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Trauma immobilisation

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https://www.readbyqxmd.com/read/28163926/rapid-analgesia-for-prehospital-hip-disruption-rapid-protocol-for-feasibility-study-of-randomised-controlled-trial
#1
Jenna K Bulger, Alan Brown, Bridie A Evans, Greg Fegan, Simon Ford, Katy Guy, Sian Jones, Leigh Keen, Ashrafunnesa Khanom, Ian Pallister, Nigel Rees, Ian T Russell, Anne C Seagrove, Helen A Snooks
BACKGROUND: Adequate pain relief at the point of injury and during transport to hospital is a major challenge in all acute traumas, especially for those with hip fractures, whose injuries are difficult to immobilise and whose long-term outcomes may be adversely affected by administration of opiate analgesics. Fascia iliaca compartment block (FICB) is a procedure routinely undertaken by doctors and nurses in the emergency department for patients with hip fracture but not yet evaluated for use by paramedics at the scene of emergency calls...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28157082/venous-thromboembolism-prophylaxis-in-outpatient-lower-limb-fractures-and-injuries
#2
Sanil H Ajwani, Alex Shaw, Osamah Naiz, Deepu Bhaskar, Charalambos P Charalambous
BACKGROUND: The risk of venous thromboembolism (VTE) is a preventable complication of trauma in ambulatory patients requiring temporary lower limb immobilisation. We introduced a VTE risk assessment and management tool in fracture clinics, to help improve appropriate VTE management of trauma patients that do not require hospitalisation. This was based on guidelines published by the College of Emergency Medicine (UK). Clinicians were asked to follow the screening tool and manage patients as per the pathway...
May 5, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#3
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28052526/effectiveness-of-a-multi-layer-foam-dressing-in-preventing-sacral-pressure-ulcers-for-the-early-acute-care-of-patients-with-a-traumatic-spinal-cord-injury-comparison-with-the-use-of-a-gel-mattress
#4
Andréane Richard-Denis, Cynthia Thompson, Jean-Marc Mac-Thiong
Individuals with spinal cord injury are at risk of sacral pressure ulcers due to, among other reasons, prolonged immobilisation. The effectiveness of a multi-layer foam dressing installed pre-operatively in reducing sacral pressure ulcer occurrence in spinal cord injured patients was compared to that of using a gel mattress, and stratified analyses were performed on patients with complete tetraplegia and paraplegia. Socio-demographic and clinical data were collected from 315 patients admitted in a level-I trauma centre following a spinal cord injury between April 2010 and March 2016...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#5
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27533711/c-mac-videolaryngoscope-compared-with-direct-laryngoscopy-for-rapid-sequence-intubation-in-an-emergency-department-a-randomised-clinical-trial
#6
Simon Sulser, Dirk Ubmann, Martin Schlaepfer, Martin Brueesch, Georg Goliasch, Burkhardt Seifert, Donat R Spahn, Kurt Ruetzler
BACKGROUND: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE: The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting...
December 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27527678/maxillofacial-trauma-underestimation-of-cervical-spine-injury
#7
Waldemar Reich, Alexey Surov, Alexander Walter Eckert
Undiagnosed cervical spine injury can have devastating results. The aim of this study was to analyse patients with primary maxillofacial trauma and a concomitant cervical spine injury. It is hypothetised that cervical spine injury is predictable in maxillofacial surgery. A monocentric clinical study was conducted over a 10-year period to analyse patients with primary maxillofacial and associated cervical spine injuries. Demographic data, mechanism of injury, specific trauma and treatments provided were reviewed...
September 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27474412/heterogeneity-in-cervical-spine-assessment-in-paediatric-trauma-a-survey-of-physicians-knowledge-and-application-at-a-paediatric-major-trauma-centre
#8
Aaron J Buckland, Silvia Bressan, Helen Jowett, Michael B Johnson, Warwick J Teague
OBJECTIVE: Evidence-based decision-making tools are widely used to guide cervical spine assessment in adult trauma patients. Similar tools validated for use in injured children are lacking. A paediatric-specific approach is appropriate given important differences in cervical spine anatomy, mechanism of spinal injury and concerns over ionising radiation in children. The present study aims to survey physicians' knowledge and application of cervical spine assessment in injured children. METHODS: A cross-sectional survey of physicians actively engaged in trauma care within a paediatric trauma centre was undertaken...
October 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27298289/the-need-to-immobilise-the-cervical-spine-during-cardiopulmonary-resuscitation-and-electric-shock-administration-in-out-of-hospital-cardiac-arrest
#9
Milene Desroziers, Sophie Mole, Daniel Jost, Jean-Pierre Tourtier
In cases of out-of hospital cardiac arrest (OHCA), falling to the ground can cause brain and neck trauma to the patient. We present a case of a man in his mid-60s who suffered from an OHCA resulting in a violent collapse. The patient received immediate cardiopulmonary resuscitation, but his spine was immobilised only after a large frontal haematoma was found. The resuscitation efforts resulted in return of spontaneous circulation and discharge from hospital. After this, doctors performed angioplasty, followed by a cardiopulmonary bypass...
June 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27277072/the-characteristics-and-pre-hospital-management-of-blunt-trauma-patients-with-suspected-spinal-column-injuries-a-retrospective-observational-study
#10
J T Oosterwold, D C Sagel, P M van Grunsven, M Holla, J de Man-van Ginkel, S Berben
BACKGROUND: Pre-hospital spinal immobilisation by emergency medical services (EMS) staff is currently the standard of care in cases of suspected spinal column injuries. There is, however, a lack of data on the characteristics of patients who received spinal immobilisation during the pre-hospital phase and on the adverse effects of immobilisation. The objectives of this study were threefold. First, we determined the pre-hospital characteristics of blunt trauma patients with suspected spinal column injuries who were immobilised by EMS staff...
June 8, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27260639/scaphoid-waist-internal-fixation-for-fractures-trial-swifft-protocol-a-pragmatic-multi-centre-randomised-controlled-trial-of-cast-treatment-versus-surgical-fixation-for-the-treatment-of-bi-cortical-minimally-displaced-fractures-of-the-scaphoid-waist-in-adults
#11
Joseph Dias, Stephen Brealey, Surabhi Choudhary, Liz Cook, Matthew Costa, Caroline Fairhurst, Catherine Hewitt, Stephen Hodgson, Laura Jefferson, Kanagaratnam Jeyapalan, Ada Keding, Paul Leighton, Amar Rangan, Gerry Richardson, Claire Rothery, Nicholas Taub, John Thompson, David Torgerson
BACKGROUND: A scaphoid fracture is the most common type of carpal fracture affecting young active people. The optimal management of this fracture is uncertain. When treated with a cast, 88 to 90 % of these fractures unite; however, for the remaining 10-12 % the non-union almost invariably leads to arthritis. The alternative is surgery to fix the scaphoid with a screw at the outset. METHODS/DESIGN: We will conduct a randomised controlled trial (RCT) of 438 adult patients with a "clear" and "bicortical" scaphoid waist fracture on plain radiographs to evaluate the clinical effectiveness and cost-effectiveness of plaster cast treatment (with fixation of those that fail to unite) versus early surgical fixation...
June 4, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27255183/diagnostic-accuracy-of-flexion-extension-radiography-for-the-detection-of-ligamentous-cervical-spine-injury-following-a-normal-cervical-spine-computed-tomography
#12
Jason Jaeseong Oh, Stephen Edward Asha, Kate Curtis
BACKGROUND: Flexion-extension radiography (FER) has been utilised for the detection of ligamentous injury in patients who have been cleared of bony injury. Some studies call into question the diagnostic accuracy of FER, the high proportion of inadequate FER images and the adverse effects of prolonged cervical collar immobilisation although awaiting FER. METHODS: We conducted a two-part retrospective study of trauma patients presenting to a trauma centre between January 2007 and December 2014...
August 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27091739/effect-of-spineboard-and-headblocks-on-the-image-quality-of-head-ct-scans
#13
Baukje Hemmes, Cécile R L P N Jeukens, Aliaa Al-Haidari, Paul A M Hofman, Ed S Vd Linden, Peter R G Brink, Martijn Poeze
Trauma patients at risk for, or suspected of, spinal injury are frequently transported to hospital using full spinal immobilisation. At the emergency department, immobilisation is often maintained until radiological work-up is completed. In this study, we examined how these devices for spinal stabilization influence visual image quality. Image quality was judged for both patient CT scans and phantom CT scans. CT scans of 217 patients were assessed retrospectively by two radiologists for visual scoring of image quality, scoring both quantity and impact of artifacts caused by the immobilization devices...
June 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27034926/airway-management-with-cervical-spine-immobilisation-a-comparison-between-the-macintosh-laryngoscope-truview-evo2-and-totaltrack-vlm-used-by-novices-a-manikin-study
#14
Dawid Aleksandrowicz, Tomasz Gaszyński
Airway management in patients with suspected cervical spine injury plays an important role in the pathway of care of trauma patients. The aim of this study was to evaluate three different airway devices during intubation of a patient with reduced cervical spine mobility. Forty students of the third year of emergency medicine studies participated in the study (F = 26, M = 14). The time required to obtain a view of the entry to the larynx and successful ventilation time were recorded. Cormack-Lehane laryngoscopic view and damage to the incisors were also assessed...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27033333/interventions-for-treating-ankle-fractures-in-children
#15
REVIEW
Denise E Yeung, Xueli Jia, Clare A Miller, Simon L Barker
BACKGROUND: Ankle fractures, which usually occur after a twisting incident, are a diverse collection of injuries with different levels of complexity and severity. They have an incidence of 1 in 1000 a year in children. Treatment generally involves splints and casts for minor fractures and surgical fixation with screws, plates and pins followed by immobilisation for more serious fractures. OBJECTIVES: To assess the effects (benefits and harms) of different interventions for treating ankle fractures in children...
April 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27013521/lisfranc-fracture-dislocation-a-review-of-a-commonly-missed-injury-of-the-midfoot
#16
REVIEW
Simon Lau, Michael Bozin, Tharsa Thillainadesan
Musculoskeletal trauma to the foot is a common presentation to EDs. A Lisfranc fracture dislocation involves injury to the bony and soft tissue structures of the tarsometatarsal joint. While it is most commonly seen post high velocity trauma, it can also present post minor trauma. It is also misdiagnosed in approximately 20% of cases. These Lisfranc injuries typically present to EDs with pain particularly with weight bearing, swelling and post a characteristic mechanism of injury. Diagnosis is via clinical examination and radiological investigation-typically plain radiographs and CTs...
January 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27005407/can-emergency-nurses-safely-and-accurately-remove-cervical-spine-collars-in-low-risk-adult-trauma-patients-an-integrative-review
#17
REVIEW
Nicola Smith, Kate Curtis
BACKGROUND: Well validated clinical decision rules exist to facilitate the safe removal of collars in the alert, orientated, low risk adult trauma patient, however this practice is traditionally conducted by medical staff. The aim of this review is to synthesise current evidence to determine the efficacy of emergency nurses in safely and accurately removing cervical spine collars using cervical spine rules, in alert, orientated, low risk trauma adult patients. METHODS: A multi-method search strategy was used to find primary research studies followed by a rigorous screening and quality appraisal process...
May 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/26861798/pelvic-x-ray-misses-out-on-detecting-sacral-fractures-in-the-elderly-importance-of-ct-imaging-in-blunt-pelvic-trauma
#18
Andreas Schicho, Stefan A Schmidt, Kevin Seeber, Alain Olivier, Peter H Richter, Florian Gebhard
Patients aged 75 years and older with blunt pelvic trauma are frequently seen in the ER. The standard diagnostic tool in these patients is the plain a.p.-radiograph of the pelvis. Especially lesions of the posterior pelvic ring are often missed due to e.g. bowel gas projection and enteric overlay. With a retrospective study covering these patients over a 3 year period in our level I trauma centre, we were able to evaluate the rate of missed injuries in the a.p.-radiograph whenever a corresponding CT scan was performed...
March 2016: Injury
https://www.readbyqxmd.com/read/26685877/utility-of-flexion-extension-radiography-for-the-detection-of-ligamentous-cervical-spine-injury-and-its-current-role-in-the-clearance-of-the-cervical-spine
#19
REVIEW
Jason Jaeseong Oh, Stephen Edward Asha
Detecting the presence of injuries to the cervical spine is an important component of the initial assessment of patients sustaining blunt trauma. A small proportion of cervical spine injuries consists of ligamentous disruption. Accurate detection of ligamentous injury is essential as it may result in sequelae including radiculopathy, quadriplegia and death. Flexion-extension (FE) radiography has traditionally been utilised for the detection of ligamentous injury in patients who have been cleared of bony injury...
April 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/26560014/interventions-for-treating-proximal-humeral-fractures-in-adults
#20
REVIEW
Helen H G Handoll, Stig Brorson
BACKGROUND: Fracture of the proximal humerus, often termed shoulder fracture, is a common injury in older people. The management of these fractures varies widely. This is an update of a Cochrane Review first published in 2001 and last updated in 2012. OBJECTIVES: To assess the effects (benefits and harms) of treatment and rehabilitation interventions for proximal humeral fractures in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and other databases, conference proceedings and bibliographies of trial reports...
November 11, 2015: Cochrane Database of Systematic Reviews
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