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Penetrating trauma

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https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#1
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29142582/pseudoaneurysm-of-left-proximal-common-carotid-artery-following-penetrating-trauma
#2
Rehana Shaikh, Saba Sohail, Parvez Ahmed Shaikh, Qamar-Un-Nisa Nisa
A 33-year male with history of penetrating trauma to left upper chest in 2006, presented through Medical unit to Radiology Department with complain of hemoptysis. Chest X-ray showed a soft tissue lesion in left upper lobe with a linear metallic foreign body. Contrast enhanced CT scan of chest and later CTA was performed which showed a saccular aneurysm arising from mediastinal part of left common aortic artery surrounded by thrombosis with a cylindrical linear metallic foreign body. He was planned for endovascular repair with stenting which he could not afford due to financial constraints...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29133650/epidemiology-clinical-profile-and-factors-predicting-final-visual-outcome-of-pediatric-ocular-trauma-in-a-tertiary-eye-care-center-of-central-india
#3
Satendra Singh, Bhavana Sharma, Kavita Kumar, Aditi Dubey, Kanchan Ahirwar
PURPOSE: Ocular trauma constitutes an important cause of preventable visual morbidity worldwide. This study was done to study the incidence, sociodemographic pattern, and clinical profile of ocular trauma in pediatric age group. Also to evaluate the factors influencing final visual outcome in these patients. METHODS: This was a prospective interventional study concerning ocular trauma in pediatric patients up to 16 years of age of either sex. Various variables having an impact on final visual outcome were studied, and results were analyzed using statistical indices - relative risk, Chi-square test, P value, and linear regression analysis...
November 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#4
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29131915/visual-and-refractive-outcomes-of-children-after-early-secondary-cataract-extraction-following-wound-repair-for-penetrating-ocular-trauma
#5
Kamaldeep Arora, Priyanka Arora, Suma Ganesh, Shriya Gupta, Rashmi Ranjan Das
PURPOSE: To evaluate the visual and refractive outcomes in children 8 years of age or younger with corneal laceration and cataract following penetrating ocular injuries who underwent primary corneal tear repair followed within 1 to 8 weeks by early secondary cataract extraction. METHODS: This retrospective, non-comparative case series reviewed the admission and operative charts of children 8 years of age or younger (range: 3 to 8 years) who underwent corneal wound repair as the primary surgical procedure followed within 1 to 8 weeks by cataract extraction with intraocular lens implantation, with a minimum follow-up period of 6 months...
November 11, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29125266/decision-making-in-very-severe-traumatic-brain-injury-glasgow-coma-scale-3-5-a-literature-review-of-acute-neurosurgical-management-of-the-most-severely-threatened-brain-trauma-patients
#6
Jeroen van Dijck, Florence Reith, Inge van Erp, Thomas van Essen, Andrew Maas, Wilco C Peul, Godard de Ruiter
BACKGROUND: Patients presenting with an early GCS score of 3-5 after blunt or penetrating skull-brain assaults are categorized as having sustained a very severe Traumatic Brain Injury (vs-TBI). This category is often overlooked in literature. Impact on patients and families lives however is huge and the question "whether to surgically treat or not" frequently poses a dilemma to treating physicians. Little is known about mortality and outcome, compared to what is known for the group of severe TBI patients (s-TBI) (GCS 3- 8)...
November 10, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29124035/successful-tractotomy-technique-for-a-penetrating-lung-injury-in-a-patient-with-one-lung
#7
Dong Hoon Kang, Hyun Oh Park, Sung Ho Moon, In Seok Jang, Jung Hoon Byun, Sung Hwan Kim
We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29120063/systematic-sonography-for-detection-of-occult-wounds-in-trauma
#8
Jordan Rupp, Warren Cooper, Robinson Ferre
Treating victims of penetrating trauma is challenging, especially in a mass-casualty or resource-limited setting. The traditional focused assessment with sonography for trauma examination is a well-established clinical tool in the initial evaluation of trauma victims. This article describes a novel technique of systematic sonography of the abdomen to look for occult wounds, which is used in conjunction with the focused assessment with sonography for trauma examination to evaluate occult intraperitoneal injury and improve patient treatment and use of resources...
November 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29119562/validating-performance-of-triss-tarn-and-normit-survival-prediction-models-in-a-norwegian-trauma-population
#9
N O Skaga, T Eken, S Søvik
INTRODUCTION: Anatomic injury, physiological derangement, age, injury mechanism and pre-injury comorbidity are well-founded predictors of trauma outcome. Statistical prediction models may have poorer discrimination, calibration and accuracy when applied in new locations. We aimed to compare the TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population. METHODS: Consecutive patients admitted to Oslo University Hospital Ullevål within 24 h after injury, with Injury Severity Score ≥ 10, proximal penetrating injuries, or received by trauma team, were studied...
November 8, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29119221/preparing-japanese-surgeons-for-potential-mass-casualty-situations-will-require-innovative-and-systematic-programs
#10
H Uchino, V Y Kong, J L Bruce, G V Oosthuizen, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers...
November 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29112551/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-inferior-vena-cava-filters
#11
Raquel Ferrandis Comes, Patrick Mismetti, Arash Afshari
: The indications for the use of an inferior vena cava filter (IVCF) in the context of deep venous thrombosis to prevent pulmonary embolism remain controversial. Despite wide use in clinical practice, great variation exists in national and international guidelines in regard to the indications. In addition, clinical practice is based on poor-quality data from trauma and bariatric surgery with a high incidence of complications. It is often difficult to assess their efficacy and lack of filter retrieval appears to be a substantial issue compared with a potential benefit by insertion of these devices...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29111081/timing-of-mortality-in-pediatric-trauma-patients-a-national-trauma-data-bank-analysis
#12
Cory McLaughlin, Jessica A Zagory, Michael Fenlon, Caron Park, Christianne J Lane, Daniella Meeker, Randall S Burd, Henri R Ford, Jeffrey S Upperman, Aaron R Jensen
BACKGROUND/PURPOSE: The classic "trimodal" distribution of death has been described in adult patients, but the timing of mortality in injured children is not well understood. The purpose of this study was to define the temporal distribution of mortality in pediatric trauma patients. METHODS: A retrospective cohort of patients with mortality from the National Trauma Data Bank (2007-2014) was analyzed. Categorical comparison of 'dead on arrival', 'death in the emergency department', and early (≤24h) or late (>24h) inpatient death was performed...
October 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29110975/traumatic-perforation-of-the-tympanic-membrane-a-review-of-80-cases
#13
Doron Sagiv, Lela Migirov, Eran Glikson, Jobran Mansour, Ruth Yousovich, Michael Wolf, Yisgav Shapira
BACKGROUND: Traumatic perforation of the tympanic membrane (TPTM) is often encountered in primary care or in the emergency department (ED). Several therapeutic interventions have been described, but conservative follow-up until spontaneous complete recovery is the most common choice. OBJECTIVE: Our goal was to analyze the trauma mechanism, perforation characteristics, and outcome of patients with TPTM. METHODS: The study included patients examined in the ED of a tertiary, university-affiliated medical center because of TPTM between 2012 and 2016...
October 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29108845/validation-of-the-age-adjusted-shock-index-using-pediatric-trauma-quality-improvement-program-data
#14
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Shannon Acker, Denis Bensard, Brian Kenney
PURPOSE: In adults, shock index (SI; heart rate/systolic blood pressure) >0.9 predicts injury severity and trauma outcomes. However, age-adjusted shock index (SIPA) out-performs SI in blunt trauma patients 4-16years old. We sought to confirm these findings and expand this tool to include penetrating trauma and children aged 1-4years. METHODS: We developed cutoff values for patients 1-3years old using age-based vital signs and queried the 2014 Pediatric Trauma Quality Improvement Program (TQIP) database for patients aged 1-16years sustaining blunt or penetrating trauma...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29089697/selective-non-operative-management-of-patients-with-abdominal-trauma-is-cect-scan-mandatory
#15
Sunil Kumar, Puneet Prakash, Mohit Kumar Joshi, Vinita Rathi
CECT scan is considered essential for selective non-operative management (SNOM) of patients with abdominal trauma. However, CECT has its own hazards and limitations. We evaluated the safety and efficacy of selective non-operative management of patients with abdominal trauma without the mandatory use of CECT scan in a prospective study. Patients with peritonitis and ongoing intra-abdominal bleed were excluded. Consenting FAST positive, hemodynamically stable patients with blunt and penetrating abdominal trauma between 18 and 60 years of age were included and admitted for SNOM and detailed ultrasonography of the abdomen (in all) with or without CECT abdomen (selectively)...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29089680/acute-post-traumatic-portal-venous-thrombosis-associated-with-shattered-spleen-a-case-report
#16
Ranjana Gupta, Puneet Mittal, Preetparkash S Sekhon, Amit Mittal, Harkirat Kaur, Mohammad Aamir
Post-traumatic portal venous thrombosis is a rare event, and is usually seen in association with penetrating injuries. Portal venous thrombosis following blunt abdominal trauma is extremely rare with only few reports in the literature, some associated with underlying coagulation disorders. We report multidetector computed tomography findings in a case of blunt abdominal trauma with otherwise normal coagulation profile, which showed shattered spleen and MDCT evidence of acute thrombosis in the right branch of the portal vein...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29089165/a-case-of-intrauterine-lethal-fetal-injury-after-attempted-suicide-of-the-mother
#17
Lucia Tattoli, Giancarlo Di Vella, Biagio Solarino
Traumatic injuries in pregnancy such as abdominal trauma, pelvic fractures and penetrating trauma are major causes of maternal and neonatal morbidity and mortality. The most common causes of trauma during pregnancy are motor vehicle accidents, falls, assaults, gunshots, and burns. Pregnancy itself has been identified as a risk factor for trauma, together with a younger age, drug use, alcohol use, and domestic violence. We report the case of a 46-year-old woman, 34 weeks pregnant, who attempted suicide by jumping from a flyover, immediately after a probably deliberate traffic collision with the guardrail...
October 18, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29082822/endovascular-treatment-of-penetrating-arterial-trauma-with-stent-grafts
#18
Rodrigo Bruno Biagioni, Marcelo Calil Burihan, Felipe Nasser, Luisa Ciucci Biagioni, José Carlos Ingrund
BACKGROUND: The endovascular management of arterial injuries has resulted in reduced operating time, blood loss, hospital mortality, lower incidence of sepsis, and decrease in mortality rates. For penetrating trauma, however, the benefits of endovascular therapy are questionable. PATIENTS AND METHODS: Data were obtained by retrospective analysis of electronic medical records. All patients with vascular trauma seeking care at our institution from January 2010 to December 2015 were reviewed...
October 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29082327/endoscopic-management-of-penetrating-urethral-injury-after-an-animal-attack
#19
Amy Reed, Grant H Evans, Jacqueline Evans, Jeremy Kelley, David Ong
Background: Initial management of urethral injury remains controversial concerning the use of suprapubic urinary diversion and delayed repair, primary open realignment, and primary endoscopic realignment. To our knowledge, we present the first reported case of a penetrating urethral injury because of an animal attack, without concomitant extragenitourinary system involvement, managed entirely endoscopically. Case Presentation: This is a case of an 82-year-old male who presented to the emergency department after an attack by a semidomesticated deer...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29081016/a-review-of-imaging-modalities-used-in-the-diagnosis-and-management-of-scrotal-trauma
#20
REVIEW
Alexis Wang, Ian Stormont, M Minhaj Siddiqui
Genitourinary tract injuries account for 3 to 10% of trauma patients, and scrotal trauma is particularly prevalent in males 10 to 30 years of age. Prompt diagnosis and timely surgical intervention are essential to prevent future complications of infertility, delayed orchiectomy, infection, and testicular atrophy. While clinical examination provides valuable information, it may be inconclusive due to soft tissue swelling and difficult to perform due to testicular pain with palpation. Conversely, testicular rupture does not always present with pain or tenderness...
October 28, 2017: Current Urology Reports
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