keyword
https://read.qxmd.com/read/38635088/no-trauma-related-diagnosis-in-emergency-trauma-room-whole-body-computer-tomography-of-patients-with-inconspicuous-primary-survey
#1
JOURNAL ARTICLE
Arnold J Suda, Julia Pepke, Udo Obertacke, Holger Stadthalter
PURPOSE: Whole-body computer tomographic examinations (WBCT) are essential in diagnosing the severely injured. The structured clinical evaluation in the emergency trauma room, according to ATLS® and guidelines, helps to indicate the correct radiological imaging to avoid overtriage and undertriage. This retrospective, single-center study aimed to evaluate the value of WBCT in patients with an inconspicuous primary survey and whether there is any evidence for this investigation in this group of patients...
April 18, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38521635/the-paediatric-polytrauma-ct-indication-pepci-score-development-of-a-prognostic-model-to-reduce-unnecessary-ct-scans-in-paediatric-trauma-patients
#2
JOURNAL ARTICLE
Strahl André, Willemsen Jan Fritjof, Schoof Benjamin, Reinshagen Konrad, Frosch Karl-Heinz, Wintges Kristofer
BACKGROUND: Whole-Body CT (WBCT) is frequently used in emergency situations for promptly diagnosing paediatric polytrauma patients, given the challenges associated with obtaining precise details about the mechanism and progression of trauma. However, WBCT does not lead to reduced mortality in paediatric patients, but is associated with high radiation exposure. We therefore wanted to develop a screening tool for CT demand-driven emergency room (ER)-trauma diagnostic to reduce radiation exposure in paediatric patients...
March 11, 2024: Injury
https://read.qxmd.com/read/38478361/the-relationship-between-intra-articular-fracture-energy-and-a-patient-s-inflammatory-response
#3
JOURNAL ARTICLE
Justin M Haller, Diane Fink, Hannah Smith, Zachary Olsen, Cale Jacobs, Donald Anderson
OBJECTIVES: Prior studies have demonstrated elevated inflammatory cytokine concentrations in the synovial fluid of articular fracture patients post-injury. Similarly, CT-based fracture energy measurements have been correlated to PTOA risk after pilon fracture. The purpose of this study was to determine the associations between synovial fluid cytokine levels, fracture energy, and overall trauma to the body in articular fracture patients. METHODS: Acute tibial plateau, tibial plafond, and rotational ankle fracture patients were prospectively enrolled from December 2011 through January 1, 2019...
March 12, 2024: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/38451003/rethinking-the-tiered-trauma-team-response-a-case-series-study-in-a-regional-trauma-centre
#4
JOURNAL ARTICLE
Kate Curtis, Benjamin Clark, Mary K Lam, Ryan Huckle, Geoffrey Melville, Simon Binks, Ms Wende Ryan, Trevor Gardner, Ms Brooke Parsons, Bruce Ashford
OBJECTIVE: To reduce perceived unnecessary resource use, we modified our tiered trauma response. If a patient was not physiologically compromised, surgical registrar attendance was not mandated. We investigated the effect of this change on missed injury, unplanned representation to ED, diagnostic imaging rates and staff satisfaction. METHODS: A retrospective case series study assessing the 3-month period before and after the intervention was conducted. Logistic regression analyses were used to examine the association between ordering of computerised tomography (CT) and ED length of stay (LOS), injury severity (ISS), age, surgical review and admission...
March 7, 2024: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/38441580/coronary-artery-calcification-detected-by-initial-polytrauma-ct-in-severely-injured-patients-retrospective-single-center-cohort-study
#5
JOURNAL ARTICLE
Hans-Jonas Meyer, Tihomir Dermendzhiev, Michael Hetz, Georg Osterhoff, Christian Kleber, Timm Denecke, Jeanette Henkelmann, Michael Metze, Robert Werdehausen, Gunther Hempel, Manuel F Struck
OBJECTIVES: Coronary artery calcifications detected by computed tomography (CT) provide prognostic relevance for vascular disorders and coronary heart disease, whereas their prognostic relevance in severely injured trauma patients remains unclear. MATERIAL AND METHODS: All consecutive trauma patients requiring emergency tracheal intubation before initial CT at a level-1 trauma center and admission to the intensive care unit (ICU) over a 12-year period (2008-2019) were reanalyzed...
March 5, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38396199/diagnostic-utility-of-whole-body-computed-tomography-pan-scan-in-trauma-a-systematic-review-and-meta-analysis-study
#6
REVIEW
Mobina Fathi, Arshia Mirjafari, Shirin Yaghoobpoor, Milad Ghanikolahloo, Zohre Sadeghi, Ashkan Bahrami, Lee Myers, Ali Gholamrezanezhad
Trauma is a significant cause of mortality and morbidity. It is crucial to diagnose trauma patients quickly to provide effective treatment interventions in such conditions. Whole-body computed tomography (WBCT)/pan-scan is an imaging technique that enables a faster and more efficient diagnosis for polytrauma patients. The purpose of this systematic review and meta-analysis is to evaluate the efficacy of WBCT in diagnosing injuries in polytrauma patients. We will also assess its impact on the mortality rate and length of hospital stay among trauma centers between patients who underwent WBCT and those who did not (non-WBCT)...
February 23, 2024: Emergency Radiology
https://read.qxmd.com/read/38364589/ai-based-automated-detection-and-stability-analysis-of-traumatic-vertebral-body-fractures-on-computed-tomography
#7
JOURNAL ARTICLE
Constanze Polzer, Eren Yilmaz, Carsten Meyer, Hyungseok Jang, Olav Jansen, Cristian Lorenz, Christian Bürger, Claus-Christian Glüer, Sam Sedaghat
PURPOSE: We developed and tested a neural network for automated detection and stability analysis of vertebral body fractures on computed tomography (CT). MATERIALS AND METHODS: 257 patients who underwent CT were included in this Institutional Review Board (IRB) approved study. 463 fractured and 1883 non-fractured vertebral bodies were included, with 190 fractures unstable. Two readers identified vertebral body fractures and assessed their stability. A combination of a Hierarchical Convolutional Neural Network (hNet) and a fracture Classification Network (fNet) was used to build a neural network for the automated detection and stability analysis of vertebral body fractures on CT...
February 13, 2024: European Journal of Radiology
https://read.qxmd.com/read/38333492/incidental-computed-tomography-findings-among-traumatized-adults-a-one-year-analysis-at-a-trauma-center
#8
JOURNAL ARTICLE
Sawsan Sabiq, Abdulaziz Alzauir, Sarah A Alenizi
Background Computed tomography (CT) for patients with trauma represents a widely accepted diagnostic method. Non-trauma-related incidentalomas or incidental findings are commonly depicted based on CT examination. Our study aimed to assess the frequency of incidental findings on CT scans among traumatized adult patients during one year at a trauma center. Methods We performed a retrospective case review of all adult patients triaged at the King Abdullah Medical Complex trauma service in Jeddah, Saudi Arabia, between 31 May 2022 and 30 May 2023...
January 2024: Curēus
https://read.qxmd.com/read/38331307/cutaneous-burn-injury-represents-a-major-risk-factor-for-the-development-of-traumatic-ectopic-bone-formation-following-blast-related-extremity-injury
#9
JOURNAL ARTICLE
Cassie J Rowe, Uloma Nwaolu, Daniela Salinas, Jefferson L Lansford, Conor F McCarthy, Joseph A Anderson, Michael S Valerio, Benjamin K Potter, Philip J Spreadborough, Thomas A Davis
Blast-related traumatic heterotopic ossification (tHO) impacts clinical outcomes in combat-injured patients, leading to delayed wound healing, inflammatory complications, and reduced quality of life. Blast injured patients often have significant burns. This study investigated whether a partial thickness thermal burn injury exacerbates blast-related tHO in a clinically relevant polytrauma animal model. Adult male Sprague Dawley rats were subjected to an established model involving a whole-body blast overpressure exposure (BOP), complex extremity trauma followed by hind limb amputation (CET) followed by the addition of a 10 % total body surface area (TBSA) second degree thermal burn (BU)...
February 6, 2024: Bone
https://read.qxmd.com/read/38306870/diagnosis-of-small-intestinal-microperforation-by-cell-morphology-detection-in-abdominal-puncture-fluid-a-case-report
#10
Yaqin Zheng, Zijun Li, Qinbing Zhou
INTRODUCTION AND IMPORTANCE: Although abdominal computed tomography angiography (CTA) may be a gold standard for early diagnosis of small intestinal microperforation, early missed and delayed diagnosis are often important factors leading to poor prognosis. The cellular morphology diagnosis of abdominal puncture fluid (DAPF) or diagnostic peritoneal lavage (DPL) may have unexpected clinical outcomes. CASE PRESENTATION: We report a case of small bowel microperforation which dues to BAT...
February 1, 2024: International Journal of Surgery Case Reports
https://read.qxmd.com/read/38293705/treatment-strategy-for-severe-trauma-patients-requiring-aortic-occlusion-for-impending-cardiopulmonary-arrest-in-the-hybrid-emergency-room
#11
JOURNAL ARTICLE
Shuhei Maruyama, Daiki Wada, Tomoyuki Yoshihara, Fukuki Saito, Kazuhisa Yoshiya, Yasushi Nakamori, Yasuyuki Kuwagata
AIM: Computed tomography (CT) is useful in trauma care. Severely ill trauma patients may not tolerate whole-body CT even without patient transfer. This study examined clinical flow of severe trauma patients requiring aortic occlusion (AO) such as resuscitative thoracotomy or REBOA in the hybrid emergency room (ER) and investigated patient clinical courses prioritizing CT first versus resuscitation including AO first. METHODS: This retrospective, single-center observational study included consecutive trauma patients visiting our ER between May 2016 and February 2023...
2024: Acute Medicine & Surgery
https://read.qxmd.com/read/38289419/eurotrauma-delays-in-access-to-bleeding-control-a-comparison-between-a-conventional-and-a-hybrid-trauma-center-both-european%C3%A2-military-trauma-centers
#12
JOURNAL ARTICLE
Hilaire de Malleray, Lisa Hackenberg, Michael Cardinale, Erwin Kollig, Robert Schwab, Julien Bordes, Dan Bieler
PURPOSE: Comparison of access times to CT and surgical/radiological bleeding control between two European military trauma centers. METHODS: Retrospective and observational study conducted in two military level 1 trauma centers in Toulon (France) and Koblenz (Germany) between 2013 and 2018. Inclusion of severe trauma patients with ISS > 15 with clinical and biological criteria of bleeding. RESULTS: Inclusion of 607 patients (318 in Toulon and 289 in Koblenz)...
January 30, 2024: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/38272956/the-use-of-whole-body-computed-tomography-does-not-lead-to-increased-24-h-mortality-in-severely-injured-patients-in-circulatory-shock
#13
JOURNAL ARTICLE
Ivana Hanzalova, Mylène Bourgeat, Nicolas Demartines, François-Xavier Ageron, Tobias Zingg
The Advanced Trauma Life Support (ATLS) approach is generally accepted as the standard of care for the initial management of severely injured patients. While whole body computed tomography (WBCT) is still considered a contraindication in haemodynamically unstable trauma patients, there is a growing amount of data indicating the absence of harm from cross sectional imaging in this patient group. Our study aimed to compare the early mortality of unstable trauma patients undergoing a WBCT during the initial workup with those who did not...
January 25, 2024: Scientific Reports
https://read.qxmd.com/read/38242618/-in-situ-simulation-training-of-medical-surgical-teams-in-the-management-of-severe-trauma-patients
#14
JOURNAL ARTICLE
Raphaël Paris, Henri de Lesquen, Éric Bernaudon, Julien Chouvier, Édouard Martin
In the management of severe trauma, the aim is to assess the patient's clinical stability as quickly as possible, enabling referral to imaging (whole-body CT scan, embolization if necessary) or the operating room, or even the decision to perform in situ surgery (resuscitation thoracotomy). To cope with these critical situations, team training is essential, with the aim of ensuring the reproducibility of the difficulties encountered. High-fidelity in situ simulation is the ideal tool for meeting this training challenge...
January 2024: Revue de L'infirmière
https://read.qxmd.com/read/38157779/can-the-use-of-whole-body-ct-be-reduced-in-cases-of-kinetic-based-polytrauma-patients-without-a-clinical-severity-criterion-a-bi-center-retrospective-study
#15
JOURNAL ARTICLE
Robin Naccache, Ugo Scemama, Ahmed-Ali El Ahmadi, Paul Habert, Laurent Zieleskiewicz, Kathia Chaumoitre, Pierre Michelet, Arthur Varoquaux, Mathieu Di Bisceglie
OBJECTIVE: To identify clinical and biological criteria predictive of significant traumatic injury in only kinetic-based polytrauma patients without clinical severity criteria. To propose a decisional algorithm to assist the emergency doctor in deciding whether or not to perform a WBCT in the above population. METHODS: Retrospective bi-center study. 1270 patients with high velocity trauma without clinical severity criteria, for whom a WBCT was performed in 2017, were included...
December 26, 2023: European Journal of Radiology
https://read.qxmd.com/read/38116364/selective-arterial-catheterization-as-a-bridging-therapy-for-blunt-traumatic-aortic-injury-with-intraperitoneal-organ-malperfusion
#16
Koji Miura, Seigo Urushidani
Blunt thoracic aortic injury (BTAI) is fatal and requires thoracic endovascular aortic repair (TEVAR) for its optimal management. Performing TEVAR requires multidisciplinary specialists and supportive facilities.  We report a case of an 89-year-old man who presented to the emergency department with blunt trauma. Whole-body computed tomography (CT) revealed grade II aortic injury with disrupted blood flow to the left kidney. Sudden paralysis of the left lower extremity and distal progression of the aortic dissection occurred...
November 2023: Curēus
https://read.qxmd.com/read/38092647/diagnosis-of-metaphyseal-fractures-in-infants-and-young-children-with-suspected-inflicted-injury-a-systematic-review-of-cross-sectional-imaging-techniques
#17
JOURNAL ARTICLE
A T Alshammari, A J Oates, A S Rigby, A C Offiah
AIM: To compare the diagnostic accuracy, advantages, and disadvantages of different medical imaging techniques for detecting metaphyseal fractures (also known as classic metaphyseal lesions [CMLs]) in infants and young children with suspected inflicted trauma. MATERIALS AND METHODS: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist and Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool criteria...
November 29, 2023: Clinical Radiology
https://read.qxmd.com/read/38082141/the-nutcracker-spino-laminar-fracture-evaluation-as-a-sentinel-lesion-of-a-hyperextension-mechanism-in-cervical-spine-trauma
#18
JOURNAL ARTICLE
Alexandre Lê, Guillaume Bierry, Thibault Willaume
OBJECTIVE: We hypothesised that the orientation of the fracture line in the cervical vertebral arch depends on the traumatic mechanism, specifically focusing on frontal oblique spino-laminar fractures to determine if this pattern can serve as an indicator of a hyperextension mechanism of injury of the cervical spine. MATERIALS AND METHODS: We reviewed the imaging records of 114 adult patients admitted to the emergency department of the Strasbourg University Hospital for severe polytrauma between January 2016 and December 2021 and who presented with a fracture of the posterior vertebral arch of the lower cervical spine on the whole-body CT scan...
December 11, 2023: Skeletal Radiology
https://read.qxmd.com/read/38070965/a-65-year-old-man-with-concerns-of-hemoptysis-after-recent-motor-vehicle-accident-and-blunt-trauma-to-chest
#19
Shaheryar Usman, Shahan Haseeb, Muhammad Jahanzaib Khan, Andrew Weber
A 65-year-old man with a medical history of anxiety and depression came to the ED with concerns of coughing blood-tinged phlegm for the past 3 days. Four days before the presentation, the patient had a motor vehicle accident as a restrained driver with airbag deployment. The patient struck his chest against the steering wheel. He was evaluated at a level 1 trauma center and underwent a whole-body scan, including a CT scan of the chest, which showed no acute abnormalities. Apart from mild-to-moderate bruising and tenderness on the right side of his face, nose, and anterior chest, the patient was stable and was discharged the next day...
December 2023: Chest
https://read.qxmd.com/read/38021201/hepatobiliary-specific-magnetic-resonance-contrast-agents-role-in-biliary-trauma
#20
REVIEW
Marco Di Serafino, Francesca Iacobellis, Roberto Ronza, Alberto Martino, Dario Grimaldi, Chiara Rinaldo, Martina Caruso, Giuseppina Dell'Aversano Orabona, Luigi Barbuto, Francesco Verde, Vittorio Sabatino, Maria Laura Schillirò, Antonio Brillantino, Luigia Romano
Non-iatrogenic traumatic bile duct injuries (NI-TBIs) are a rare complication after abdominal trauma, with an estimated prevalence of 2.8-7.4% in patients underwent blunt liver injuries. They may be overlooked in patients with extensive multi-organ trauma, particularly hepatic, splenic and duodenal injuries, which have a prevalence of 91%, 54% and 54%, respectively. Whole body contrast-enhanced computed tomography (CE-CT) represents the examination of choice in polytraumatized hemodynamically stable patients, as it allows a comprehensive evaluation of vascular, parenchymal, bone and soft tissues injuries, but the diagnosis of any biliary leaks is limited to the evaluation of nonspecific imaging findings and on findings evolution in the follow-up, such as the progressive growth of fluid collections...
October 30, 2023: Gland Surgery
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