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https://www.readbyqxmd.com/read/28717905/analysis-of-injury-and-mortality-patterns-in-deceased-patients-with-road-traffic-injuries-an-autopsy-study
#1
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
July 17, 2017: World Journal of Surgery
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
#2
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/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#3
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire Oâ Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28687342/comparison-of-ultrasonography-and-radiography-in-diagnosis-of-rib-fractures
#4
Elham Pishbin, Koorosh Ahmadi, Molood Foogardi, Maryam Salehi, Farrokh Seilanian Toosi, Vafa Rahimi-Movaghar
PURPOSE: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. METHODS: In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography...
May 26, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28681368/a-case-of-incarcerated-and-perforated-stomach-in-delayed-traumatic-diaphragmatic-hernia
#5
Shinjiro Wakai, Hiroyuki Otsuka, Hiromichi Aoki, Takeshi Yamagiwa, Yoshihide Nakagawa, Sadaki Inokuchi
The patient was an emergency transported, 57-year-old man complaining of left thoraco-lateroabdominal pain, with a history of blunt chest trauma 3 months prior. Thoracoabdominal computed tomography (CT) resulted in a diagnosis of diaphragmatic hernia with incarceration and perforation of the stomach, and same-day emergency surgery was performed. The surgery was performed via an abdominal approach, and after manually repositioning the stomach incarceration, the perforated region was resected and the diaphragm sutured closed...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#6
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28673353/anatomical-landmarks-for-safely-implementing-resuscitative-balloon-occlusion-of-the-aorta-reboa-in-zone-1-without-fluoroscopy
#7
Yohei Okada, Hiromichi Narumiya, Wataru Ishi, Ryoji Iiduka
BACKGROUND: Resuscitative balloon occlusion of the aorta (REBOA) can maintain hemodynamic stability during hemorrhagic shock after a following torso injury, although inappropriate balloon placement may induce brain or visceral organ ischemia. External anatomical landmarks [the suprasternal notch (SSN) and xiphoid process (Xi)] are empirically used to implement REBOA in zone 1. We aimed to confirm if these landmarks were useful for determining a balloon catheter length for safe implementation of REBOA in zone 1 without using fluoroscopy...
July 3, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28673321/open-chest-versus-closed-chest-cardiopulmonary-resuscitation-in-blunt-trauma-analysis-of-a-nationwide-trauma-registry
#8
Akira Endo, Atsushi Shiraishi, Yasuhiro Otomo, Makoto Tomita, Hiroki Matsui, Kiyoshi Murata
BACKGROUND: Although open-chest cardiopulmonary resuscitation (OCCPR) is often considered as the last salvage maneuver in critically injured patients, evidence on the effectiveness of OCCPR has been based only on the descriptive studies of limited numbers of cases or expert opinions. This study aimed to compare the effectiveness of OCCPR with that of closed-chest cardiopulmonary resuscitation (CCCPR) in an emergency department (ED). METHODS: A nationwide registry-based, retrospective cohort study was conducted...
July 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28671152/effect-of-analgesia-on-the-changes-in-respiratory-parameters-in-blunt-chest-injury-with-multiple-rib-fractures
#9
Eyo Effiong Ekpe, Catherine Eyo
BACKGROUND: Blunt chest injury with multiple rib fractures can result in such complications as pneumonia, atelectasis, bronchiectasis, empyema thoracis, acute respiratory distress syndrome, and prolonged Intensive Care Unit and hospital stay, with its concomitant mortality. These may be prevented or reduced by good analgesic therapy which is the subject of this study. METHODS: This was a prospective study of effects of analgesia on changes in pulmonary functions of patients with traumatic multiple rib fractures resulting from blunt chest injury...
July 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28670065/aortic-valve-perforation-secondary-to-blunt-force-trauma
#10
Sachin Mehta, Gibbs Wilson, Keith Suarez, Christopher D Chiles
Blunt chest trauma has seldom been reported as a cause of rupture of an aortic valve cusp. We report the case of a 63-year-old man who had a motor vehicle collision resulting in transection of the descending thoracic aorta, splenic pseudoaneurysm, and rupture of an aortic valve cusp causing severe aortic regurgitation. Despite replacement of the aortic valve, he died of multiorgan failure.
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28659674/blunt-diaphragmatic-injuries-pericardial-ruptures
#11
Tevrat Özalp, Mustafa Küpeli, Yaşar Sönmezoğlu, Abdülkadir Çakmak, Siraç Akgül, Mithat Fazlioğlu, Cevdet Tokat
Blunt traumatic diaphragmatic injuries (BTDIs) can be misdiagnosed. Careful evaluation of associated injuries in BTDI is important. In this study, we evaluated treatment options and difficulties in the diagnosis of patients with BTDI. We evaluated ten patients retrospectively with BTDI admitted to our departments, between January 2004 and 2015. Age, gender, trauma type, symptoms, radiological findings, diagnosis time, location and grade of the diaphragmatic injury, surgical type of repair, associated injuries and pericardial rupture, and morbidity and mortality rates were recorded...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28652316/the-modified-jo-burg-technique-for-securing-intercostal-chest-drains
#12
Daniel J Ablett, L Navaratne, D Chua, C G Streets, N R M Tai
Insertion of an intercostal chest drain (ICD) is a common intervention in the management of either blunt or penetrating thoracic trauma. It is frequently performed by junior medical personnel as an emergency procedure during the initial resuscitation period and often within a stressful environment. Approximately one-fifth of all ICD insertions are associated with complications. In a retrospective review of over 1000 ICD insertions, 7% of the complications observed were due to inadequate fixation, resulting in dislodgement...
June 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28648782/traumatic-thoracic-burst-fracture-associated-with-bronchial-rupture
#13
Wei-Ting Lin, Shih-Yang Su, Cheng-Fang Hsieh, Chih-Cheng Lai, Chien-Ming Chao
BACKGROUND: Rupture of, or injury to, the tracheobronchial tree is a rare occurrence in blunt chest trauma. CASE REPORT: We present a case of bronchial rupture caused by fragmented bone from a spinal burst fracture after blunt chest trauma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although tracheobronchial injury is infrequent, clinicians should be aware of this possible complication after blunt chest trauma. Bronchoscopy can help in the diagnosis.
June 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#14
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#15
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632138/monitoring-lung-contusion-in-a-porcine-polytrauma-model-using-eit-an-application-study
#16
Susana Aguiar Santos, Carlos Castelar Wembers, Klemens Horst, Roman Pfeifer, Tim-Philipp Simon, Hans-Christoph Pape, Frank Hildebrand, Michael Czaplik, Steffen Leonhardt, Daniel Teichmann
Lung contusion is the most common lung injury following blunt chest trauma which, in turn, is associated with high mortality rates (Gavelli et al., 2002). Lung contusion is characterized by hemorrhage and edema with consecutively reduced compliance. In this study, unilateral lung contusion and other traumata were induced in 12 pigs by using a bolt gun machine. To investigate the pathophysiological consequences of lung contusion, information on clinical parameters was collected and monitored regularly while animals were additionally monitored with electrical impedance tomography (EIT) before trauma, and at 4, 24, 48 and 72 h after polytrauma...
June 20, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28631272/a-unique-fatal-moose-attack-mimicking-homicide
#17
Petur Gudmannsson, Johan Berge, Henrik Druid, Göran Ericsson, Anders Eriksson
Fatalities caused by animal attacks are rare, but have the potential to mimic homicide. We present a case in which a moose attacked and killed a woman who was walking her dog in a forest. Autopsy showed widespread blunt trauma with a large laceration on one leg in which blades of grass were embedded. Flail chest was the cause of death. The case was initially conceived as homicide by means of a riding lawn mower. A review of the case by moose experts and analyses of biological trace material that proved to originate from moose, established the true source of injury...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28623881/cardiac-tamponade-associated-with-delayed-ascending-aortic-perforation-after-blunt-chest-trauma-a-case-report
#18
Dae Woong Ryu, Mi Kyung Lee
BACKGROUND: Cardiac tamponade due to aortic injury after blunt trauma is a rare and potentially fatal injury. Most aortic injuries caused by blunt trauma present as aortic dissection or rupture of the aortic isthmus. Several cases of delayed aortic injury have been reported. However, all of these injuries were observed in the descending aorta because they had been caused by a posterior rib fracture. CASE PRESENTATION: We report the first case of cardiac tamponade associated with delayed ascending aortic perforation 2 weeks after blunt trauma...
June 17, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28614862/-thoracic-trauma-prehospital-treatment
#19
Michael Hansen, Thomas Hachenberg
Penetrating thoracic injuries are rare in Germany and common in urban regions. 10 percent of the patients in Emergency Departments suffer from blunt thoracic trauma. Mechanism of trauma can predict the severity of the injuries. Very fast life-threatening injuries with hemodynamic problems like tension pneumothorax or cardiac tamponade have to be diagnosed. Prehospital emergency physicians need skills in ultrasound for diagnosis and in invasive therapy like chest tube or pericardium drainage tube. The application of an algorithm in exploration of a thoracic trauma seems to be useful...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28614141/role-of-hemorrhagic-shock-in-experimental-polytrauma
#20
Stephanie Denk, Sebastian Weckbach, Philipp Eisele, Christian K Braun, Rebecca Wiegner, Julia J Ohmann, Lisa Wrba, Felix M Hoenes, Philipp Kellermann, Peter Radermacher, Ulrich Wachter, Sebastian Hafner, Oscar McCook, Anke Schultze, Annette Palmer, Sonja Braumüller, Florian Gebhard, Markus Huber-Lang
Hemorrhagic shock (HS) after tissue trauma increases the complication and mortality rate of polytrauma (PT) patients. Although several murine trauma models have been introduced, there is a lack of knowledge about the exact impact of an additional HS. We hypothesized that HS significantly contributes to organ injury, which can be reliably monitored by detection of specific organ damage markers.Therefore we established a novel clinically relevant PT plus HS model in C57BL/6 mice which were randomly assigned to control, HS, PT or PT+HS procedure (n = 8 per group)...
June 13, 2017: Shock
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