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Trauma anesthesiology

C C Chang, C C Liao, T L Chen
"Big data", characterized by 'volume', 'velocity', 'variety', and 'veracity', being routinely collected in huge amounts of clinical and administrative healthcare-related data are becoming common and generating promising viewpoints for a better understanding of the complexity for medical situations. Taiwan National Health Insurance Research Database (NHIRD), one of large and comprehensive nationwide population reimbursement databases in the world, provides the strength of sample size avoiding selection and participation bias...
November 18, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Gaspar Alberto Motta-Ramírez
BACKGROUND: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team. OBJECTIVE: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography...
July 2016: Gaceta Médica de México
Samuel Michael Galvagno, Charles E Smith, Albert J Varon, Erik A Hasenboehler, Shahnaz Sultan, Gregory Shaefer, Kathleen B To, Adam D Fox, Darrell E R Alley, Michael Ditillo, Bellal A Joseph, Bryce R H Robinson, Elliot R Haut
INTRODUCTION: Thoracic trauma is the second most prevalent nonintentional injury in the United States and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma. As a result, updated guidelines for this topic using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework recently adopted by EAST are presented...
November 2016: Journal of Trauma and Acute Care Surgery
Emily S Carr, Ashley De La Cerda, Katherine Fiala
Complex regional pain syndrome (CRPS) is a neurologic disorder that often results in debilitating chronic pain, but the diagnosis may elude providers as it is one of exclusion. A history of trauma may be elucidated. We report a case of CRPS and review the clinical findings, appropriate workup, and treatment options for the patient. The patient we describe went through an extensive workup before receiving the correct diagnosis. Delay in diagnosis leads to prolonged suffering for the patient and, at times, unnecessary invasive debridement procedures...
July 2016: Proceedings of the Baylor University Medical Center
Thomas J Luger, Markus F Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
April 2016: Zeitschrift Für Gerontologie und Geriatrie
J Knapp, S Hofer, H Lier
Peripartum hemorrhage (PPH) is a frequent obstetric emergency situation with increasing incidence in the last decades. It requires a fast, coordinated and interdisciplinary management. This life-threatening situation is often recognized too late and not adequately treated (too little is done too late); therefore, it is important to be aware of the most important risk factors for PPH known as the 4 Ts (i.e. tonus, trauma, tissue and thrombin). Due to the special patient population there is only little evidence-based data on hemostatic therapy in this situation; therefore, the currently available studies on the therapy of PPH is discussed...
March 2016: Der Anaesthesist
Cátia Luciana Abdulfattáhe Taibo, Troy D Moon, Orvalho A Joaquim, Carlos R Machado, Amina Merchant, Kelly McQueen, Mohsin Sidat, Elena Folgosa
BACKGROUND: Trauma is a major public health concern. Worldwide, injuries resulted in 4.8 million deaths in 2013, an increase of 11 % since 1990. The majority of deaths from trauma in low-and middle-income countries occur in a pre-hospital setting. Morbidity from trauma contributes significantly to disability in these countries. Mozambique has experienced a rise in injury-related morbidity and mortality. Efforts are underway to prioritize surgical and anesthesiology care in the post-2015 Global Surgery agenda that will build on momentum of the Millennium Development Goals...
December 2016: International Journal of Emergency Medicine
M Coburn, A B Röhl, M Knobe, A Stevanovic, C Stoppe, R Rossaint
BACKGROUND: The demographic change is accompanied by an increasing number of elderly trauma patients. Geriatric patients with trauma often show several comorbidities and as a result have a high perioperative risk to develop postoperative morbidity and mortality. The 30-day mortality is high. AIM: This article presents an overview of the perioperative management of elderly trauma patients in order to improve the perioperative outcome of these high risk patients. MATERIAL AND METHODS: A literature search was carried out focusing on the latest developments in the field of elderly trauma patients in order to present guidance on preoperative, intraoperative and postoperative anesthesiological management...
February 2016: Der Anaesthesist
M Huber-Lang, P Radermacher, A Palmer, S Geiler, C Grab, U Wachter, M Georgieff, F Gebhard, W Öchsner
BACKGROUNDS AND OBJECTIVES: As part of the expansion of the site-specific education profile of the medical curriculum MED@ULM of the University of Ulm, a new track "trauma care and trauma research" was established in the winter semester 2012/2013. The acceptance of the track was evaluated during the winter semester 2013/2014. MATERIAL AND METHODS: The 6-semester track extends the existing curriculum by offering subjects in trauma management and trauma research to students of human medicine...
December 7, 2015: Der Unfallchirurg
Jan Benes, Jan Zatloukal, Jakub Kletecka
Viscoelastic methods (VEM) made available the bedside assessment of blood clotting. Unlike standard laboratory tests, the results are based on the whole blood coagulation and are available in real time at a much faster turnaround time. In combination with our new knowledge about pathophysiology of the trauma-induced coagulopathy, the goal-oriented treatment protocols have been recently proposed for the initial management of bleeding in trauma victims. Additionally, the utility of viscoelastic monitoring devices has been proved even outside this setting in cardiosurgical patients or those undergoing liver transplantation...
2015: Frontiers in Medicine
Evan S Smith, Rajiv B Gala
BACKGROUND: Cesarean scar ectopic pregnancies are rare, with an incidence of approximately 1 in 2,000 pregnancies. The trauma of a cesarean section and a subsequent cesarean scar pregnancy can lead to the formation of an arteriovenous malformation (AVM). The resulting intractable bleeding is difficult to manage and can result in an emergent surgical intervention that could jeopardize a female's ability to become pregnant in the future. CASE REPORT: A 29-year-old female, gravida 2 para 1, with 1 prior low transverse cesarean section had a presumed cervical ectopic pregnancy treated with intramuscular methotrexate...
2015: Ochsner Journal
J Mourão, J Moreira, J Barbosa, J Carvalho, J Tavares
STUDY OBJECTIVE: The study objective is to determine the incidence of oral soft tissue trauma during classic direct laryngoscopy for tracheal intubation and the risk factors associated with it. DESIGN: This is a prospective observational study. SETTING: The setting is at a ward. PATIENTS: The patients are adults submitted to elective interventions in general surgery requiring tracheal intubation by classic direct laryngoscopy...
December 2015: Journal of Clinical Anesthesia
M J Colomina, M Basora Macaya, E Bisbe Vives
The objective of this article is to determine the availability of a perioperative transfusion management program (Patient Blood Management [PBM]) in various hospitals through a survey that included a description of the preanesthesia visit, the availability and use of the various blood-sparing techniques and the factors limiting their implementation in elective surgery. The survey included 42 questions, directed at the representative departments of anesthesiology of hospitals in Spain (n=91). The survey was conducted from September to November 2012...
June 2015: Revista Española de Anestesiología y Reanimación
Avner Sidi, Nikolaus Gravenstein, Samsun Lampotang
BACKGROUND: It is not known if construct-related validity (progression of scores with different levels of training) and generalizability of Objective Structured Clinical Examination (OSCE) scenarios previously used with non-US graduating anesthesiology residents translate to a US training program. OBJECTIVE: We assessed for progression of scores with training for a validated high-stakes simulation-based anesthesiology examination. METHODS: Fifty US anesthesiology residents in postgraduate years (PGYs) 2 to 4 were evaluated in operating room, trauma, and resuscitation scenarios developed for and used in a high-stakes Israeli Anesthesiology Board examination, requiring a score of 70% on the checklist for passing (including all critical items)...
September 2014: Journal of Graduate Medical Education
Hervé Quintard, Mathilde Severac, Claude Martin, Carole Ichai
INTRODUCTION: The development of specialized units dedicated to life-threatening management has demonstrated to improve the prognosis of patients requiring such treatments. However, apart those focused on trauma and stroke, networks are still lacking in France. Despite, the implementation of standardisation of practices and guidelines, particularly in prehospital care, in-hospital clinical practices at admission remain heterogenous. This survey aimed to assess the structural and human organization of teaching hospitals in France concerning the primary in-hospital care for critically ill patients...
August 2015: Anaesthesia, Critical Care & Pain Medicine
Heather A Vallier, Timothy A Moore, John J Como, Andrea J Dolenc, Michael P Steinmetz, Karl G Wagner, Charles E Smith, Patricia A Wilczewski
OBJECTIVES: We developed a protocol to determine the timing of definitive fracture care based on the adequacy of resuscitation. Inception of this project required a multidisciplinary group, including physicians from anesthesiology, general trauma and critical care, neurosurgery, orthopaedic spine, and orthopaedic trauma. The purposes of this study were to review our initial experience with adherence to protocol recommendations and to assess barriers to implementation. DESIGN: Prospective...
November 2015: Journal of Orthopaedic Trauma
Oliver Strobel, Lutz Schneider, Sebastian Philipp, Stefan Fritz, Markus W Büchler, Thilo Hackert
BACKGROUND: Elective pancreatic surgery can be carried out with mortality rates below 5% in specialized centers today. Only few data exist on pancreatic resections in emergency situations. The aim of the study was to characterize indications, procedures, and outcome of emergency pancreatic surgery in a tertiary center. METHODS: Prospectively collected data of all patients undergoing pancreatic operations at the authors' institution between October 2001 and December 2012 were analyzed regarding primary emergency operations in terms of indications, procedures, perioperative complications, and outcome...
October 2015: Langenbeck's Archives of Surgery
Dionysios K Giannoulis, Panagiotis Koulouvaris, Evgenia Zilakou, Dimitrios B Papadopoulos, Marios G Lykissas, Alexandros N Mavrodontidis
Study Design Case report. Objective Sacral fractures, traumatic or atraumatic, are a rather rare cause of low back pain. The majority of the cases of pregnancy-related sacral fractures are reported as a postpartum complication, and only few cases of sacral atraumatic fractures have been reported in the last trimester of the pregnancy. The aim of this study is to report a rare case of atraumatic sacral fracture in the third trimester of pregnancy. Methods We report the case of a 30-year-old Caucasian European woman during her 37th week (36 weeks and 4 days) of gestation, who complained during her scheduled obstetric examination of continuous low back pain with no associated history of trauma...
June 2015: Global Spine Journal
Norman James Halliday
More than 50% of the population in most developing countries is younger than 18 years, and it has been estimated that 85% of these children may require some sort of surgery before their 15th birthday. Common congenital surgical requirements are for cleft lip and palate, inguinal hernia, meningomyelocele, as well as hydrocephalus. In addition, there is a greater incidence of trauma experienced by pediatric patients. Burn and scald injuries are also common because of the proximity of domestic open fires and boiling pots of water...
June 2015: Journal of Craniofacial Surgery
E Schieb, C-A Greim
Emergency sonography encompasses a number of targeted sonographic investigation techniques, which allow a quick response to frequently occurring situations arising in anesthesiology, including intensive care and emergency medicine. Emergency sonography supports point of care diagnostics to clarify the possible causes of hemodynamic and respiratory instability, e.g. to determine the extent of intra-abdominal bleeding in a still compensated patient with multiple trauma and to support interventions, such as pleural fluid drainage...
April 2015: Der Anaesthesist
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