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https://www.readbyqxmd.com/read/29155270/efficient-hemorrhage-control-skills-training-for-healthcare-employees
#1
Richard A Sidwell, Sarah K Spilman, Richard S Huntsman, Carlos A Pelaez
BACKGROUND: Several national initiatives are aimed at training citizens to assist bleeding victims. The purpose of this study was to evaluate an effort to quickly and efficiently teach basic bleeding control techniques to a clinical and nonclinical workforce. STUDY DESIGN: The research study was conducted at four hospitals in a mid-sized metropolitan area. In spring 2017, the trauma department at a Level 1 trauma center set an ambitious goal to provide hands-on training to 1000 employees over the course of 6 weeks...
November 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29153864/changes-in-markers-of-thrombin-generation-and-interleukin-6-during-unicondylar-knee-and-total-knee-arthroplasty
#2
Edwin P Su, Lauren E Mount, Allina A Nocon, Thomas P Sculco, George Go, Nigel E Sharrock
BACKGROUND: Total knee arthroplasty (TKA) is associated with a risk of thromboembolism requiring routine thromboprophylaxis, but there is debate about the risk with unicondylar knee arthroplasty (UKA) as it is a more minor procedure. We sought to investigate the relative risk of thromboembolism with UKA compared to TKA and one-staged bilateral TKA (BTKA) by measuring the increase in circulating biochemical markers of thrombin generation during the procedures. Degree of surgical trauma was also assessed by measuring interleukin-6, a marker of metabolic injury...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29152297/sudden-swelling-and-redness-of-the-toe
#3
Vera Tengattini, Michela Magnano, Annalisa Patrizi, Iria Neri
The presence of history of redness and swelling of toe in an infant without history of trauma is typical of hair threat tourniquet syndrome. The treatment simply involves incision and removal of hair fibers. Physicians should be aware of this syndrome because early diagnosis and treatment avoid serious complications.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29148009/preoperative-ultrasound-for-runoff-venous-decompression-of-peripheral-nerves-for-arteriovenous-access-related-pain-in-the-upper-limb
#4
Hiroaki Matsuda, Yoshinari Oka, Ryuichi Yoshida, Yuki Katsura, Hidemi Takeuchi, Yasuo Fujimoto, Shigeko Takatsu, Masashi Miyazaki
INTRODUCTION: Arteriovenous access (AVA)-related pain treated successfully with runoff-venous decompression of the causative nerve, following ultrasound (US)-assisted preoperative evaluation, has never been reported. CASE PRESENTATION: A 57-year-old man suffering from constant exhausting pains along the outflow cephalic vein of the radiocephalic arteriovenous fistula at the wrist and the antecubital fossa, was treated surgically after the diagnosis of AVA-related pain derived from cephalic vein compression on two peripheral cutaneous nerves, the superficial radial nerve (SRN) and the lateral antebrachial cutaneous nerve (LACN)...
November 9, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29145985/use-of-wide-awake-local-anesthesia-no-tourniquet-in-hand-and-wrist-surgery
#5
REVIEW
Murphy M Steiner, James H Calandruccio
WALANT (wide-awake local anesthesia no tourniquet) appears to be a safe and effective anesthesia technique for many hand and wrist surgeries. Patient satisfaction is high because of the avoidance of preoperative testing and hospital admission. Postoperative recovery is rapid, and procedures can be done in outpatient settings, resulting in substantial savings in time and money.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#6
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29141522/perceived-comfort-during-minor-hand-surgeries-with-wide-awake-local-anaesthesia-no-tourniquet-walant-versus-local-anaesthesia-la-tourniquet
#7
Jayaletchumi Gunasagaran, Ee Soon Sean, Sachin Shivdas, Shams Amir, Tunku Sara Ahmad
PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29141358/-effect-of-different-tourniquet-releasing-strategy-on-blood-loss-in-total-knee-arthroplasty
#8
Y Li, M Lu, H Tian, Z J Li, K Zhang
Objective: To explore the influences on peri-operative blood loss and postoperative blood transfusion in primary total knee arthroplasty when using different methods to release the pneumatic tourniquet. Methods: From January 2015 to December 2016, 484 patients with osteoarthritis were enrolled, undergoing primary unilateral total knee arthroplasty in the Orthopedics Department of Peking University Third Hospital. Retrospective data was used, and all the patients had been operated on by three independent working groups...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140886/safety-of-venipuncture-sites-at-the-cubital-fossa-as-assessed-by-ultrasonography
#9
Kanae Mukai, Yukari Nakajima, Tomotaka Nakano, Manami Okuhira, Aya Kasashima, Rina Hayashi, Misaki Yamashita, Tamae Urai, Toshio Nakatani
OBJECTIVE: The aim of the present observational study was to identify safe and suitable venipuncture sites for nursing in the clinical setting using ultrasonography to measure the depth and cross-sectional area of each superficial vein before and after tourniquet application as well as the distance between each superficial vein and the median nerve or brachial artery. METHODS AND RESULTS: Twenty healthy volunteers (21.8 [0.6] y) were recruited. The visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein...
November 15, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29137681/influence-of-tourniquet-use-in-primary-total-knee-arthroplasty-with-drainage-a-prospective-randomised-controlled-trial
#10
Kai Zhou, Tingxian Ling, Haoyang Wang, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
BACKGROUND: We aimed to compare the effect of tourniquet use or lack of it on recovery following uncomplicated primary total knee arthroplasty (TKA). METHODS: In a prospective randomised double-blinded study, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group. At the early phase, 3 and 6 months after surgery, an independent observer assessed the primary outcome measure (i.e. total blood loss) and secondary outcome measures (i...
November 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29132576/management-of-major-vascular-injuries-neck-extremities-and-other-things-that-bleed
#11
REVIEW
Chris Evans, Tim Chaplin, David Zelt
Vascular injuries represent a significant burden of mortality and disability. Blunt injuries to the neck vessels can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiography and managed with either antiplatelet medications or anticoagulation. In contrast, patients with penetrating injuries to the neck vessels require airway management, hemorrhage control, and damage control resuscitation before surgical repair. The keys to diagnosis and management of peripheral vascular injury include early recognition of the injury; hemorrhage control with direct pressure, packing, or tourniquets; and urgent surgical consultation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29114639/knee-septic-arthritis-after-arthroscopy-incidence-risk-factors-functional-outcome-and-infection-eradication-rate
#12
REVIEW
G Balato, S L Di Donato, T Ascione, A D'Addona, F Smeraglia, G Di Vico, D Rosa
Purpose  Septic knee arthritis following arthroscopy is a rare but dreaded complication. Definition and management of knee deep infections are quite discussed in literature. In this review, literature regarding infections after knee arthroscopy is analyzed highlighting the incidence, causative bacteria, risk factors as well as clinical outcomes. Methods  We performed a review of the literature matching the following key words: "septic arthritis" OR "infection" AND "arthroscopy" AND "knee." Knee arthroscopic procedures, such as debridement, meniscectomy, meniscus repair, synovectomy, microfracture, and lateral release, were considered...
June 2017: Joints
https://www.readbyqxmd.com/read/29106608/-caput-medusae-tension-reduction-on-a-dehiscent-native-annulus-in-valve-implantation-in-an-endocarditis-case
#13
Johannes M Albes
Interrupted pledget-armed braided sutures are widely used for valve implantation. In a 74-year-old woman with aortic valve endocarditis and shallow annular abscess, annulus dehiscence resulted after resection. As resistance was too high for sufficient primary approximation, a snug fit of the valve by means of circumferential application of curbed tourniquets resembling Medusa's head after suture placement was achieved. Closest possible approximation of the upper and lower part of the annulus with the prosthesis prior to final fixation was thus possible, so that application of too much tension on a single suture could be avoided...
July 4, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29106292/preanalytic-factors-associated-with-hemolysis-in-emergency-department-blood-samples
#14
Michael P Phelan, Edmunds Z Reineks, Jesse D Schold, Frederic M Hustey, Janelle Chamberlin, Gary W Procop
CONTEXT: - Hemolysis of emergency department blood samples is a common occurrence and has a negative impact on health care delivery. OBJECTIVES: - To determine the effect of preanalytic factors (straight stick, intravenous [IV] line, needle gauge, location of blood draw, syringe versus vacuum tube use, tourniquet time) on hemolysis in emergency department blood samples. DESIGN: - A single 65 000-visit emergency department's electronic health record was queried for emergency department potassium results and blood draw technique for all samples obtained in calendar year 2014, resulting in 54 531 potassium results...
November 6, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29104792/three-anatomical-levels-possibilities-to-decrease-invasiveness-of-reconstructive-surgery-for-congenital-penile-curvature
#15
Wojciech Perdzyński, Marek Adamek
Introduction: The aim of the study was to report methods - based on penile anatomy - leading to the minimization in the invasiveness of reconstructive surgery for congenital penile curvature (CPC). Material and methods: From 2006 to 2016 authors operated on 186 adult men with CPC.To avoid degloving, the authors used the longitudinal skin and tunica dartos incision. For decreasing invasiveness to the dorsal neurovascular bundle (NVB), the authors separated it only locally in the shape of a triangle or a trapezium, elevating it only over the place of the tunical reconstruction...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/29103849/the-effect-of-skin-pigmentation-on-determination-of-limb-ischemia
#16
Elizabeth M Polfer, Ryan M Zimmerman, Eshetu Tefera, Ryan D Katz, James P Higgins, Kenneth R Means
PURPOSE: Timely identification of tissue ischemia is critical, both in the traumatized limb and following free tissue transfer. The purpose of this study was to determine if skin pigmentation affects the ability to detect limb ischemia. METHODS: We conducted a study of healthy controls exposed to limb ischemia. The subjects were classified based on skin pigmentation using a defined skin type assessment tool, a visual color scale, and self-description of race. Participants were randomized by limb and tourniquet status; surgeons were blinded to both...
November 2, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29095273/risk-factors-of-wound-infection-after-open-reduction-and-internal-fixation-of-calcaneal-fractures
#17
Jun Su, Xuecheng Cao
The aim of this study was to investigate the risk factors of wound infection after open reduction and internal fixation of calcaneal fractures.In all, 299 patients with 318 calcaneal fractures who underwent open reduction and internal fixation by a single surgeon were grouped according to different outcomes. We gathered the data on each patient including sex, age, injury mechanism, body mass index (BMI), time to operation, fracture type, associated injuries, treatment course, tourniquet time, blood loss, bone graft (yes or no), diabetes (yes or no), smoking history, and complications...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29095191/determination-of-pneumatic-tourniquet-pressure-of-lower-limb-by-ultrasonic-doppler
#18
Jinyan Mu, Dan Liu, Daihong Ji, Borui Li, Zhigang Li, Feng Zhang, William C Lineaweaver
OBJECTIVE: The aim of this study was to investigate the clinical effect of tourniquet inflation pressure setting by ultrasonic Doppler on lower limb operation. METHODS: Ninety-six patients with total knee arthroplasty were selected in this study from January 2015 to December 2015. The patients were randomly divided into the study group and the control group with 48 cases in each group. In the control group, the tourniquet pressure is determined by the doctor's request for the patient's condition, but all the tourniquet pressure values should be 80 KPa or less...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29092968/hair-thread-tourniquet-syndrome-in-a-male-infant-a-rare-surgical-emergency
#19
Louise Dunphy, Yash Verma, Rossel Morhij, Michael Lamyman
Hair thread tourniquet syndrome (HTTS) is a rare surgical emergency that occurs when one or more appendages are acutely circumferentially strangulated by human hair. If left untreated it may induce prolonged ischaemia, resulting in tissue necrosis or autoamputation of the affected digit. It may involve the fingers, toes, penis or labia. It typically occurs in infants, but cases have also been reported in adults. Prompt recognition and treatment by complete removal of the constricting agent is crucial to preserve the affected tissue...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29091490/prospective-evaluation-of-opioid-consumption-following-hand-surgery-performed-wide-awake-versus-with-sedation
#20
Andrew Miller, Nayoung Kim, Asif M Ilyas
BACKGROUND: We prospectively evaluated opioid consumption postoperatively following trigger finger release (TFR) and open carpal tunnel release (CTR), and hypothesized that cases performed wide awake with local anesthesia and no tourniquet (WALANT) would result in increased opioid consumption compared with cases performed under monitored anesthesia care (MAC). METHODS: Postoperative opioid consumption following CTR and TFR was prospectively collected over 6 months...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
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