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crashing ventilated patient

Emine Türkmen, Selvet Sevinç, Marziye İlhan
BACKGROUND: International and national standards for ICUs have been developed to ensure patient safety and provide effective and efficient service in these units. However, global economic crises along with shortages in professional health care staff affect the ability of ICUs to meet and maintain these standards. AIMS AND OBJECTIVES: The aim of this study was to ascertain whether the equipment and workforce in intensive care units (ICUs) in Turkish hospitals meet current ICU standards...
September 2016: Nursing in Critical Care
Rebecca H Striker, Alistair J Chapman, Rachel A Titus, Alan T Davis, Carlos H Rodriguez
BACKGROUND: Michigan repealed a 35-year mandatory helmet law in April 2012. We examined the impact of this legislation on a level 1 trauma center. METHODS: A retrospective cohort study comparing the 7-month period before and the 3 motorcycle seasons after the helmet law repeal. RESULTS: A total of 345 patients were included in the study. Nonhelmeted riders increased from 7% to 28% after the repeal. Nonhelmeted crash scene fatalities were higher after the repeal (14% vs 68%)...
March 2016: American Journal of Surgery
Cassandra V Villegas, Stephen M Bowman, Cheryl K Zogg, Valerie K Scott, Elliott R Haut, Kent A Stevens, David T Efron, Adil H Haider
BACKGROUND: Off-road motorsports are an increasing popular activity, yet the relative safety profile of all-terrain vehicles (ATV) to off-road motorcycles (ORMC) has not been compared. STUDY DESIGN: A retrospective review of the 2002-2006 US National Trauma Data Bank of ATV and ORMC crash victims. Patients were described according to demographic (age, sex, race and ethnicity, insurance status) and injury characteristics (Injury Severity Score, hypotension, motor component of the Glasgow Coma Score, presence of a severe head or extremity injury) known to affect trauma outcomes...
January 2016: Injury
Fumihiro Ohchi, Nobuyasu Komasawa, Noriko Kadono, Toshiaki Minami
We report a case of impossible ventilation in a patient with severe nasal bleeding. A 47-year-old man with intractable nasal bleeding was scheduled for emergent hemostasis under general anesthesia. He also had alcohol-related cirrhosis and was highly obese (165 cm, 93 kg). Although he sufficiently fasted and did not experience nausea in the supine position, we planned crash intubation in the head-elevated position with the Pentax-AWS Airwayscope (AWS) in order to avoid vomiting after induction of anesthesia...
January 2015: Masui. the Japanese Journal of Anesthesiology
Shahla Siddiqui, Edwin Seet, Wing Yan Chan
We herein report a witnessed cardiopulmonary collapse of a patient with difficult mask ventilation and near-impossible laryngoscopy-cum-intubation in the critical care unit. The airway was successfully rescued with a laryngeal mask airway Supreme™, followed by an open, crash tracheostomy by the otolaryngologist.
December 2014: Singapore Medical Journal
Saeed Mahmood, Mushrek Alani, Hassan Al-Thani, Ismail Mahmood, Ayman El-Menyar, Rifat Latifi
OBJECTIVES: To determine the causes, predictors and outcomes of re-intubation. METHODS: Retrospective analysis of data collected from the trauma data base registry was conducted to identify the extubation failure cases in Trauma ICU at Hamad General Hospital, the only Level I trauma center in Qatar between January 2009 and December 2010. Demographics, mechanism of Injury, complications, injury severity score (ISS), Glasgow Coma Scale (GCS), ICU-length of stay (LOS), and mortality were analyzed among trauma patients who need reintubation within 48 hrs after extubation (group 1) compared to successfully extubated patients (group 2)...
July 2014: Oman Medical Journal
Ashok Parchani, Ayman El-Menyar, Hassan Al-Thani, Ahmed El-Faramawy, Ahmad Zarour, Mohammad Asim, Rifat Latifi
BACKGROUND: Traumatic brain injury (TBI) is a common cause of morbidity and mortality worldwide. It is difficult to estimate the real incidence of traumatic subarachnoid hemorrhage (TSAH). Although TSAH after trauma is associated with poor prognoses, the impact of mechanism of injury (MOI) and the pathophysiology remains unknown. We hypothesized that outcome of TSAH caused by motor vehicle crash (MVC) or fall from height (FFH) varies based on the MOI. METHODS: Data were collected retrospectively from a prospectively created database registry in the section of Trauma Surgery at Hamad General Hospital between January 2008 and July 2012...
November 2014: World Neurosurgery
Jonathan A Messing, Victor Gall, Babak Sarani
A review on the role of open reduction and internal fixation of flail chest injuries is presented. A 37-year-old woman involved in a motorcycle crash sustained comminuted rib fractures on her right 3rd through 12th ribs. On postinjury day 2, the patient's fifth through ninth ribs were surgically reduced and plated. Later that same day, the patient was successfully weaned from mechanical ventilation and experienced a rapid improvement in incentive spirometry volumes. Further studies are needed to definitively determine the benefits of rib plating versus conventional treatment...
March 2014: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Alistair J Chapman, Rachel Titus, Hannah Ferenchick, Alan Davis, Carlos Rodriguez
BACKGROUND: Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS: Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS: One hundred ninety-two patients were included. After the repeal, nonhelmeted motorcyclists rose from 7% to 29% (P < .01)...
March 2014: American Journal of Surgery
D Dante Yeh, John O Hwabejire, Marc A DeMoya, Hasan B Alam, David R King, George C Velmahos
BACKGROUND: The clinical significance of sternal fractures (SFs) after blunt trauma is heavily debated. We aimed to test the hypothesis that isolated SF is not associated with significant morbidity or mortality. MATERIALS AND METHODS: The National Trauma Data Bank (NTDB) sets for 2007-2010 were retrospectively examined. Adult subjects with SF were identified by International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Data collected included demographics, mechanisms of injury, clinical variables, and in-hospital mortality...
January 2014: Journal of Surgical Research
Andrew F Philip, William Fangman, Junlin Liao, Michele Lilienthal, Kent Choi
OBJECTIVE: The number of registered motorcycles in the United States has been steadily increasing, as have the number of motorcycle injuries and fatalities. The Midwest has the lowest incidence of helmet use in the country. Iowa in particular has no helmet law. MATERIALS AND METHODS: We conducted a retrospective study of the motorcycle crash victims treated at our level 1 trauma center between 2002 and 2008. Data from 713 motorcycle trauma victims were analyzed for correlations between helmet use and multiple outcome measures...
2013: Traffic Injury Prevention
Sven M Almdahl, Terje Veel, Per Halvorsen, Stein E Rynning
OBJECTIVES: Although rare, life-threatening complications requiring emergency cardiac surgery do occur after diagnostic and therapeutic cardiac catheterization procedures. The operative mortality has been persistently reported to remain high. The purpose of this observational study was to evaluate and report the outcomes, with particular emphasis on early mortality, of these risky operations that were performed in a single highly specialized cardiac centre. METHODS: Between June 1997 and August 2007, 100 consecutive patients, 13 after diagnostic complicated cardiac catheterization (0...
August 2013: Interactive Cardiovascular and Thoracic Surgery
Katherine A Heldt, Catherine Hackett Renner, David J Boarini, James R Swegle
OBJECTIVE: The relationship between injuries sustained in a motorcycle crash (MCC) by unhelmeted motorcyclists and the multitude of costs associated with those injuries has been a decades-long debate. Results from research addressing injuries and mortality due to helmet use in MCCs demonstrates that unhelmeted motorcyclists experience more severe injuries, resulting in higher health care costs and an increased likelihood of requiring care beyond the hospital in other facilities. However, a link between injury severity and hospital costs has not been established with its spillover effect onto health insurance providers...
2012: Traffic Injury Prevention
Marcello Fonseca Salgado Filho, Arthur Siciliano, Alexandre Siciliano, Andrey José de Oliveira, Júlia Salgado, Izabela Palitot
BACKGROUND AND OBJECTIVES: The use of transesophageal echocardiography (TEE) during heart harvesting for transplantation can guide the heart assessment, as harvesting a marginal heart can jeopardize the cardiac transplantation. CASE REPORT: Male, 30 years old, suffered a car crash that resulted in a severe traumatic brain injury (TBI) that evolved to brain death. The patient was intubated and ventilated with a fraction of inspired oxygen of 0.6, presetting Vt 500 mL, RR 14 bpm, PEEP of 3 mm Hg, 99% O(2) saturation, and normal blood gases...
March 2012: Revista Brasileira de Anestesiologia
Sang-Won Hwang, Han-Yong Kim, Jung Hun Byun
BACKGROUND: Traumatic rupture of the diaphragm is an unusual type of trauma. In addition, it is difficult to diagnose because it can be accompanied by injuries to other organs. If it is not detected early, the mortality rate can increase due to serious complications. Diaphragmatic rupture is an important indicator of the severity of the trauma. The aim of this study was to investigate the factors affecting the incidence of complications and mortality in patients who had surgery to treat traumatic rupture of the diaphragm...
October 2011: Korean Journal of Thoracic and Cardiovascular Surgery
D Kilic, A Findikcioglu, S Akin, T H Akay, E Kupeli, A Aribogan, A Hatipoglu
OBJECTIVE: Flail chest is most often accompanied by significant underlying pulmonary parenchymal injuries and may constitute a life-threatening thoracic injury. In this study we evaluated the treatment modalities for flail chest depending on the effect of trauma localization on mortality and morbidity. METHODS: Between 2003 and 2008, 23 patients (20 males/3 females) were treated for flail chest. Location of the trauma in the chest wall, mechanical ventilation support, prognosis and injury severity score (ISS) were recorded for all patients...
February 2011: Thoracic and Cardiovascular Surgeon
Robert A Cherry, Pamela A Nichols, Theresa M Snavely, Lindsay J Camera, David T Mauger
BACKGROUND: The high risk behavior of intoxicated drivers, impaired reaction time, lack of seat belt use, and increased incidence of head injury raises questions of whether pre-hospital use of alcohol leads to a higher injury severity score and worse clinical outcomes. We therefore compared intoxicated and non-intoxicated drivers of motor vehicle crashes with respect to outcome measurements and also describe the resources utilized to achieve those outcomes at our Level 1 trauma center...
2010: Journal of Trauma Management & Outcomes
Nicole Campbell, Paul Conaglen, Katherine Martin, Phillip Antippa
BACKGROUND: A variety of operative techniques have been described in the past for the surgical stabilization of fractured ribs. METHODS: From February 2004 to November 2008, consecutive patients who underwent open reduction and internal fixation of traumatic fractured ribs during their index admission using the Inion orthopedic trauma plating system (OTPS) at a Level I trauma center were retrospectively analyzed. Demographics, Injury Severity Scores, number and site of rib fractures, operative details, and complications were recorded...
September 2009: Journal of Trauma
George M Testerman
BACKGROUND: All-terrain vehicle (ATV) riding is a popular recreation in the mountainous areas of Southeastern Kentucky, Southwest Virginia and East Tennessee. We hypothesized that admissions for serious injuries have increased among ATV riders. A retrospective data review from a Level 1 trauma center trauma registry presents injury characteristics and outcomes, comparing patients in earlier and later time periods. METHODS: Patient demographics, drug and alcohol positivity, helmet use, injury type and location, internal disposition (admission to the Operating Room or Intensive Care Unit [ICU]), Injury Severity Score (ISS), Glasgow Coma Scale (GCS), Functional Independence Measure (FIM), hospital length of stay, ICU length of stay, ventilator days, Abbreviate Injury Score (AIS), scores for head and neck, chest, abdomen, and extremities, procedures performed, complications, and discharge destination were analyzed among individuals who had sustained ATV crash-related injuries between March 1997 and March 2007...
August 2009: Tennessee Medicine: Journal of the Tennessee Medical Association
Cristina R Neumann, Albert V Brasil, Felix Albers
BACKGROUND: Predictive factors for mortality are different among countries; knowledge of risk factors is important for planning strategies to reduce mortality in trauma. The objective of this study was to identify predictors of death in traumatic cervical spinal cord injury (TSCI) in Brazil. METHODS: From 2001 to 2005, 84 patients with clinically detectable TSCI were identified in this retrospective study. For each patient, neurologic and associated injuries, physiologic variables, complications, treatment, and hospital mortality were recorded...
July 2009: Journal of Trauma
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