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"Trauma" AND "Thoracotomy" AND "Emergency"

Kaori Ito, Kahoko Nakazawa, Tsuyoshi Nagao, Hirohito Chiba, Yasufumi Miyake, Tetsuya Sakamoto, Takashi Fujita
BACKGROUND: Our institution has emergency rooms (ERs) with an operating room (OR) setup, which enables surgeons to perform thoracotomy and/or laparotomy for trauma patients without transferring patients to the OR. We hypothesized that the ERs with an OR setup improve the timeliness of surgery for trauma patients. MATERIALS AND METHODS: Data were reviewed from trauma patients who underwent emergency surgeries performed by our acute care surgery group from April 2013 to June 2017...
December 2018: Journal of Surgical Research
Bellal Joseph, Muhammad Khan, Faisal Jehan, Rifat Latifi, Peter Rhee
Background: Advancement in trauma care has led to the evolution of emergency resuscitative thoracotomy (ERT) for the revival of trauma patients. We now have more precise understanding of selecting suitable patients for achieving optimal outcomes. The aim of our study was to analyze the utilization and survival trends during the past 5 years, as well as factors that influence survival after ERT. Methods: A 5-year (2010-2014) analysis of all trauma patients ≥18 years who underwent ERT in the American College of Surgeons Trauma Quality Improvement Program...
2018: Trauma surgery & acute care open
Christopher J Goodenough, Tyler A Cobb, John B Holcomb
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. An 83-year-old man with multiple medical comorbidities and a history of chronic mesenteric ischemia was admitted to our institution for an elective mesenteric revascularization...
2018: Trauma surgery & acute care open
Antônio Oliveira de Araújo, Fernando Luiz Westphal, Luiz Carlos de Lima, Jéssica de Oliveira Correia, Pedro Henrique Gomes, Emanoel Nascimento Costa, Luciana Macedo Level Salomão, Cleinaldo Nascimento Costa
OBJECTIVE: to determine the frequency of fatal cardiac trauma in the city of Manaus, Brazil, between November 2015 and October 2016, and to clarify the mechanisms of trauma and death, previous hospital treatment, as well as the injuries associated with cardiac trauma. METHODS: retrospective, observational, and cross-sectional study, which reviewed the necropsy reports of individuals whose cause of death was cardiac injury. RESULTS: the cardiac trauma rate was of 5...
October 4, 2018: Revista do Colégio Brasileiro de Cirurgiões
Koshi Ota, Satoshi Fumimoto, Ryo Iida, Takayuki Kataoka, Kanna Ota, Kohei Taniguchi, Nobuharu Hanaoka, Akira Takasu
BACKGROUND: Massive hemothorax resulting from a minor injury mechanism is considered to be rare particularly when the diaphragm is injured. We report a case of massive hemothorax with bleeding from the intercostal artery and diaphragmatic damage caused by minor blunt trauma. CASE PRESENTATION: An 83-year-old Japanese man was transported to our hospital 3 hours after falling out of bed. Computed tomography revealed hemothorax and multiple rib fractures. He underwent fluid resuscitation and a tube thoracostomy, but he became hemodynamically unstable...
October 7, 2018: Journal of Medical Case Reports
Kenji Kandori, Wataru Ishii, Ryoji Iiduka
INTRODUCTION: Systemic arterial air embolism (SAAE) is a rare but fatal condition, with only a few cases reported, and the detailed etiology underlying SAAE remains unknown. We report a first case of massive SAAE after blunt chest injury, wherein the presence of traumatic air shunt was confirmed by direct observation during surgery. We also summarize our experience with six other SAAE cases. PRESENTATION OF CASE: A 68-year-old woman was admitted in a state of cardiac arrest after a fall...
2018: International Journal of Surgery Case Reports
Fareed Cheema, Carrie Garcia, Aksim G Rivera, Edward Chao
: Hemorrhage is the leading cause of preventable death in trauma patients. In recent years, technological innovations and research efforts aimed at preventing death from hemorrhagic shock have resulted in the emergence of resuscitative endovascular balloon occlusion of the aorta (REBOA). REBOA offers a less invasive option for emergent hemorrhage control in noncompressible areas of the body without the added risks and morbidities of an ED thoracotomy. This article outlines the procedure and device used, describes the procedure's evolution, and discusses various considerations, pitfalls, and nursing implications...
October 2018: American Journal of Nursing
Tristan Monchal, Matthew J Martin, Jared L Antevil, Donald R Bennett, William C DeVries, Scott Zakaluzny, Robert L Ricca, Homer Tien, Philip S Mullenix, Zsolt T Stockinger
Resuscitative thoracotomy has been extensively described in the civilian trauma literature and has a high mortality rate, due largely to the nature of the injuries leading to arrest. The survival rates are generally highest (10-30%) for penetrating truncal injuries and patients who arrive with vital signs and proceed to arrest or who have impending arrest. They are significantly lower (less than 5%) for blunt trauma victims, particularly those who arrest in the field or during transport (1% or less). In addition, the likelihood of survival with intact neurologic function is significantly lower than the overall survival rates, particularly for blunt trauma victims and for prehospital arrest...
September 1, 2018: Military Medicine
Craig Prentice, Jeyasankar Jeyanathan, Richard De Coverly, Julia Williams, Richard Lyon
OBJECTIVES: The aim of this study is to describe the demographics of reported traumatic cardiac arrest (TCA) victims, prehospital resuscitation and survival to hospital rate. SETTING: Helicopter Emergency Medical Service (HEMS) in south-east England, covering a resident population of 4.5 million and a transient population of up to 8 million people. PARTICIPANTS: Patients reported on the initial 999 call to be in suspected traumatic cardiac arrest between 1 July 2016 and 31 December 2016 within the trust's geographical region were identified...
September 5, 2018: BMJ Open
Omer Ehsan, Usama Khalid Choudry, Atif Rana, Zahid Amin Khan
Traumatic aortic injury (TAI) or aortic transection is the second most common cause of death after blunt trauma. The conventional management approach towards a thoracic aortic injury is open thoracotomy and surgical repair; however, there is a recent increase in the trend towards the use of endovascular approach in this regard, particularly in the developed countries. We here report the cases of two young healthy male patients presenting in emergency department with thoracic aortic injury, following a road traffic accident (RTA)...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Scott D Steenburg, Tracy Spitzer, Amy Rhodes
PURPOSE: To describe our institutional experience with post-mortem computed tomography (PMCT) and its impact on decedent injury severity score (ISS) and to assess the adequacy of emergently placed support medical devices. METHODS: Over a 5-year period, patients who died at or soon after arrival and have physical exam findings inconsistent with death were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place...
August 29, 2018: Emergency Radiology
Patrick Schober, Marcel A de Leeuw, Maartje Terra, Stephan A Loer, Lothar A Schwarte
Clamshell thoracotomy (CST) may be indicated and life-saving in carefully selected cases of blunt trauma. As such, the current clinical stance of general contraindication of CST in blunt trauma should be reviewed and criteria developed to accommodate select cases, considering the diversity of injuries resulting from blunt trauma.
August 2018: Clinical Case Reports
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tokiya Ishida, Yohei Okada, Yuri Kon, Kazuyuki Oka, Kenichiro Ishida, Yukitoshi Toyoda, Tomohiro Funabiki
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been used in refractory hemorrhagic shock patients. Since the optimal timing of arterial access remains unclear, we evaluated the preocclusion status of patients, and elapsed time from the arrival to the hospital is associated with the survival outcomes in the REBOA patients. METHODS: From August 2011 to December 2016, The Diagnostic and Interventional Radiology in Emergency, Critical care and Trauma-Intra-Aortic Balloon Occlusion (DIRECT-IABO) investigators registered refractory hemorrhagic shock patients undergoing REBOA from 23 hospitals in Japan...
September 2018: Journal of Trauma and Acute Care Surgery
Luis M García-Núñez, Irving I Morales-Pogoda, Edgar F Hernández-García, Juan A Rodríguez-Inurrigarro, Raúl García-Ramírez, Fernando F Arcaute-Velázquez
Instituida bajo recomendaciones objetivas, la toracotomía en el departamento de urgencias (TDU) se ha descrito como una maniobra quirúrgica salvatoria de la vida en pacientes traumatizados in extremis. Sin embargo, hay pocos reportes acerca de la experiencia con su empleo en la actividad eléctrica sin pulso no traumática. Describimos el caso de una paciente obstétrica exanguinada por sangrado masivo transoperatorio, en la que se realizó una TDU con un resultado óptimo para la vida y la función neurológica...
2018: Cirugia y Cirujanos
Edward John Nevins, Nicholas Thomas Edward Bird, Hassan Zakria Malik, Simon Jude Mercer, Khalid Shahzad, Raimundas Lunevicius, John Vincent Taylor, Nikhil Misra
PURPOSE: Emergency department thoracotomy (EDT) is a potentially life-saving procedure, performed on patients suffering traumatic cardiac arrest. Multiple indications have been reported, but overall survival remains unclear for each indication. The objective of this systematic review is to determine overall survival, survival stratified by indication, and survival stratified by geographical location for patients undergoing EDT across the world. METHODS: Articles published between 2000 and 2016 were identified which detailed outcomes from EDT...
July 14, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Nupur Verma, Jeffery D Robinson, Martin L Gunn
Pericardial rupture in blunt trauma is rarely seen on computed tomography (CT) imaging due to its high initial mortality. We report a case of a 53-year-old man who presented to the Emergency Department in hemodynamic shock after intentional fall from height. Chest radiograph, which was taken in the trauma bay as a part of his primary survey, showed abnormal mediastinum contour with pneumopericardium. Pericardial rupture with cardiac herniation, and tamponade secondary to pneumopericardium, was diagnosed on trauma CT scan...
June 2018: Radiology Case Reports
M Chance Spalding, Peter G Thomas, M Shay O'Mara, Christine L Ramirez, Franz S Yanagawa, Heidi H Hon, Brian A Hoey, William S Hoff, James Cipolla, Stanislaw P Stawicki
No abstract text is available yet for this article.
April 2018: International Journal of Critical Illness and Injury Science
J Norton, G Whittaker, D S Kennedy, J M Jenkins, D Bew
Introduction Metropolitan Police data, and those from the emergency department at a London major trauma centre show a resurgence in gun crime. The aim of this study was to collect data on all gunshot injuries over a seven-year period at South-East London's trauma hub. Materials and methods This was a retrospective observational study of all gunshot injuries between 1 January 2010 and 31 December 2016 at a London major trauma centre. Information regarding patient demographics, morbidity and mortality was collected...
July 2018: Annals of the Royal College of Surgeons of England
W Schreiner, I Castellanos, W Dudek, H Sirbu
Thoracic trauma can be a life-threatening condition due to the involvement of vital organs, such as the heart, lungs, tracheobronchial tree and the great vessels. A coordinated interdisciplinary management is vital for the survival of the injured person. Modern diagnostic procedures provide an essential basis for the surgical treatment of patients. Surgical treatment principles include insertion of chest drainage, emergency thoracotomy, complex bronchoplastic and vascular reconstructive techniques and cardiac surgical maneuvers...
August 2018: Der Unfallchirurg
K Elias, M Engelhardt
BACKGROUND: Severe hemorrhage remains the leading cause of death among trauma patients. Resuscitative balloon occlusion of the aorta (REBOA) is an endovascular alternative to the established emergency room thoracotomy with cross-clamping of the aorta in patients with severe abdominal or pelvic bleeding. OBJECTIVE: The article reports on initial experiences with REBOA. METHODS: Based on the literature and own experiences the pathophysiology, indications, contraindications, technical details and first results with REBOA are presented...
July 2018: Der Unfallchirurg
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