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Cardiac trauma

Mark G Van Vledder, Vicky Kwakernaak, Tjebbe Hagenaars, Esther M M Van Lieshout, Michiel H J Verhofstad
BACKGROUND: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. METHODS: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected...
June 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
John K Yue, Angel Ordaz, Ethan A Winkler, Hansen Deng, Catherine G Suen, John F Burke, Andrew K Chan, Geoffrey T Manley, Sanjay S Dhall, Phiroz E Tarapore
OBJECTIVE: Predictors of surgical outcomes following traumatic axis (C2) fractures in octogenarians remain undercharacterized. METHODS: Patients aged ≥80-years undergoing cervical spine surgery following traumatic C2 fractures were extracted from the National Sample Program of the National Trauma Data Bank (2003-2012). Outcomes include overall inpatient complications, individual complications >1% incidence, hospital length of stay (HLOS), discharge disposition, and mortality...
June 7, 2018: World Neurosurgery
Hyun Oh Park, Joung Hun Byun, Seong Ho Moon, Jong Woo Kim, Sung Hwan Kim, Ki Nyun Kim, Jae Jun Jung, Dong Hoon Kang, Jun Young Choi, Jun Ho Yang, In Seok Jang, Chung Eun Lee
BACKGROUND: The pseudoaneurysms of sinus of Valsalva is an uncommon and serious complication of an infection, trauma, or after cardiac surgery or procedure. Pseudoaneurysms of sinus of Valsalva from left is rare. We describe a case of pseudoaneurysm of the left coronary sinus of Valsalva invaded into the left ventricle (LV) diagnosed by transthoracic echocardiography (TTE), transesophageal ecoccardiography (TEE), and multiple detector computed tomography (MDCT). CASE PRESENTATION: A 44-year-old male patient had New York Heart Association (NYHA) class II / III dyspnea during 4 months...
June 7, 2018: Journal of Cardiothoracic Surgery
Marko Hoikka, Tom Silfvast, Tero I Ala-Kokko
OBJECTIVES: The prehospital research field has focused on studying patient survival in cardiac arrest, as well as acute coronary syndrome, stroke, and trauma. There is little known about the overall short-term mortality and its predictability in unselected prehospital patients. This study examines whether a prehospital National Early Warning Score (NEWS) predicts 1-day and 30-day mortalities. METHODS: Data from all emergency medical service (EMS) situations were coupled to the mortality data obtained from the Causes of Death Registry during a six-month period in Northern Finland...
June 7, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Chris DeClue, John M Donatelli, Carlos A Rojas
The purpose of this article was to review the pathophysiology, imaging features, and imaging pitfalls of noncongenital ventricular septal defects (VSDs). Noncongenital VSDs can result from ischemic heart disease, trauma, infection, and iatrogenic causes. Ischemic VSDs typically involve the posterior descending or left anterior descending vascular territories and are commonly seen in the apical septum or basal-mid inferoseptum. VSDs can also occur in patients with infectious endocarditis or as a complication following cardiac surgery...
June 5, 2018: Journal of Thoracic Imaging
Teresa Ojode, Joshua W Sappenfield
Thoracic trauma poses a risk of injury to the thoracic organs and great vessels, including the coronaries. We present an interesting case of occult, life-threatening coronary bypass graft injury resulting from thoracic trauma. In this case, the diagnosis and management were contingent on understanding the nature of the bypass graft, which was not apparent at the time of presentation in extremis . Ultimate hemostasis required cardiac catheterization and placement of an exclusionary stent. Though there are several case reports describing native coronary injury resulting from thoracic injury, we found a single case of thoracic trauma-associated coronary bypass graft injury, which was managed medically...
June 2018: Trauma Case Reports
Janosch Dahmen, Marko Brade, Christian Gerach, Martin Glombitza, Jan Schmitz, Simon Zeitter, Eva Steinhausen
BACKGROUND: The European Resuscitation Council guidelines for resuscitation in patients with traumatic cardiac arrest recommend the immediate treatment of all reversible causes, if necessary even prior to continuous chest compression. In the case of cardiac tamponade immediate emergency thoracotomy should also be considered. OBJECTIVE: The authors report the case of a 23-year-old male patient with multiple injuries including blunt thoracic trauma, which caused a witnessed cardiac arrest...
June 5, 2018: Der Unfallchirurg
Orrin Devinsky, Anthony Kim, Daniel Friedman, Annie Bedigian, Ellen Moffatt, Zian H Tseng
OBJECTIVE: Since cardic fibrosis was previously found more frequently in patients with sudden unexpected death in epilepsy (SUDEP) than control cases, we compared blinded and quantitative reviews of cardiac pathology in SUDEP to multiple control groups. METHODS: We adjudicated causes of death in epilepsy patients as part of consecutive out-of-hospital sudden cardiac deaths (SCDs) from the Postmortem Systematic Investigation of Sudden Cardiac Death (POSTSCD) study...
June 1, 2018: Neurology
Kimon L H Ioannides, Avi Baehr, David N Karp, Douglas J Wiebe, Brendan G Carr, Daniel N Holena, M Kit Delgado
OBJECTIVES: We determined the impact of including race, ethnicity, and poverty in risk adjustment models for emergency care sensitive conditions mortality that could be used for hospital pay-for-performance initiatives. We hypothesized that adjusting for race, ethnicity, and poverty would bolster rankings for hospitals that cared for a disproportionate share of non-white, Hispanic, or poor patients. METHODS: We performed a cross-sectional analysis patients admitted from the emergency department to 157 hospitals in Pennsylvania with trauma, sepsis, stroke, cardiac arrest, and ST-elevation myocardial infarction...
May 31, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jon B Cole, Lauren R Klein, Marc L Martel
BACKGROUND: Acute agitation secondary to alcohol intoxication frequently requires parenteral sedatives for patient and caregiver safety. Antipsychotics play a prominent role, however no consensus exists regarding the ideal agent. One important consideration when evaluating the choice of antipsychotic is its association with ED length of stay (LOS). OBJECTIVES: We sought to determine the median ED LOS for patients receiving a single parenteral dose of an antipsychotic for acute agitation secondary to alcohol intoxication in an urban level 1 trauma center...
May 31, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Stephanie A Eyerly-Webb, Rachele Solomon, Seong K Lee, Rafael Sanchez, Eddy H Carrillo, Dafney L Davare, Chauniqua Kiffin, Andrew Rosenthal
More people are struck and killed by lightning each year in Florida than any other state in the United States. This report discusses a couple that was simultaneously struck by lightning while walking arm-in-arm. Both patients presented with characteristic lightning burns and were admitted for hemodynamic monitoring, serum labs, and observation and were subsequently discharged home. Despite the superficial appearance of lightning burns, serious internal electrical injuries are common. Therefore, lightning strike victims should be admitted and evaluated for cardiac arrhythmias, renal injury, and neurological sequelae...
August 2017: Clinical practice and cases in emergency medicine
Benjamin Thomas, Edward Durant, Sophie Barbant, Arun Nagdev
We report a case of a 52-year-old man who presented to the emergency department (ED) in extremis (hypotensive with an altered sensorium) with subsequent cardiac arrest after a motor vehicle collision. The initial trauma evaluation did not reveal a source of the hemodynamic compromise. A point-of-care ultrasound revealed severe mitral regurgitation secondary to an anterolateral papillary muscle rupture. Patient underwent successful emergent mitral valve replacement after initial resuscitative efforts and intraaortic balloon pump placement...
August 2017: Clinical practice and cases in emergency medicine
Kristin Meigh, Madison Caja, Melinda Sharon, Allison Tadros, Shane Dragan, David Henkel, Joseph Minardi
Takotsubo cardiomyopathy (TCM) is an important condition for the emergency physician to consider in patients with cardiovascular symptoms. A 70-year-old woman presented with chest pain and nausea following emotional trauma. She had an elevated troponin and a normal electrocardiogram with no history of previous cardiac disease. Point-of-care focused cardiac ultrasound (FOCUS) showed reduced left ventricular systolic function with mid to apical hypokinesis. Cardiac catheterization revealed clean coronary arteries and confirmed the suspected diagnosis of TCM...
May 2018: Clinical practice and cases in emergency medicine
P Setälä, H Hellevuo, H Huhtala, A Kämäräinen, J Tirkkonen, S Hoppu
BACKGROUND: We aimed to determine the incidence of and associated risk factors for cardiopulmonary resuscitation (CPR)-related injuries in non-survivors of out-of-hospital cardiac arrests (OHCAs) in an emergency medical service (EMS) system in which all CPR procedures are performed on scene and patients are not routinely transported to the hospital with ongoing CPR. MATERIAL AND METHODS: We conducted this prospective observational study between 1 June 2013, and 31 May 2014...
May 24, 2018: Acta Anaesthesiologica Scandinavica
Satoshi Higuchi, Kenichi Matsushita, Yoshihiro Niina, Konomi Sakata, Toru Satoh, Hideaki Yoshino
Blunt chest trauma may lead to cardiac involvement such as myocardial contusion, coronary artery dissection, cardiac rupture, or myocardial infarction. Early detection and treatment of complications such as these are essential. We describe a case status post collision with an iron ball and discuss how to detect myocardial infarction. We emphasize the importance of careful interview, physical examination, and electrocardiogram even in seemingly healthy patients. A severe blow, such as that described, can impair coronary artery flow and may potentially cause myocardial infarction...
May 23, 2018: International Heart Journal
T Gauss, E Gayat, A Harrois, M Raux, A Follin, J-L Daban, F Cook, S Hamada
BACKGROUND: The role of vasopressors in trauma-related haemorrhagic shock (HS) remains a matter of debate. They are part of the most recent European recommendations on the management of HS and are regularly used in France. We assessed the effect of early administration of noradrenaline in 24 h mortality of trauma patients in HS, using a propensity-score analysis. METHODS: The study included patients from a multicentre prospective regional trauma registry. HS was defined as transfusion of ≥4 erythrocyte-concentrate units during the first 6 h...
June 2018: British Journal of Anaesthesia
M Decavèle, N Gault, T Gauss, S Pease, J D Moyer, C Paugam-Burtz, A Foucrier
BACKGROUND: The significance of cardiac troponin I (cTnI) elevation after trauma is debated. We therefore explored the association between cTnI elevation at admission after trauma and ICU mortality. METHODS: We performed a retrospective analysis from a prospectively constituted database, of patients admitted to ICU after trauma at a single centre, over a 36 month period. According to cTnI plasma concentration at admission, patients were categorised into three groups: normal (<0...
June 2018: British Journal of Anaesthesia
Ahmet Uluşan, Özgür Karakurt
BACKGROUND: This study mainly aimed to determine the frequency of sternal fractures in thoracic trauma patients and to assess the differences in surgical need, cardiac findings, and treatment processes between patients with fracture on different sternal zones and displaced and non-displaced sternal fractures. METHODS: We analyzed the data of patients with sternal fracture due to thoracic trauma admitted to a state hospital between January 2011 and December 2015...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Patricia A Pimental, John B O'Hara, Jessica L Jandak
By virtue of their extensive knowledge base and specialized training in brain-behavior relationships, neuropsychologists are especially poised to execute a unique broad-based approach to overall cognitive wellness and should be viewed as primary care providers of cognitive health. This article will describe a novel comprehensive cognitive wellness service delivery model including cognitive health, anti-aging, lifelong wellness, and longevity-oriented practices. These practice areas include brain-based cognitive wellness, emotional and spiritually centric exploration, and related multimodality health interventions...
July 2018: Applied Neuropsychology. Adult
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