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Penetrating trauma

Edward J Nevins, Parisa L Moori, Jonathan Smith-Williams, Nicholas T E Bird, John V Taylor, Nikhil Misra
PURPOSE: The indications for pre-hospital resuscitative thoracotomy (PHRT) remain undefined. The aim of this paper is to explore the variation in practice for PHRT in the UK, and review the published literature. METHODS: MEDLINE and PUBMED search engines were used to identify all relevant articles and 22 UK Air Ambulance Services were sent an electronic questionnaire to assess their PHRT practice. RESULTS: Four European publications report PHRT survival rates of 9...
March 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Radha Annamalai, Jyotirmay Biswas
Sympathetic ophthalmia is an ocular inflammatory disease commonly associated with penetrating trauma. We report a case of sympathetic ophthalmia who had Dalen-Fuchs nodules on presentation and developed a frosted branch angiitis (FBA)-like picture which is not a known feature of this disease. A 25-year-old male patient was seen 8 months following penetrating trauma to the left eye. He was treated with oral steroids and immunosuppressives. Fundus fluorescein angiography confirmed the presence of perivascular retinitis; optical coherence tomography showed retinal thickening and ultrasonography showed peripapillary choroidal thickening...
January 2018: Oman Journal of Ophthalmology
Eugene Ng, Ian Campbell, Andrew Choong, Allan Kruger, Philip J Walker
Although penetrating neck trauma (PNT) is uncommon, it is associated with the significant morbidity and mortality. The management of PNT has changed significantly over the past 50 years. A radiological assessment now is a vital part of the management with a traditional surgical exploration. A 22 years old male was assaulted by a screwdriver and sustained multiple penetrating neck injuries. A contrast CT scan revealed a focal pseudoaneurysm in the left common carotid artery bulb. There was no active bleeding or any other vascular injuries and the patient remained haemodynamically stable...
February 20, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
T Arad, U Voßmerbäumer, N Pfeiffer, A Gericke
The two presented case examples demonstrate that scleral perforation through highly accelerated, seemingly harmless confetti particles is possible. In addition to penetrating injuries that should be treated directly, contusions with serious consequential complications can also occur. A careful assessment and examination are essential to promptly provide the patient with the right treatment and to minimize complications.
March 20, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Caitlin R Woolcott, Stephanie Torrey, Patricia V Turner, Lilia Serpa, Karen Schwean-Lardner, Tina M Widowski
On-farm euthanasia is a critical welfare issue in the poultry industry and can be particularly difficult to perform on mature turkeys due to their size. We evaluated the efficacy of two commercially available non-penetrating captive bolt devices, the Zephyr-EXL and the Turkey Euthanasia Device (TED), on 253 turkeys at three stages of production: 4-5, 10, and 15-20 weeks of age. Effectiveness of each device was measured using both ante- and post-mortem measures. Application of the Zephyr-EXL resulted in a greater success rate (immediate abolishment of brainstem reflexes) compared to the TED (97...
March 20, 2018: Animals: An Open Access Journal From MDPI
Minna M Wieck, Aaron J Cunningham, Brandon Behrens, Erika T Ohm, Bryan G Maxwell, Nicholas A Hamilton, M Christopher Adams, Frederick J Cole, Mubeen A Jafri
BACKGROUND: Expediting evaluation and intervention for severely injured patients has remained a mainstay of advanced trauma care. One technique, direct to operating room (DOR) resuscitation, for selective adult patients has demonstrated decreased mortality. We sought to investigate the application of this protocol in children. METHODS: All DOR pediatric patients from 2009-2016 at a pediatric Level I Trauma Center were identified. DOR criteria included penetrating injury, chest injuries, amputations, significant blood loss, cardiopulmonary resuscitation, and surgeon discretion...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Alireza Mojtahedi, Sohail Contractor, Piotr S Kisza
Bullet embolization to the right heart through the vasculature is seen infrequently in cases presenting with penetrating trauma. Patients with unstable hemodynamic status are managed operatively. For a patient with stable hemodynamic parameters, diagnostic evaluation such as computed tomography angiogram, echocardiogram, or angiography could be performed to select the best treatment option. Endovascular treatment is employed infrequently in these cases but can be a viable option for select patients. We present a case of a bullet embolus to the right ventricle treated successfully with endovascular approach and discuss the technical aspects of this approach...
January 1, 2018: Vascular and Endovascular Surgery
Andre S Madsen, John L Bruce, George V Oosthuizen, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This paper reviews our experience with penetrating cervical venous trauma and aims to validate the selective non-operative management (SNOM) of these injuries. METHODS: This was a retrospective review of a prospectively maintained registry. All patients presenting alive with an injury to the internal jugular vein, subclavian vein or innominate vein following a PNI were reviewed for a 6-year period. RESULTS: Among 817 patients admitted for the management of PNI, 76 (9...
March 15, 2018: World Journal of Surgery
Mariya E Skube, Quinn Mallery, Elizabeth Lusczek, Joel Elterman, Mary A Spott, Greg J Beilman
Introduction: Although there are multiple studies regarding the management and outcomes of colonic injuries incurred in combat, the literature is limited with regard to small bowel injuries. This study seeks to provide the largest reported review of the characteristics of combat-associated small bowel injuries. Materials and Methods: The Department of Defense Trauma Registry was queried for U.S. Armed Forces members who sustained hollow viscus injuries in the years 2007-2012 during Operations Enduring Freedom, Iraqi Freedom, and New Dawn...
March 13, 2018: Military Medicine
Konstantinos S Mylonas, Diamantis I Tsilimigras, Pavlos Texakalidis, Pouya Hemmati, Dimitrios Schizas, Konstantinos P Economopoulos
Literature discussing cardiac injuries in children is limited. Systematic search of PubMed identified 21 studies enrolling 1,062 pediatric patients who experienced cardiac trauma in the United States during the period 1961 to 2012. The predominant type of injury was blunt cardiac contusion affecting 59.7% (n = 634/1,062) of the study population. Motor vehicle crashes (53.5%, n = 391/731) were the leading cause of blunt cardiac trauma, while gunshot wounds (50%, n = 150/300) accounted for most penetrating injuries...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Cristiane de Alencar Domingues, Raul Coimbra, Renato Sérgio Poggetti, Lilia de Souza Nogueira, Regina Marcia Cardoso de Sousa
Background: The objective of this study is to propose three new adjustments to the Trauma and Injury Severity Score (TRISS) equation and compare their performances with the original TRISS as well as this index with coefficients adjusted for the study population. Methods: This multicenter, retrospective study evaluated trauma victims admitted to two hospitals in São Paulo-Brazil and San Diego-EUA between January 1st, 2006, and December 31st, 2010. The proposed models included a New Trauma and Injury Severity Score (NTRISS)-like model that included Best Motor Response (BMR), systolic blood pressure (SBP), New Injury Severity Score (NISS), and age variables; a TRISS peripheral oxygen saturation (SpO2 ) model that included Glasgow Coma Scale (GCS), SBP, SpO2 , Injury Severity Score, and age variables; and a NTRISS-like SpO2 model that included BMR, SBP, SpO2 , NISS, and age variables...
2018: World Journal of Emergency Surgery: WJES
Allen F Morey
No abstract text is available yet for this article.
May 2017: Journal of Urology
Grace E Martin, Heng He, Amy T Makley, Timothy A Pritts, Joel B Elterman, Jay A Johannigman, Michael D Goodman
BACKGROUND: Penetrating injuries to the extremity proximal to the elbow or knee are anatomic criteria for full trauma team activation by the American College of Surgeon's Committee on Trauma standards. This criterion lacks objective evidence-based support. Overtriage of trauma team activation may result in excessive costs and resource burden at trauma centers. We hypothesized that full trauma team activation for penetrating injuries to the proximal extremities by anatomic criteria alone may lead to significant overtriage...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Richard J Napier, Brendan J Gallagher, Darrin S Wilson
Background: The 1994 Northern Ireland ceasefire heralded a new beginning for the region after 30-years of violence. In the 20-years following the cessation of hostilities, paramilitary punishment attacks continue to occur in breach of the ceasefire. The aim of this study was to review trends in these attacks over the 20-years and their impact on orthopaedic services. Methods: We conducted a retrospective review of patients admitted under orthopaedic services following paramilitary assault across Northern Ireland over the last 20-years...
May 2017: Ulster Medical Journal
Joseph J Kavolus, David Sia, Hollis G Potter, David E Attarian, Paul F Lachiewicz
BACKGROUND: Surgeon-performed periarticular injections and anesthesiologist-performed femoral nerve or adductor canal blocks with local anesthetic are in common use as part of multimodal pain management regimens for patients undergoing TKA. However, femoral nerve blocks risk causing quadriceps weakness and falls, and anesthesiologist-performed adductor canal blocks are costly in time and resources and may be unreliable. We investigated the feasibility of a surgeon-performed saphenous nerve ("adductor canal") block from within the knee at the time of TKA...
January 2018: Clinical Orthopaedics and related Research
Abdullah Shariff, Ruby Skinner, Andrea Pakula
INTRODUCTION: Visceral artery aneurysms are an uncommon clinical problem with aneurysms of the celiac artery only making up a small percentage of all visceral artery aneurysms. The more common splenic and hepatic aneurysms are often symptomatic with pain or rupture and associated hemorrhage. PRESENTATION OF CASE: We present a case of an otherwise healthy 30 yo male with an asymptomatic, posttraumatic arterial aneurysm of the celiac artery. He initially presented to our trauma center after sustaining multiple gunshot wounds which required multiple abdominal surgeries...
February 21, 2018: International Journal of Surgery Case Reports
Jeremy R Wortman, Jennifer W Uyeda, Urvi P Fulwadhva, Aaron D Sodickson
Computed tomography (CT) is key to the assessment of hemodynamically stable patients with blunt or penetrating trauma to the abdomen and pelvis. Dual-energy (DE) CT is a technology that allows acquisition of data at both high and low kilovolt peaks, allowing materials that have different x-ray absorption behaviors as a function of kilovolt peak (such as iodine) to be differentiated and quantified. DE CT has a variety of postprocessing applications that may be helpful in abdominal and pelvic trauma, including iodine-selective imaging, virtual monenergetic imaging, and virtual noncalcium imaging...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Salah G Aoun, Nicole Bedros, Tarek Y El Ahmadieh, Jake Kreck, Nikhil Mehta, Mazin Al Tamimi
BACKGROUND: Venous thromboembolism can be a significant cause of morbidity in the trauma population. Medical and surgical specialties have been pushing the indication for prophylactic filter placement. CASE DESCRIPTION: A 36-year-old man presented with axial lower back pain with a radicular right L2 component after lifting a heavy object. He had a history of penetrating brain trauma 3 years prior, with placement of a prophylactic inferior vena cava filter. His x-ray, computed tomography, and magnetic resonance imaging of the lumbar spine showed fracture of his filter, with migration of the fractured fragment through the inferior vena cava and into the L2-L3 disc space, and surrounding bony lysis and severe osteodiscitis...
March 7, 2018: World Neurosurgery
James M Bardes, Kenji Inaba, Morgan Schellenberg, Daniel Grabo, Aaron Strumwasser, Kazuhide Matsushima, Damon Clark, Niquelle Brown, Demetrios Demetriades
BACKGROUND: The distribution of trauma deaths was classically described as trimodal. With advances in both technology and trauma systems, this was re-evaluated and found to be bimodal in the early 2000s. Over the last decade there have been continued improvements in trauma and ICU care, related to damage control techniques and evidence based ICU pathways. A better understanding of the distribution of trauma deaths may be used to improve trauma systems. This study aimed to evaluate the contemporary distribution of trauma deaths after the widespread implementation of modern trauma and critical care principles...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Martin G Rosenthal, David J Ebler, Kristina M Weitzel, James C Cunningham, David J Skarupa
No abstract text is available yet for this article.
March 8, 2018: Journal of Trauma and Acute Care Surgery
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