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Thorax trauma

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https://www.readbyqxmd.com/read/29409595/the-pediatric-resuscitative-thoracotomy-during-combat-operations-in-iraq-and-afghanistan-a-retrospective-cohort-study
#1
Steven G Schauer, Guyon J Hill, Richard E Connor, John S Oh, Michael D April
BACKGROUND: Combat zone trauma poses a unique set of challenges and injury patterns not seen in the civilian setting. The role of the pediatric resuscitative thoracotomy in combat zones remains unclear given a paucity of data regarding procedure outcomes in this setting. We compare outcomes among children in traumatic arrest undergoing resuscitative thoracotomy versus cardiopulmonary (CPR) resuscitation only. METHODS: We queried the Department of Defense Trauma Registry (DODTR) from 2007 to 2016 for all pediatric subjects that underwent a resuscitative thoracotomy or CPR in the prehospital or emergency department setting during operations in Iraq or Afghanistan...
January 31, 2018: Injury
https://www.readbyqxmd.com/read/29350048/triple-split-bolus-versus-single-bolus-ct-in-abdominal-trauma-patients-a-comparative-study
#2
Johannes Clemens Godt, Torsten Eken, Anselm Schulz, Cathrine K Johansen, Anette Aarsnes, Johann Baptist Dormagen
Background Split-bolus computed tomography (CT) is a recent development in trauma imaging. Instead of multiple scans in different contrast phases after a single contrast bolus, split-bolus protocols consist of one single scan of the thorax and abdomen after two or three contrast injections at different points of time. Purpose To evaluate and compare image quality and injury findings of a new triple-split-bolus CT (TS-CT) protocol of thorax and abdomen with those of a portal venous phase CT (PV-CT) in the same patient group...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29321113/top-cited-publications-on-point-of-care-ultrasound-the-evolution-of-research-trends
#3
Shao-Feng Liao, Pai-Jung Chen, Chung-Hsien Chaou, Ching-Hsing Lee
STUDY OBJECTIVES: Point-of-care ultrasound (POCUS) has been a rapidly growing and broadly used modality in recent decades. The purpose of this study was to determine how POCUS is incorporated into clinical medicine by analyzing trends of use in the published literature. METHODS: POCUS-related publications were retrieved from the Web of Science (WoS) database. The search results were ranked according to the number of times an article was cited during three time frames and average annual number of citations...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#4
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29232883/same-abbreviated-injury-scale-values-may-be-associated-with-different-risks-to-mortality-in-trauma-patients-a-cross-sectional-retrospective-study-based-on-the-trauma-registry-system-in-a-level-i-trauma-center
#5
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center...
December 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29203574/blunt-chest-trauma-a-clinical-chameleon
#6
REVIEW
Kaveh Eghbalzadeh, Anton Sabashnikov, Mohamed Zeriouh, Yeong-Hoon Choi, Alexander C Bunck, Navid Mader, Thorsten Wahlers
The incidence of blunt chest trauma (BCT) is greater than 15% of all trauma admissions to the emergency departments worldwide and is the second leading cause of death after head injury in motor vehicle accidents. The mortality due to BCT is inhomogeneously described ranging from 9% to 60%. BCT is commonly caused by a sudden high-speed deceleration trauma to the anterior chest, leading to a compression of the thorax. All thoracic structures might be injured as a result of the trauma. Complex cardiac arrhythmia, heart murmurs, hypotension, angina-like chest pain, respiratory insufficiency or distention of the jugular veins may indicate potential cardiac injury...
December 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29201839/trauma-patterns-of-drowning-after-falling-from-bridges-over-han-river
#7
Jung Hwan Lee, Chung Kee Chough, Jae Il Lee
Objective: Recently, the number of patients who fell or jumped from bridges over Han River has rapidly increased. However, the injury patterns and outcomes of these patients have been poorly characterized. The aim of this study was to determine the injury characteristics of these patients. Methods: We reviewed the medical records of all patients who were transferred to the Emergency Room due to jumping or falling from bridges over Han River between 2011 and 2015...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29174350/predicting-pediatric-patients-who-require-care-at-a-trauma-center-analysis-of-injuries-and-other-factors
#8
Andrea N Doud, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, John K Petty, J Wayne Meredith, R Shayn Martin, Joel D Stitzel, Ashley A Weaver
BACKGROUND: Triage decision correctness for children in motor vehicle crashes can be affected by occult injuries. There is a need to develop a transfer score (TS) metric for children that can help quantify the likelihood that an injury is present that would require transfer to a trauma center (TC) from a non-TC, and improve triage decision making. Ultimately, the TS metric might be useful in an advanced automatic crash notification algorithm, which uses vehicle telemetry data to predict the risk of serious injury after a motor vehicle crash using an approach that includes metrics to describe injury severity, time sensitivity, and predictability...
January 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29170351/54%C3%A2-paediatric-traumatic-cardiac-arrest-in-england-and-wales-a-10-year-epidemiological-study
#9
James Vassallo, Melanie Webster, Edward Barnard, Marisol Fragoso Iniguez, Mark Lyttle, Jason Smith
INTRODUCTION: Traumatic cardiac arrest (TCA) has traditionally been described as futile, with poor outcomes. Reported survival rates vary widely, with higher rates observed from mechanisms leading to a respiratory cause of traumatic cardiac arrest (e.g., drowning and hanging). Currently there is little evidence regarding outcomes following TCA in children. The primary aim of our study was to describe 30 day survival following TCA. Secondary aims were to provide an analysis of injury patterns (severe haemorrhage or traumatic brain injury), describe the functional outcome at discharge and to report the association between survival and interventions performed...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170313/16%C3%A2-investigating-the-effects-of-under-triage-by-existing-major-incident-triage-tools
#10
James Vassallo, Jason Smith
INTRODUCTION: Triage, the process of prioritising patients on the basis of clinical acuity, is a key principle in the effective management of a major incident. The overall effectiveness of the triage process is not only a balance between identifying those who need or don't need a life-saving intervention, but also those who are under or over-triaged as either incorrectly needing/not needing intervention. The primary aim of this study was to describe the implications of under-triage using existing major incident triage tools, including the 2013 National Ambulance Resilience Unit (NARU) Sieve...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29167928/pulmonary-contusions-after-blunt-chest-trauma-clinical-significance-and-evaluation-of-patient-management
#11
Z Požgain, D Kristek, I Lovrić, G Kondža, M Jelavić, J Kocur, M Danilović
INTRODUCTION: A pulmonary contusion is an entity defined as alveolar haemorrhage and pulmonary parenchymal destruction after blunt chest trauma. According to the literature, most pulmonary contusions can only be seen on a chest CT. The aim of this study was to evaluate the patients with pulmonary contusions, as well as their management, considering diagnostic and therapeutic options related to their outcomes, since we assumed, based on everyday clinical practice, that an 'overdiagnosing' and 'overtreatment' attitude towards this injury could be present...
November 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29146418/diagnostic-accuracy-of-the-extended-focused-abdominal-sonography-for-trauma-e-fast-performed-by-emergency-physicians-compared-to-computed-tomography
#12
Haldun Akoglu, Omer Faruk Celik, Ali Celik, Rabia Ergelen, Ozge Onur, Arzu Denizbasi
INTRODUCTION: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area, especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#13
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/29120878/investigating-the-effects-of-under-triage-by-existing-major-incident-triage-tools
#14
James M Vassallo, Jason E Smith, Lee A Wallis
OBJECTIVES: Triage is a key principle in the effective management of a major incident. Its effectiveness is a balance between identifying those in need of life-saving intervention, and those triaged incorrectly as either needing/not needing life-saving intervention. The primary aim of this study was to report mortality in those under-triaged by existing major incident triage tools. Secondary aims were to report the ability of triage tools at identifying serious injury by body region (defined as the Abbreviated Injury Scale≥3)...
November 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29049240/the-thorax-trauma-severity-score-and-the-trauma-and-injury-severity-score-do-they-predict-in-hospital-mortality-in-patients-with-severe-thoracic-trauma-a-retrospective-cohort-study
#15
Seong Ho Moon, Jong Woo Kim, Joung Hun Byun, Sung Hwan Kim, Jun Young Choi, In Seok Jang, Chung Eun Lee, Jun Ho Yang, Dong Hun Kang, Ki Nyun Kim, Hyun Oh Park
Several scoring systems are commonly used to evaluate severity in patients with traumatic injuries. However, there is no generally accepted standard scoring system to assess the severity of thoracic trauma, specifically in patients who have sustained severe injuries. The present study aimed to evaluate the validity of the trauma and injury severity score (TRISS) and the thorax trauma severity score (TTSS) as predictors of in-hospital mortality in patients with severe thoracic trauma.We conducted a retrospective, consecutive review of the medical records of patients with severe thoracic trauma who were managed at our institution between January 2005 and December 2015...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019536/trauma-mechanism-predicts-the-frequency-and-the-severity-of-injuries-in-blunt-trauma-patients
#16
José Gustavo Parreira, Giovanna Zucchini Rondini, Cristiano Below, Giuliana Olivi Tanaka, Julia Nunes Pelluchi, Jacqueline Arantes-Perlingeiro, Silvia Cristine Soldá, José César Assef
OBJECTIVE: to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients. METHODS: retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL)...
July 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28988190/the-outcome-of-patients-in-traumatic-cardiac-arrest-presenting-to-deployed-military-medical-treatment-facilities-data-from-the-uk-joint-theatre-trauma-registry
#17
Ed B G Barnard, P A F Hunt, P E H Lewis, J E Smith
BACKGROUND: The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns. METHODS: A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken...
October 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28930098/bioimpedance-technology-for-detection-of-thoracic-injury
#18
Ruben Buendia, Stefan Candefjord, Benjamin Sanchez, Hans Granhed, Bengt-Arne Sjöqvist, Per Örtenwall, Eva-Corina Caragounis
OBJECTIVE: Thoracic trauma is one of the most common and lethal types of injury, causing over a quarter of traumatic deaths. Severe thoracic injuries are often occult and difficult to diagnose in the field. There is a need for a point-of-care diagnostic device for severe thoracic injuries in the prehospital setting. Electrical bioimpedance (EBI) is non-invasive, portable, rapid and easy to use technology that can provide objective and quantitative diagnostic information for the prehospital environment...
October 31, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28924833/rho-inhibiting-c2in-c3-fusion-toxin-inhibits-chemotactic-recruitment-of-human-monocytes-ex-vivo-and-in-mice-in-vivo
#19
Tobias Martin, Amelie Möglich, Ina Felix, Christina Förtsch, Anne Rittlinger, Annette Palmer, Stephanie Denk, Julian Schneider, Lena Notbohm, Mona Vogel, Hartmut Geiger, Stephan Paschke, Markus Huber-Lang, Holger Barth
Bacterial protein toxins became valuable molecular tools for the targeted modulation of cell functions in experimental pharmacology and attractive therapeutics because of their potent and specific mode of action in human cells. C2IN-C3lim, a recombinant fusion toxin (~50 kDa) of the Rho-inhibiting C3lim from Clostridium (C.) limosum and a non-toxic portion of the C. botulinum C2 toxin (C2IN), is selectively internalized into the cytosol of monocytic cells where C3lim specifically ADP-ribosylates Rho A and -B, thereby inhibiting Rho-mediated signaling...
September 18, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28910469/prehospital-administration-of-tranexamic-acid-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#20
Steven G Schauer, Michael D April, Jason F Naylor, Jonathan Wiese, Kathy L Ryan, Andrew D Fisher, Cord W Cunningham, Noah Mitchell, Mark A Antonacci
BACKGROUND: Tranexamic acid (TXA) was shown to reduce overall mortality and death secondary to hemorrhage in a large prospective study. This intervention is time sensitive. As such, the Tactical Combat Casualty Care (TCCC) guidelines recommend use of this low-cost, safe intervention among patients with possible hemorrhagic shock, penetrating trauma to the thorax or trunk, or extremity amputation. OBJECTIVE: Prehospital administration of TXA by ground forces in the Afghanistan combat theater is described...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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