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Trauma resuscitation

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https://www.readbyqxmd.com/read/28730296/early-computed-tomography-or-focused-assessment-with-sonography-in-abdominal-trauma-what-are-the-leading-opinions
#1
L Grünherz, K O Jensen, V Neuhaus, L Mica, C M L Werner, B Ciritsis, C Michelitsch, G Osterhoff, H-P Simmen, K Sprengel
PURPOSE: The initial assessment of severely injured patients in the resuscitation room requires a systematic and quickly performed survey. Whereas the Advanced Trauma Life Support (ATLS(®))-based algorithm recommends focused assessment with sonography in trauma (FAST) among others, recent studies report a survival advantage of early whole-body computed tomography (WBCT) in haemodynamically stable as well as unstable patients. This study assessed the opinions of trauma surgeons about the early use of WBCT in severely injured patients with abdominal trauma, and abdominal CT in patients with isolated abdominal trauma, during resuscitation room treatment...
July 20, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28727610/the-metabolopathy-of-tissue-injury-hemorrhagic-shock-and-resuscitation-in-a-rat-model
#2
Anne L Slaughter, Geoffrey R Nunns, Angelo D'Alessandro, Anirban Banerjee, Kirk C Hansen, E E Moore, Christopher C Silliman, Travis Nemkov, Hunter B Moore, Miguel Fragoso, Kiara Leasia, Erik D Peltz
INTRODUCTION: The metabolic consequences of trauma induce significant clinical pathology. In this study we evaluate the independent, metabolic contributions of tissue injury (TI) and combined tissue injury and hemorrhagic shock (TI / HS) using MS-metabolomics in a controlled animal model of critical injury. METHODS: Sprague-Dawley rats (n = 14) underwent TI alone or TI / HS, followed by resuscitation with normal saline and shed blood. Plasma was collected (baseline, post-laparotomy, post-HS, post-resuscitation) for Ultra High Pressure Liquid Chromatography (UHPLC) MS-metabolomics...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28725258/a-meta-analysis-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-or-open-aortic-cross-clamping-by-resuscitative-thoracotomy-in-non-compressible-torso-hemorrhage-patients
#3
REVIEW
Ramiro Manzano Nunez, Maria Paula Naranjo, Esteban Foianini, Paula Ferrada, Erika Rincon, Herney Andrés García-Perdomo, Paola Burbano, Juan Pablo Herrera, Alberto F García, Carlos A Ordoñez
BACKGROUND: The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients. METHODS: Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28724601/focused-assessment-with-sonography-for-trauma-fast-identifies-liver-injury-following-cardiopulmonary-resuscitation
#4
Hiroshi Nashiki, Yoshiharu Miyate, Yousuke Terui, Masayuki Otani
Liver trauma is a recognised rare complication of cardiopulmonary resuscitation (CPR) and may be difficult to detect. We report a case of intraperitoneal haemorrhage due to liver injury following CPR in a 50-year-old man admitted to the intensive care unit. The haemorrhage was diagnosed with focused assessment with sonography for trauma (FAST). FAST can rapidly and easily diagnose liver injury. FAST is recommended for excluding haemoperitoneum in patients who are haemodynamically unstable after resuscitation...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28723841/military-civilian-partnership-in-device-innovation-development-commercialization-and-application-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#5
Todd E Rasmussen, Jonathan L Eliason
Noncompressible torso hemorrhage (NCTH) and shock is a leading cause of trauma-related mortality and evidence suggests that survival from this injury pattern has not improved in decades. As such, innovating new approaches and devices, including technologies which can be used by providers within a short of time after severe injury, is a priority for the military. Guided by wartime observations, and through partnerships with civilian academia and private investment, the military has led an effort to define resuscitative endovascular balloon occlusion of the aorta (REBOA) and assess its potential to address this problem...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#6
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#7
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#8
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28715125/acute-alcohol-binge-deteriorates-metabolic-and-respiratory-compensation-capability-after-blunt-chest-trauma-followed-by-hemorrhagic-shock-a-new-research-model
#9
Nils Wagner, Niklas Franz, Scott Dieteren, Mario Perl, Katharina Mörs, Ingo Marzi, Borna Relja
BACKGROUND AND PURPOSE: The clinical relevance of blunt (thoracic) chest trauma (TxT) and hemorrhagic shock is indisputable due to the high prevalence of this injury type, as well as its close association with mortality and/or preventable deaths. Furthermore, there is an ongoing discussion about the influence of alcohol in trauma patients. Thus, we established a model of TxT followed by hemorrhagic shock and resuscitation (H/R) in alcohol-intoxicated rats. EXPERIMENTAL APPROACH: Depending on group allocation, twelve (sub-acute) or two (acute) hours before experimentation, the animals received a single oral dose of alcohol (ethanol, EtOH) or saline (NaCl) followed by TxT, hemorrhagic shock (35 ± 3 mm Hg) and resuscitation (TxT+H/R)...
July 17, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28711949/pediatric-out-of-hospital-cardiopulmonary-resuscitation-by-helicopter-emergency-medical-service-does-it-has-added-value-compared-to-regular-emergency-medical-service
#10
X R J Moors, K Rijs, D Den Hartog, R J Stolker
PURPOSE: To determine the outcome of out-of-hospital (OOH) cardiopulmonary resuscitation (CPR) and the advanced life support (ALS) procedures provided in pediatrics by the Rotterdam Helicopter Emergency Medical Service (HEMS) METHODS: Retrospective evaluation of all pediatric (0-17 years) OOH cardiopulmonary arrests within a 6-year period and attended by the Rotterdam HEMS team. RESULTS: There were 201 OOH CPRs from October 2008 until October 2014. Endotracheal intubation was performed in 164 cases and done by HEMS in 104 patients (63%), intraosseous/intravenous cannulation 43/27 times, and additional medication given by HEMS in 70 patients (35%)...
July 15, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28707273/team-communication-patterns-in-emergency-resuscitation-a-mixed-methods-qualitative-analysis
#11
Lisa Anne Calder, George Mastoras, Mitra Rahimpour, Benjamin Sohmer, Brian Weitzman, A Adam Cwinn, Tara Hobin, Avi Parush
BACKGROUND: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. METHODS: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#12
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#13
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#14
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28702076/the-management-of-intra-abdominal-infections-from-a-global-perspective-2017-wses-guidelines-for-management-of-intra-abdominal-infections
#15
REVIEW
Massimo Sartelli, Alain Chichom-Mefire, Francesco M Labricciosa, Timothy Hardcastle, Fikri M Abu-Zidan, Abdulrashid K Adesunkanmi, Luca Ansaloni, Miklosh Bala, Zsolt J Balogh, Marcelo A Beltrán, Offir Ben-Ishay, Walter L Biffl, Arianna Birindelli, Miguel A Cainzos, Gianbattista Catalini, Marco Ceresoli, Asri Che Jusoh, Osvaldo Chiara, Federico Coccolini, Raul Coimbra, Francesco Cortese, Zaza Demetrashvili, Salomone Di Saverio, Jose J Diaz, Valery N Egiev, Paula Ferrada, Gustavo P Fraga, Wagih M Ghnnam, Jae Gil Lee, Carlos A Gomes, Andreas Hecker, Torsten Herzog, Jae Il Kim, Kenji Inaba, Arda Isik, Aleksandar Karamarkovic, Jeffry Kashuk, Vladimir Khokha, Andrew W Kirkpatrick, Yoram Kluger, Kaoru Koike, Victor Y Kong, Ari Leppaniemi, Gustavo M Machain, Ronald V Maier, Sanjay Marwah, Michael E McFarlane, Giulia Montori, Ernest E Moore, Ionut Negoi, Iyiade Olaoye, Abdelkarim H Omari, Carlos A Ordonez, Bruno M Pereira, Gerson A Pereira Júnior, Guntars Pupelis, Tarcisio Reis, Boris Sakakhushev, Norio Sato, Helmut A Segovia Lohse, Vishal G Shelat, Kjetil Søreide, Waldemar Uhl, Jan Ulrych, Harry Van Goor, George C Velmahos, Kuo-Ching Yuan, Imtiaz Wani, Dieter G Weber, Sanoop K Zachariah, Fausto Catena
Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28700412/parathyroid-hormone-as-a-marker-for-hypoperfusion-in-trauma-a-prospective-observational-study
#16
Scott C Fligor, Katie M Love, Bryan R Collier, Daniel I Lollar, Mark E Hamill, Andrew D Benson, Eric H Bradburn
BACKGROUND: Hyperparathyroidism is common in critical illness. Intact parathyroid hormone has a half-life of 3 to 5 minutes due to rapid clearance by the liver, kidneys, and bone. In hemorrhagic shock, decreased clearance may occur, thus making parathyroid hormone a potential early marker for hypoperfusion. We hypothesized that early hyperparathyroidism predicts mortality and transfusion in trauma patients. METHODS: A prospective observational study was performed at a Level 1 trauma center in consecutive adult patients receiving the highest level of trauma team activation...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697025/reboa-for-the-ivc-resuscitative-balloon-occlusion-of-the-inferior-vena-cava-rebovc-to-abate-massive-hemorrhage-in-retro-hepatic-vena-cava-injuries
#17
Cassandra L Reynolds, Adam C Celio, Lindsay C Bridges, Catalina Mosquera, Brian O'Connell, Michael R Bard, Connie M DeLa'o, Eric A Toschlog
BACKGROUND: The use of resuscitative endovascular balloon occlusion as a maneuver for occlusion of the aorta is well described. This technique has life-saving potential in other cases of traumatic hemorrhage. Retro-hepatic inferior vena cava (IVC) injuries have a high rate of mortality, in part, due to the difficulty in achieving total vascular isolation. This studies purpose was to investigate the ability of resuscitative balloon occlusion of the IVC (REBOVC) to control supra-hepatic IVC hemorrhage in a swine model of trauma...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697023/clot-dynamics-and-mortality-the-ma-r-ratio
#18
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing TEG to identify those at risk for subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28693651/models-of-care-for-traumatically-injured-patients-at-trauma-centres-in-british-columbia-variability-and-sustainability
#19
Benjamin Tuyp, Kasra Hassani, Lisa Constable, Joseph Haegert
BACKGROUND: Successful trauma systems employ a network of variably-resourced hospitals, staffed by experienced providers, to deliver optimal care for injured patients. The "model of care"-the manner by which inpatients are admitted and overseen, is an important determinant of patient outcomes. OBJECTIVES: To describe the models of inpatient trauma care at British Columbia's (BC's) ten adult trauma centres, their sustainability, and their compatibility with accreditation guidelines...
July 11, 2017: CJEM
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#20
REVIEW
Sarah Buse, Marc Blancher, Damien Viglino, Mathieu Pasquier, Maxime Maignan, Pierre Bouzat, Thorsten Annecke, Guillaume Debaty
BACKGROUND: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. METHODS: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors...
July 5, 2017: Resuscitation
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