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management of polytrauma

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https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#1
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#2
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27984453/management-of-closed-diaphyseal-humerus-fractures-in-patients-with-injury-severity-score-iss-17
#3
Cassandra Dielwart, Luke Harmer, Jeremy Thompson, Rachel B Seymour, Madhav A Karunakar
OBJECTIVES: The management of closed diaphyseal humerus fractures in the Polytrauma patient varies widely. The aim of this study was to compare outcomes of operative and non-operative management in this patient population. DESIGN: Single center, retrospective cohort analysis SETTING:: Urban, Level 1 trauma center PATIENTS:: 71 patients with closed diaphyseal humerus fractures, and ISS of > 17, treated between 2006-2011 were identified. INTERVENTION: Patients were treated operatively versus non-operatively with a functional brace by surgeon preference...
December 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27920244/are-the-registry-data-reliable-an-audit-of-a-regional-trauma-registry-in-the-netherlands
#4
E E Horton, P Krijnen, H M Molenaar, I B Schipper
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#5
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27912037/avalanche-accidents-causing-fatalities-are-they-any-different-in-the-summer
#6
Mathieu Pasquier, Olivier Hugli, Alexandre Kottmann, Frank Techel
: Pasquier, Mathieu, Olivier Hugli, Alexandre Kottmann, and Frank Techel. Avalanche accidents causing fatalities: are they any different in the summer? High Alt Med Biol. 16:000-000, 2016. AIMS: This retrospective study investigated the epidemiology of summer avalanche accidents that occurred in Switzerland and caused at least one fatality between 1984 and 2014. Summer avalanche accidents were defined as those that occurred between June 1st and October 31st. RESULTS: Summer avalanches caused 21 (4%) of the 482 avalanches with at least one fatality occurring during the study period, and 40 (6%) of the 655 fatalities...
December 2, 2016: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#7
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
December 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27809989/management-of-polytrauma-patients-in-the-uk-is-there-a-weekend-effect
#8
Vasileios Giannoudis, Michalis Panteli, Peter V Giannoudis
BACKGROUND/PURPOSE: It has been suggested that hospital admission during weekends poses a risk for adverse outcomes and increased patient mortality, the so-called 'weekend effect'. We undertook an evaluation of the impact of weekend admissions to the management of polytraumatised patients, in a Level I Major Trauma Centre (MTC) in the UK. MATERIALS AND METHODS: A retrospective review of prospectively documented data of polytrauma patients (injury severity score (ISS)>15), admitted between April 2013 and August 2015 was performed...
November 2016: Injury
https://www.readbyqxmd.com/read/27799653/-reboa-is-it-really-safe-a-case-with-massive-intracranial-hemorrhage-possibly-due-to-endovascular-balloon-occlusion-of-the-aorta-reboa
#9
Hayaki Uchino, Nobuichiro Tamura, Ryosuke Echigoya, Tetsunori Ikegami, Toshio Fukuoka
BACKGROUND Non-compressible torso hemorrhage continues to be the leading cause of preventable death in trauma patients. Recent case series report that resuscitative endovascular balloon occlusion of the aorta (REBOA) in the trauma population is a technically feasible method to manage the patients with exsanguinating hemorrhage. On the other hand, it seems that REBOA is being widely promoted prematurely. Complications due to REBOA haven't been reported much in the literature, and they could have been underestimated...
November 1, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27791418/a-review-of-the-management-of-blunt-splenic-trauma-in-england-and-wales-have-regional-trauma-networks-influenced-management-strategies-and-outcomes
#10
P Yiannoullou, C Hall, K Newton, L Pearce, O Bouamra, T Jenks, A B Scrimshire, J Hughes, F Lecky, Adh Macdonald
INTRODUCTION The spleen remains one of the most frequently injured organs following blunt abdominal trauma. In 2012, regional trauma networks were launched across England and Wales with the aim of improving outcomes following trauma. This retrospective cohort study investigated the management and outcomes of blunt splenic injuries before and after the establishment of regional trauma networks. METHODS A dataset was drawn from the Trauma Audit Research Network database of all splenic injuries admitted to English and Welsh hospitals from 1 April 2010 to 31 March 2014...
January 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27779577/extracorporeal-membrane-oxygenation-for-adult-respiratory-distress-syndrome-in-trauma-patients-a-case-series-and-systematic-literature-review
#11
Chiara Robba, Andrea Ortu, Federico Bilotta, Alessandra Lombardo, Mypinder S Sekhon, Fabio Gallo, Basil F Matta
BACKGROUND: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an established salvage therapy for severe respiratory failure, and may provide an alternative form of treatment for trauma-induced adult respiratory distress syndrome (ARDS) when conventional treatments have failed. The need for systemic anticoagulation is a relative contraindication for patients with bleeding risks, especially in multitraumatic injury. METHODS: We describe a case series of four trauma patients with ARDS who were managed with ECMO admitted to the neuro critical care unit at Addenbrooke's Hospital, Cambridge (UK), from January 2000 to January 2016...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27751314/blunt-traumatic-dissection-of-right-coronary-artery-presenting-with-acute-inferior-wall-myocardial-infarction-dilemma-in-management
#12
Arindam Pande, Soumya Patra, Manabhanjan Jena, Rabin Chakraborty
Thirty-nine year male had a history of road traffic accident with polytrauma. At emergency room he started having chest pain with ventricular tachycardia. He was subsequentially diagnosed with right coronary artery dissection secondary to blunt trauma which is an extremely rare cause of inferior wall myocardial infarction. After some dilemmas, he was ultimately treated with intravascular ultrasound guided coronary angioplasty with stenting and had an uneventful recovery.
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27749702/templated-interdisciplinary-rehabilitation-care-plan-documentation-for-veterans-with-traumatic-brain-injury
#13
Joel Scholten, Ellen Danford, Azadeh Leland, Heather Malecki, Douglas Bidelspach, Brent Taylor, Nina Sayer
PURPOSE OF STUDY: Individualized interdisciplinary care is the hallmark for rehabilitation following traumatic brain injury (TBI). Veterans Health Administration (VHA) utilizes an electronic note template to document Interdisciplinary Rehabilitation and Community Reintegration (IRCR) care plans for Veterans with TBI requiring rehabilitation. All Veterans with a TBI diagnosis, receiving skilled therapy for TBI-related issues, and followed by a case manager must receive a care plan. The purpose of this study was to determine the level of compliance with the IRCR care plan requirements used to identify Veterans with TBI in need of the care plan and to evaluate the reasons for inconsistent compliance...
November 2016: Professional Case Management
https://www.readbyqxmd.com/read/27729461/timing-of-fracture-fixation-from-an-intensive-care-unit-perspective-the-obstacles-to-early-fracture-fixation
#14
REVIEW
Lauren Elizabeth Thomson, Nicola Fry, Richard Jackson
Trauma is one of the leading causes of death worldwide, with road traffic accidents being the leading cause of death in the age group of 15-29 years However, with modern advances in management and the introduction of specialised trauma centres, more and more are surviving severe and life-threatening trauma. The ideal timing of fracture fixation has been the subject of debate for a number of decades. There is evidence to suggest that fracture fixation in the patient with polytrauma is best achieved early on to reduce the incidence of morbidity and mortality, with damage control surgery in the more appropriate option in those patients who are haemodynamically unstable...
October 11, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27718440/an-interesting-case-report-of-vertebral-artery-dissection-following-polytrauma
#15
Vikas Acharya, Suresh Chandrasekaran, Sujit Nair
INTRODUCTION: The authors present an interesting case of a 19-year-old male who presented as a polytrauma patient following a fall from a height. PRESENTATION OF CASE: He was initially managed on the intensive care unit with intracranial pressure bolt monitoring after being intubated and sedated and having his other traumatic injuries stabilized. Upon attempting to wean sedation and extubation a repeat CT scan of the head was undertaken and showed a new area suggested of cerebral infarction, this was a new finding...
October 3, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27709870/avoiding-errors-in-the-management-of-pediatric-polytrauma-patients
#16
Kenneth Chin, Joshua M Abzug, Donald S Bae, Bernard D Horn, Martin Herman, Craig P Eberson
Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment...
February 15, 2016: Instructional Course Lectures
https://www.readbyqxmd.com/read/27704214/management-of-bone-fragments-in-nonmissile-compound-depressed-skull-fractures
#17
Mohamed AbdelRahman AbdelFatah
BACKGROUND: There is no settled standard of care or even a consensus between neurosurgeons on the replacement of bone fragments in compound depressed skull fractures (CDSF). MATERIALS AND METHODS: This cohort study retrospectively reviewed the patients with nonmissile CDSF who were admitted to our university hospitals from January 2010 to January 2015. Patients who were managed nonoperatively, polytrauma, comatose patients, and CDSF over the air sinuses were excluded from this study...
October 4, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27601311/battlefield-acupuncture-opening-the-door-for-acupuncture-in-department-of-defense-veteran-s-administration-health-care
#18
Patricia Hinton Walker, Arnyce Pock, Catherine G Ling, Kyung Nancy Kwon, Megan Vaughan
Battlefield acupuncture is a unique auricular acupuncture procedure which is being used in a number of military medical facilities throughout the Department of Defense (DoD). It has been used with anecdotal published positive impact with warriors experiencing polytrauma, post-traumatic stress disorder, and traumatic brain injury. It has also been effectively used to treat warriors with muscle and back pain from carrying heavy combat equipment in austere environments. This article highlights the history within the DoD related to the need for nonpharmacologic/opioid pain management across the continuum of care from combat situations, during evacuation, and throughout recovery and rehabilitation...
September 2016: Nursing Outlook
https://www.readbyqxmd.com/read/27574675/new-perspectives-of-volemic-resuscitation-in-polytrauma-patients-a-review
#19
REVIEW
Ovidiu Horea Bedreag, Marius Papurica, Alexandru Florin Rogobete, Mirela Sarandan, Carmen Alina Cradigati, Corina Vernic, Corina Maria Dumbuleu, Radu Nartita, Dorel Sandesc
Nowadays, fluid resuscitation of multiple trauma patients is still a challenging therapy. Existing therapies for volume replacement in severe haemorrhagic shock can lead to adverse reactions that may be fatal for the patient. Patients presenting with multiple trauma often develop hemorrhagic shock, which triggers a series of metabolic, physiological and cellular dysfunction. These disorders combined, lead to complications that significantly decrease survival rate in this subset of patients. Volume and electrolyte resuscitation is challenging due to many factors that overlap...
2016: Burns and trauma
https://www.readbyqxmd.com/read/27574345/retrospective-evaluation-of-magnitude-severity-and-outcome-of-traumatic-hepatobiliary-injury-at-a-level-i-trauma-center-in-india
#20
Sanjay Kumar Yadav, Subodh Kumar, Mahesh Chander Misra, Sushma Sagar, V K Bansal
Liver injury is the major cause of morbidity and mortality in polytrauma patients. This study was conducted to know the burden of hepatobiliary injury and its outcome in our setup. It is a retrospective study of all patients with traumatic hepatobiliary injuries from January 2008 through April 2012 at JPNATC, New Delhi. All patients were resuscitated as per ATLS guidelines. Management of patients was based on hemodynamic status and associated injuries. Liver injury occurred in 7.52 % of all trauma admissions and 20...
August 2016: Indian Journal of Surgery
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