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Trauma, emergency surgery

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https://www.readbyqxmd.com/read/29451642/damage-control-surgery-are-we-losing-control-over-indications
#1
Silvânia Klug Pimentel, Tulio Rucinski, Melina Paula DE Araújo Meskau, Guilherme Pasquini Cavassin, Nathan Harmuch Kohl
OBJECTIVE: to analyze the surgeons' subjective indications for damage control surgery, correlating with objective data about the patients' physiological state at the time the surgery was chosen. METHODS: we carried out a prospective study between January 2016 and February 2017, with 46 trauma victims who were submitted to damage control surgery. After each surgery, we applied a questionnaire to the attending surgeon, addressing the motivations for choosing the procedure...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29450690/mortality-rates-of-patients-undergoing-emergency-laparotomy-in-an-irish-university-teaching-hospital
#2
Aoife C Kiernan, Peadar S Waters, Sean Tierney, Paul Neary, Maria Donnelly, Dara O Kavanagh, Bridget Egan
INTRODUCTION: Emergency laparotomy (EL) is a commonly performed operation with increased morbidity and mortality. Currently, there is a lack of published outcomes following emergency laparotomy within an Irish population. The aim of this study was to assess our outcomes and compare these to predefined outcomes from NELA. METHODS: A review of a prospectively maintained database of all patients who underwent an emergency laparotomy between January 1st 2015 and October 31st 2016 was performed...
February 15, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29445882/procedure-rates-performed-by-emergency-medicine-residents-a-retrospective-review
#3
Joshua T Bucher, Christopher Bryczkowski, Grant Wei, Renee L Riggs, Anoop Kotwal, Brian Sumner, Jonathan V McCoy
BACKGROUND: The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency. METHODS: The study took place in an academic level I trauma center with multiple residency and fellowship programs including surgery, surgical critical care, trauma, medicine, pulmonary/critical care, anesthesiology and others...
February 14, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29441123/circulation-first-the-time-has-come-to-question-the-sequencing-of-care-in-the-abcs-of-trauma-an-american-association-for-the-surgery-of-trauma-multicenter-trial
#4
Paula Ferrada, Rachael A Callcut, David J Skarupa, Therese M Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M Nygaard, Martin A Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O Moore, Irene Tabas, Joseph Dubose
Background: The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. Methods: This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29433408/blunt-injury-of-the-innominate-artery-what-surprises-to-expect-a-case-report
#5
Marina Dias-Neto, José F Ramos, José F Teixeira
Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29429776/interventional-treatment-experience-in-multiple-injury-with-major-abdominal-or-pelvic-injuries-160-cases-analysis
#6
Tian-Xi Zhang, Mei Han, Peng Ye, Quan Hu, Jia-Lin Li, Ling Yin, An-Yong Yu
PURPOSE: To observe the therapeutic effect of interventional embolization and haemorrhage control in multiple trauma patients with a major abdominal or pelvic injury. METHODS: Data of 160 multiple trauma patients with a major abdominal or pelvic injury were retrospectively analyzed. They were admitted into the Department of Emergency of the First Affiliated Hospital of Zunyi Medical College from October 2013 to April 2016. Eighty-seven patients who received emergent intervention for embolization and haemorrhage control were set as group A, including 72 males and 15 females, with an average age of (39...
January 31, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29422726/audit-of-postoperative-surgical-intensive-care-unit-admissions
#7
Shaili K Patel, Samir M Kacheriwala, Dipesh D Duttaroy
Objective: The objective of this study was to conduct an audit of Surgical Intensive Care Unit (SICU) for identifying the admission risk factors and evaluating the outcomes of postoperative surgical patients. Design: This was a prospective, observational study. Setting: This study was conducted at SICU of a 1500-bedded tertiary care university hospital in Western India. Subject and Methods: Two hundred and forty patients admitted to the SICU postoperatively over a period of 15 months...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29421694/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-resuscitative-thoracotomy-in-select-patients-with-hemorrhagic-shock-early-results-from-the-american-association-for-the-surgery-of-trauma-aortic-occlusion-in-resuscitation-for-trauma-and-acute-care
#8
Megan Brenner, Kenji Inaba, Alberto Aiolfi, Joseph DuBose, Timothy Fabian, Tiffany Bee, John B Holcomb, Laura Moore, David Skarupa, Thomas M Scalea
BACKGROUND: Aortic occlusion (AO) is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage. STUDY DESIGN: AAST AORTA registry identified trauma patients without penetrating thoracic injury undergoing AO at the level of the descending thoracic aorta (RT or Zone 1 REBOA) in the Emergency Department (ED). Survival outcomes relative to the timing of CPR need and admission hemodynamic status were examined...
February 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29419715/spine-trauma-from-personal-watercraft-usage
#9
Chester J Donnally, Gil Metser, Eric S Roth, Justin P Moo Young, Augustus J Rush, Motasem A Al Maaieh
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To identify patient characteristics and associated injuries in those sustaining a spine fracture from personal watercraft (PWC) usage. SUMMARY OF BACKGROUND DATA: There are few studies regarding PWC use and injuries, and even more scarce are studies evaluating PWC usage and spine injuries. Identifying high risk actions and individuals can help to effectively treat them, reduce mortality, and possibly avoid certain spine fractures...
February 6, 2018: Spine
https://www.readbyqxmd.com/read/29414502/intraorbital-hemorrhage-following-a-secondary-intervention-at-integrated-zygomatic-implants-a-case-report
#10
Philippe Van Camp, Luc Vrielinck, Bert Gemels, Constantinus Politis
INTRODUCTION: Zygomatic implant placement can be the best option for restoring masticatory function of an extremely atrophic upper jaw, but the procedure is more invasive than conventional implant placement and can be associated with complications. PRESENTATION OF CASE: We report a complication that occurred during a secondary corrective surgical procedure four years after zygomatic implant placement. The patient was a 54-year-old female who had been edentulous for 25 years...
January 29, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29412018/single-contrast-ct-for-detecting-bowel-injuries-in-penetrating-abdominopelvic-trauma
#11
Hamza Jawad, Constantine Raptis, Aaron Mintz, Douglas Schuerer, Vincent Mellnick
OBJECTIVE: Many centers advocate use of triple-contrast (IV, oral, and rectal) CT for assessing hemodynamically stable patients with penetrating abdominopelvic trauma. Enteric contrast material has several disadvantages, leading our practice to pursue use of single-contrast (IV) CT. We conducted a retrospective review of electronic medical records at our institution to assess the accuracy of single-contrast CT for diagnosing bowel injuries in cases of penetrating abdominopelvic trauma...
February 7, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29410701/is-case-triaging-a-useful-tool-for-emergency-surgeries-a-review-of-106-trauma-surgery-cases-at-a-level-1-trauma-center-in-south-africa
#12
Sharfuddin Chowdhury, Andrew John Nicol, Mahammed Riyaad Moydien, Pradeep Harkison Navsaria, Luis Felipe Montoya-Pelaez
Background: The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29401188/hospital-variation-in-mortality-after-emergency-bowel-resections-the-role-of-failure-to-rescue
#13
Ambar Mehta, David Efron, Kent Stevens, Mariuxi C Manukyan, Bellal Joseph, Joseph V Sakran
INTRODUCTION: Hospital variation in failure-to-rescue (FTR) rates has partially explained nationwide differences in mortality after elective surgeries. To examine the role of FTR among emergency general surgery, we compared nationwide risk-adjusted mortality, complications, and FTR rates after emergent bowel resections. METHODS: We identified patients who underwent emergent small or large bowel resections in the 2010-2011 Nationwide Inpatient Sample using the American Association for the Surgery of Trauma criteria...
February 3, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29397897/tele-mentored-damage-control-and-emergency-trauma-surgery-a-feasibility-study-using-live-tissue-models
#14
Philip Dawe, Andrew Kirkpatrick, Max Talbot, Andrew Beckett, Naisan Garraway, Heather Wong, Syed Morad Hameed
BACKGROUND: Damage-control and emergency surgical procedures in trauma have the potential to save lives. They may occasionally not be performed due to clinician inexperience or lack of comfort and knowledge. METHODS: Canadian Armed Forces (CAF) non-surgeon Medical Officers (MOs) participated in a live tissue training exercise. They received tele-mentoring assistance using a secure video-conferencing application on a smartphone/tablet platform. Feasibility of tele-mentored surgery was studied by measuring their effectiveness at completing a set series of tasks in this pilot study...
February 2, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29396977/thoracic-endovascular-repair-for-acute-traumatic-transection-of-the-descending-thoracic-aorta-and-postendovascular-remodeling-change
#15
Joung Taek Kim, Young Sam Kim, Yong Han Yoon, Helen Ki Shin, Keun Myoung Park, Wan Ki Baek
BACKGROUND:  The recently developed thoracic endovascular repair (TEVAR) technique seems to offer a good alternative for treating acute traumatic transection of the thoracic aorta (TTA). We reviewed our experience of TEVAR in cases of acute traumatic transection and analyzed the subsequent remodeling changes. METHODS:  The medical records of 17 patients who underwent TEVAR for TTA were reviewed. The trauma mechanisms, anatomical characteristics of the transected aortas, technical details of TEVAR, and postprocedural results were reviewed...
February 2, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29394142/hypermetabolism-and-nutritional-support-in-sepsis
#16
John C Alverdy
BACKGROUND: Surgical metabolism has been a founding field of investigation in surgery without which the boundaries of critical care, trauma, and surgical oncology could not have advanced. Traditionally, understanding the shifts in electrolytes, carbohydrates, fats, and amino acids that could explain the rapidly evolving proteolysis after catabolic stress and tumor growth has been a major focus of research that led to our current approach to maintaining homeostasis over the course of major surgical intervention and injury...
February 2, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29389841/emergency-general-surgery-in-geriatric-patients-a-statewide-analysis-of-surgeon-and-hospital-volume-with-outcomes
#17
Ambar Mehta, Linda A Dultz, Bellal Joseph, Joseph K Canner, Kent Stevens, Christian Jones, Elliot R Haut, David T Efron, Joseph V Sakran
INTRODUCTION: Geriatric patients undergoing emergency general surgery (EGS) face significant morbidity and mortality. We assessed how surgeon and hospital volumes affected these outcomes. METHODS: We identified patients at least 65 years old in Maryland's Health Services Cost Review Commission database from 2012-2014 who underwent one of 12 EGS procedures, as defined by the American Association for the Surgery of Trauma, and then calculated four outcomes: mortality rate, the incidence of at least one of eight common in-hospital EGS complications, failure-to-rescue (death after experiencing a postoperative complication), and the 30-day readmission rate...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29372085/distribution-of-trauma-care-facilities-in-oman-in-relation-to-high-incidence-road-traffic-injury-sites-pilot-study
#18
Sara M Al-Kindi, Ahmed A Naiem, Kadhim M Taqi, Najla M Al-Gheiti, Ikhtiyar S Al-Toobi, Nasra Q Al-Busaidi, Ahmed Z Al-Harthy, Alaa M Taqi, Sharif A Ba-Alawi, Hani A Al-Qadhi
Objectives: Road traffic injuries (RTIs) are considered a major public health problem worldwide. In Oman, high numbers of RTIs and RTI-related deaths are frequently registered. This study aimed to evaluate the distribution of trauma care facilities in Oman with regards to their proximity to RTI-prevalent areas. Methods: This descriptive pilot study analysed RTI data recorded in the national Royal Oman Police registry from January to December 2014. The distribution of trauma care facilities was analysed by calculating distances between areas of peak RTI incidence and the closest trauma centre using Google Earth and Google Maps software (Google Inc...
November 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29371735/femoral-artery-pseudoaneurysm-due-to-a-gunshot-injury
#19
Abdullah Algin, Mehmet Ozgur Erdogan, Kaan Yusufoglu, Huseyin Avni Findikli, Hakan Aydin
Femoral artery pseudoaneurysms are commonly iatrogenic due to increasing use of the artery for arterial interventions. Other reasons of pseudoaneurysm formation are intravenous drug use and penetrating trauma. Here, we have discussed the management strategy of a femoral artery pseuodoaneursym and the modalities for preventing the misdiagnoses of the pseudoaneurysm in the emergency department. A 50-year-old male patient was referred to our emergency department (ED) with claudication and severe local swelling...
January 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29370067/effect-of-door-to-angioembolization-time-on-mortality-in-pelvic-fracture-every-hour-of-delay-counts
#20
Kazuhide Matsushima, Alice Piccinini, Morgan Schellenberg, Vincent Cheng, Patrick Heindel, Aaron Strumwasser, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Angioembolization (AE) is widely used for hemorrhagic control in patients with pelvic fracture. The latest version of the Resources for Optimal Care of theInjured Patient issued by the American College of Surgeons Committee on Trauma requires interventional radiologists to be available within 30 minutes to perform an emergent AE. However, the impact of time-to-AE on patient outcomes remains unknown. We hypothesized that a longer time-to-AE would be significantly associated with increased mortality in patients with pelvic fracture...
January 24, 2018: Journal of Trauma and Acute Care Surgery
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