GEB (n=45) intubation with Gum Elastic Bougie, and Group ILMA (n=44) intubation with Intubating Laryngeal Mask Airway...
December 28, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28031520/acute-calcification-of-intervertebral-disc-and-posterior-longitudinal-ligament-in-a-7-year-old-girl-a-case-report
#9
Churk Hang Li, Tun Hing Lui, Wai Kit Ngai
A 7-year-old girl presented with a 2-day history of acute neck pain without any preceding injury. The pain was around the left posterior paraspinal muscle and was aggravated by neck movement. There was no neurological abnormality; white cell count and inflammatory markers were slightly elevated. Radiology of the cervical spine showed calcification of C3/4 and C4/5 discs as well as the posterior longitudinal ligament over C3/4. She was treated conservatively with a neck collar and Panadol syrup. No non-steroidal anti-inflammatory drug was prescribed...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27989979/conservative-management-for-odontoid-cervical-fractures-halo-or-rigid-cervical-collar
#10
Fabio Torregrossa, Giovanni Grasso
No abstract text is available yet for this article.
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#11
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27908536/the-sensitivity-and-negative-predictive-value-of-a-pediatric-cervical-spine-clearance-algorithm-that-minimizes-computerized-tomography
#12
Mary Arbuthnot, David P Mooney
BACKGROUND: It is crucial to identify cervical spine injuries while minimizing ionizing radiation. This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm. METHODS: We performed a retrospective review of all children <21years old who were admitted following blunt trauma and underwent cervical spine clearance utilizing our institution's cervical spine clearance algorithm over a 10-year period. Age, gender, International Classification of Diseases 9th Edition diagnosis codes, presence or absence of cervical collar on arrival, Injury Severity Score, and type of cervical spine imaging obtained were extracted from the trauma registry and electronic medical record...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27903343/-investigation-of-the-compliance-of-cervical-collar-therapy-in-73-patients-with-hirayama-disease
#13
Y Fu, W Qin, Q L Sun, D S Fan
Objective: To summarize the therapeutic approaches of patients with Hirayama disease and investigate the patient's compliance to cervical collar therapy and its influencing factors. Methods: This was a retrospectively study.The clinical data of 73 patients was collected from Peking university 3(rd) hospital between 2010 and 2014. Results: (1)Of the 73 patients, 10 patients received surgery, 36 patients received collar therapy , and 27 patients received other conservative therapy at first visit.(2)The mean collar wearing time was from 0...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27893647/cervical-spine-mri-in-patients-with-negative-ct-a-prospective-multicenter-study-of-the-research-consortium-of-new-england-centers-for-trauma-reconect
#14
Adrian A Maung, Dirk C Johnson, Kimberly Barre, Thomas Peponis, Tomaz Mesar, George C Velmahos, Daniel McGrail, George Kasotakis, Ronald I Gross, Michael S Rosenblatt, Kristen C Sihler, Robert J Winchell, Walter Cholewczynski, Kathryn L Butler, Stephen R Odom, Kimberly A Davis
BACKGROUND: Although cervical spine CT (CSCT) accurately detects bony injuries, it may not identify all soft tissue injuries. Although some clinicians rely exclusively on a negative CT to remove spine precautions in unevaluable patients or patients with cervicalgia, others use MRI for that purpose. The objective of this study was to determine the rates of abnormal MRI after a negative CSCT. METHODS: Blunt trauma patients who either were unevaluable or had persistent midline cervicalgia and underwent an MRI of the C-spine after a negative CSCT were enrolled prospectively in eight Level I and II New England trauma centers...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27882535/evaluation-of-three-unchannelled-videolaryngoscopes-and-the-macintosh-laryngoscope-in-patients-with-a-simulated-difficult-airway-a-randomised-controlled-trial
#15
M Kleine-Brueggeney, M Buttenberg, R Greif, S Nabecker, L Theiler
This prospective randomised, controlled trial compares the performance of three unchannelled videolaryngoscopes (KingVision(™) , Airtraq(™) , A.P. Advance(™) MAC) and the standard Macintosh laryngoscope. With ethics committee approval and written informed consent, 480 patients were included. A difficult airway was created with a cervical collar, limiting mouth opening and neck movement. Primary outcome was first-attempt orotracheal intubation success. Overall success, laryngeal view, intubation difficulty scale, handling, intubation times and side-effects were secondary outcomes...
November 24, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27879567/collar-fixation-is-not-mandatory-after-cervical-laminoplasty-a-randomized-controlled-trial
#16
Tetsuro Hida, Yoshihito Sakai, Kenyu Ito, Sadayuki Ito, Shiro Imagama, Naoki Ishiguro, Atsushi Harada
STUDY DESIGN: Prospective randomized controlled study OBJECTIVES.: To determine the effect of collar-aided fixation on outcomes following laminoplasty for cervical compressive myelopathy. SUMMARY OF BACKGROUND DATA: Patients are often placed in a Philadelphia collar for weeks after cervical laminoplasty. However, the benefit of postoperative collar use remains controversial. We hypothesized that treatment outcomes in postoperative pain in patients without collars would not be inferior to the outcomes in patients using Philadelphia collars for two weeks...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27851553/1918-negative-pressure-pulmonary-edema-due-to-tight-cervical-collar-a-rare-event
#17
Priyanka Srivastav, Karthikeyan Sitaraman
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27797983/efficacy-of-various-types-of-laryngoscope-direct-pentax-airway-scope-and-glidescope-for-endotracheal-intubation-in-various-cervical-immobilisation-scenarios-a-randomised-cross-over-simulation-study
#18
Jong Won Kim, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Young Hwan Lee, Sang O Park
OBJECTIVE: To compare the efficacy of direct laryngoscopy (DL), Pentax Airway Scope (PAWS) and GlideScope video laryngoscope (GVL) systems for endotracheal intubation (ETI) in various cervical immobilisation scenarios: manual in-line stabilisation (MILS), Philadelphia neck collar (PNC) (moderate limit of mouth opening) and Stifneck collar (SNC) (severe limit of mouth opening). DESIGN: Randomised cross-over simulation study. SETTING AND PARTICIPANTS: 35 physicians who had >30 successful ETI experiences at a tertiary hospital in Seoul, Korea...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27753697/kinematic-effects-of-cervical-laminoplasty-for-cervical-spondylotic-myelopathy-on-the-occipitoatlantoaxial-junction
#19
Asuka Desroches, Yuichiro Morishita, Itaru Yugue, Takeshi Maeda, Charles-Henri Flouzat-Lachaniette, Philippe Hernigou, Keiichiro Shiba
STUDY DESIGN: A retrospective evaluation of sagittal angular motion from cervical spinal flexion to extension. OBJECTIVE: To evaluate the kinematic effects of cervical laminoplasty for cervical spondylotic myelopathy (CSM) on the occipitoatlantoaxial junction. SUMMARY OF BACKGROUND DATA: The kinematic effects of cervical laminoplasty for CSM on the occipitoatlantoaxial junction remain controversial. METHODS: A total of 65 CSM patients who were treated with cervical laminoplasty ranging from the C3 to C7 vertebrae were included in the study...
October 6, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27748690/cervical-spine-immobilization-during-extrication-of-the-awake-patient-a-narrative-review
#20
Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
September 29, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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