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Multitrauma

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https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#1
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29717705/-handling-of-hypermetabolism-in-major-burn-injuries
#2
Kaveh Borhani-Khomani, Martin Risom Vestergaard, Rikke Holmgaard
Multitrauma, critical illness and major burn injuries give rise to a stress response with a consequential increase in resting energy expenditure. Especially for burn trauma patients, this stress response is severe and prolonged and may cause a reduced lean muscle mass, loss of peripheral fatty tissue, hyperglycaemia and stress-induced diabetes. This review provides an overview of current strategies to attenuate the hypermetabolic stress response in order to improve the clinical outcome for these patients.
April 23, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29708915/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#3
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29569684/media-based-clinical-research-on-selfie-related-injuries-and-deaths
#4
Mehmet Dokur, Emine Petekkaya, Mehmet Karadağ
BACKGROUND: The incidence of taking selfies and sharing them on social media as well as selfie-related behaviors is increasing, particularly among young people, possible leading to selfie-related trauma. Therefore, we performed this clinical study to draw attention to selfie-related injuries and deaths. METHODS: We analyzed 159 selfie victims from 111 events or accidents, which were reported in the media sources. We evaluated vital results, demography, rhythmicity, preferences, event or accident types, selfie-related risk factors, affected body regions of victims with causes of injury, and death...
March 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29553087/oblique-chest-x-ray-an-alternative-way-to-detect-pneumothorax
#5
Cumhur Murat Tulay, Sadık Yaldız, Adnan Bilge
PURPOSE: To identify occult pneumothorax with oblique chest X-ray (OCXR) in clinically suspected patients. METHODS: In this retrospective study, we examined 1082 adult multitrauma patients who were admitted to our emergency service between January 2016 and January 2017. Clinical findings that suggest occult pneumothorax were rib fracture, flail chest, chest pain, subcutaneous emphysema, abrasion or ecchymosis and moderate to severe hypoxia in clinical parameters...
March 16, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29550926/management-of-mild-traumatic-brain-injury-trauma-energy-level-and-medical-history-as-possible-predictors-for-intracranial-hemorrhage
#6
Tomas Vedin, Sebastian Svensson, Marcus Edelhamre, Mathias Karlsson, Mikael Bergenheim, Per-Anders Larsson
PURPOSE: Head trauma is common in the emergency department. Identifying the few patients with serious injuries is time consuming and leads to many computerized tomographies (CTs). Reducing the number of CTs would reduce cost and radiation. The aim of this study was to evaluate the characteristics of adults with head trauma over a 1-year period to identify clinical features predicting intracranial hemorrhage. METHODS: Medical record data have been collected retrospectively in adult patients with traumatic brain injury...
March 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29462034/acute-thoracolumbar-spinal-cord-injury-relationship-of-cord-compression-to-neurological-outcome
#7
Peta Skeers, Camila R Battistuzzo, Jillian M Clark, Stephen Bernard, Brian J C Freeman, Peter E Batchelor
BACKGROUND: Spinal cord injury in the cervical spine is commonly accompanied by cord compression and urgent surgical decompression may improve neurological recovery. However, the extent of spinal cord compression and its relationship to neurological recovery following traumatic thoracolumbar spinal cord injury is unclear. The purpose of this study was to quantify maximum cord compression following thoracolumbar spinal cord injury and to assess the relationship among cord compression, cord swelling, and eventual clinical outcome...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29434806/extracorporeal-membrane-oxygenation-support-for-a-multitrauma-patient-with-ards-a-case-report-and-literature-review
#8
Yuexing Tu, Qi Jin, Renhua Sun, Qian Li
Extracorporeal membrane oxygenation (ECMO) provides rescue treatment for patients with severe acute respiratory distress syndrome (ARDS) when conventional management fails. The present study reported ECMO as a life-saving treatment for ARDS due to bilateral pulmonary contusion in a 24-year-old male multiple trauma patient. ECMO therapy lasted 7 days for the patient and was successively stopped without any complications. ECMO modality should be chosen according to the respiratory and circulatory condition of each individual...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#9
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29170332/35-to-pan-scan-or-not-to-pan-scan-further-analysis-of-the-tarn-database-2012-2017
#10
Paul Hunt, Fiona Lecky, Omar Bouamra
BACKGROUND: A 'whole body' or 'pan-scan' computed tomography (CT) imaging approach is now becoming the standard of care during the early management of adult patients with suspected severe blunt multitrauma. A number of studies have variously reported a mortality benefit or no benefit from a pan-scan approach compared to that of carrying out body region-focused CT and/or plain radiographs or a mixture of imaging modalities. However, unanswered questions still remain due to the significant heterogeneity in practice between institutions, and the limitations of published studies...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29138874/using-il-6-concentrations-in-the-first-24%C3%A2-h-following-trauma-to-predict-immunological-complications-and-mortality-in-trauma-patients-a-meta-analysis
#11
REVIEW
Zhi Qiao, Weikang Wang, Luxu Yin, Peng Luo, Johannes Greven, Klemens Horst, Frank Hildebrand
PURPOSE: In previous studies, interleukin-6 (IL-6) has been shown to have a high predictive value for the development of complications and mortality after trauma; however, there is some uncertainty around these results. The aim of this meta-analysis was to assess the value of early IL-6 levels (within the first 24 h after trauma) for predicting post-traumatic complications [acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, multiple organ failure (MOF), and multiple organ dysfunction syndrome (MODS)] and mortality...
November 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#12
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29051983/delayed-manifestations-of-abdominal-trauma-follow-up-abdominopelvic-ct-in-posttraumatic-patients
#13
Khaled Y Elbanna, Mohammed F Mohammed, Shih-Chieh Huang, David Mak, J Philip Dawe, Emilie Joos, Heather Wong, Faisal Khosa, Savvas Nicolaou
PURPOSE: Our study aims to investigate the frequency and patterns of delayed manifestations of abdominal and pelvic injuries which may not be identified or which fail to manifest on the initial abdominopelvic CT in posttraumatic patients. METHODS: For our institutional review board (IRB)-approved retrospective study, our hospital trauma registry was queried for patients with blunt multitrauma and Injury Severity Score (ISS) ≥ 16 between January 2010 and August 2016, yielding 3735 patients...
October 19, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#14
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28670821/pain-intensity-and-pain-self-management-strategies-following-discharge-after-surgery-an-australian-prospective-observational-study
#15
F C Veal, A J Thompson, L J Perry, L R Bereznicki, G M Peterson
WHAT IS KNOWN AND OBJECTIVE: Up to 80% of patients experience acute pain following surgery. This study aimed to improve the current understanding about the strategies individuals use to self-manage pain following discharge after surgery, stratified by pain intensity. METHODS: A prospective observational study conducted at the Royal Hobart Hospital, Australia, between November 2014 and March 2015. Eligible participants were 18 years or older and had undergone surgery requiring an incision...
February 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28665985/early-decreased-neutrophil-responsiveness-is-related-to-late-onset-sepsis-in-multitrauma-patients-an-international-cohort-study
#16
Kathelijne M Groeneveld, Leo Koenderman, Brian L Warren, Saskia Jol, Luke P H Leenen, Falco Hietbrink
BACKGROUND: Severe trauma can lead to the development of infectious complications after several days, such as sepsis. Early identification of patients at risk will aid anticipating these complications. The aim of this study was to test the relation between the acute (<24 hours) inflammatory response after injury measured by neutrophil responsiveness and the late (>5 days) development of septic complications and validate this in different trauma populations. METHODS AND FINDINGS: Two prospective, observational, cohort series in the Netherlands and South Africa, consisting of severely injured trauma patients...
2017: PloS One
https://www.readbyqxmd.com/read/28616615/the-predictive-value-of-biochemical-parameters-in-evaluating-patients-with-abdominal-trauma-the-new-scoring-system
#17
Ekrem Musalar, Murat Ersel, Funda Karbek Akarca, Güçlü Selahattin Kıyan, Özge Can
AIM: The aim of this study was to investigate the contribution of non-invasively and rapidly obtained biochemical parameter results to the diagnosis and follow-up of intraabdominal injuries in multitrauma patients. MATERIAL AND METHODS: A total of 2604 multitrauma patients who were treated following their referral to our emergency department between January 2009 and January 2012 were retrospectively reviewed. A logistic regression analysis was used in the risk assessment...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28614864/-the-patient-with-chest-trauma-surgical-management
#18
REVIEW
Patrick Zardo, Henning Busk, Stefan Piatek, Norman Zinne, Irina Kropivnitskaya, Ingo Kutschka
Even though isolated cases of penetrating chest wounds are exceptionally rare in Germany, chest trauma accounts for major morbidity and mortality in over 18 0000 multitrauma patients encountered every year. Injuries range from immediately fatal cardiac wounds and major vessel lacerations to intercostal bleeding, parenchymal damage, chronic haematothorax and secondary empyema. Placement of large-bore chest tubes constitutes a sufficient treatment for most of these pathologies. In select cases further treatment either by minimally invasive techniques (VATS) or conventional thoracotomy is warranted...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28486263/predicting-thoracic-injury-in-children-with-multitrauma
#19
Kirstin D Weerdenburg, Paul W Wales, Derek Stephens, Suzanne Beno, Jessica Gantz, Jessie Alsop, Suzanne Schuh
OBJECTIVES: Previous pediatric trauma studies focused on predictors of abnormal chest radiographs or included patients with low injury severity. This study identified predictors of thoracic injury (TI) diagnoses in a high-risk population and determined TI rate without predictors. METHODS: This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28416071/-acute-upper-airway-obstruction-caused-by-a-multinodular-goitre-after-tracheotomy
#20
Chadi Nimeh Abdel-Halim, Bibi Lange
This case report illustrates how a multinodular goitre caused acute airway obstruction in a multitrauma 66-year-old male after tracheotomy. The patient had no symptoms of the goitre before the tracheotomy but developed subglottic airway obstruction at the time of decannulation. He underwent a subacute total thyroidectomy which removed the obstructive symptoms. A weakening of the tracheal tube followed by the tracheotomy possibly caused the tracheal stenosis in combination with the goitre.
April 3, 2017: Ugeskrift for Laeger
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