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Trauma management

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https://www.readbyqxmd.com/read/28110378/belfast-limb-arterial-and-skeletal-trauma-blast-the-evolution-of-punishment-shooting-in-northern-ireland
#1
REVIEW
M Lau, S McCain, R Baker, D W Harkin
INTRODUCTION: Northern Ireland has developed significant experience in specific punishment injuries due to its unique civil unrest. Simple gunshot wound (GSW) injuries have begun to evolve into more complex injuries. CASE PRESENTATION: We describe three cases of young male victims who suffered from GSW injuries-from a single GSW injury to multiple GSW injuries involving all four limbs; the phenomenon of Belfast Limb Arterial and Skeletal Trauma. We describe the management of these injuries, with a review of current literature...
January 21, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28110110/trauma-appraisals-emotion-regulation-difficulties-and-self-compassion-predict-posttraumatic-stress-symptoms-following-childhood-abuse
#2
M Rose Barlow, Rachel E Goldsmith Turow, James Gerhart
Experiencing traumatic events and abuse is unfortunately common in general, non-clinical samples. Recent research indicates that the ways in which individuals interpret traumatic experiences, as well as the ways that they manage challenging emotions in general, may statistically predict post-traumatic stress disorder (PTSD) symptoms to a greater extent than does trauma itself. Negative trauma appraisals, generalized emotion regulation (ER) difficulties, and low levels of self-compassion have each been shown to influence the connection between trauma exposure and subsequent PTSD symptoms...
January 18, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28109668/childhood-trauma-depression-and-negative-symptoms-are-independently-associated-with-impaired-quality-of-life-in-schizophrenia-results-from-the-national-face-sz-cohort
#3
M Andrianarisoa, L Boyer, O Godin, L Brunel, E Bulzacka, B Aouizerate, F Berna, D Capdevielle, J M Dorey, C Dubertret, J Dubreucq, C Faget, F Gabayet, P M Llorca, J Mallet, D Misdrahi, R Rey, R Richieri, C Passerieux, A Schandrin, A M Tronche, M Urbach, P Vidailhet, F Schürhoff, G Fond
OBJECTIVES: Depression and negative symptoms have been associated with impaired Quality of life (QoL) in schizophrenia (SZ). However, childhood trauma may influence both QoL and depression in SZ patients, with consequences for the management of impaired QoL in SZ patients. The aim of the present study was to determine if childhood trauma was associated with impaired QoL in schizophrenia. METHOD: A sample of 544 community-dwelling stabilized SZ patients enrolled in FACE-SZ cohort were utilized in this study (74...
January 18, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28109483/otorhinolaryngology-head-and-neck-surgery-in-a-low-income-country-the-haitian-experience
#4
Maxwell P Kligerman, Anahuma Alexandre, Patrick Jean-Gilles, David Walmer, Mack L Cheney, Anna H Messner
OBJECTIVE: Little is known regarding the diagnosis and management of pediatric surgical conditions of the head and neck in low-income countries. Haiti, the western hemisphere's poorest country, recently developed its first Otorhinolaryngology (ORL) department at the Hopital de L'Universite d'Etat d'Haiti (HUEH). This manuscript assesses the caseload at HUEH with a special emphasis on pediatric cases, with the aim of characterizing ORL related conditions and their treatments in low-income countries...
February 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#5
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28108218/chest-trauma-first-48hours-management
#6
Pierre Bouzat, Mathieu Raux, Jean Stéphane David, Karim Tazarourte, Michel Galinski, Thibault Desmettre, Delphine Garrigue, Laurent Ducros, Pierre Michelet
Chest Trauma remains an issue for health services for both severe and apparently mild trauma management. Severe chest trauma is associated with high mortality and is considered liable for 25% of mortality in multiple traumas. Moreover, mild trauma is also associated with significant morbidity especially in patients with preexisting conditions. Thus, whatever the severity, a fast-acting strategy must be organized. At this time there are no guidelines available from scientific societies. These expert recommendations aim to establish guidelines for chest trauma management in both pre hospital an in hospital settings, for the first 48hours...
January 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28107308/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#7
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. Inhaled nitric oxide (iNO) lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#8
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28102533/hospital-incident-command-first-responders-or-receiving-centers
#9
Brian Fletcher, Amanda Knight, Brandy Pockrus, Matthew J Wain, Kathy Lehman-Huskamp
OBJECTIVES: (1) Propose a conceptual model of an alternative hospital incident management system (HIMS) that integrates concepts used by emergency operations centers (EOCs). (2) Compare HIMS to the standard hospital incident command system (HICS) model. DESIGN: A quasi-experimental study was performed. Two identical tabletop incident scenarios were presented, one utilizing HICS and one using HIMS. Participants completed postexercise surveys for each tabletop. Surveys contained both knowledge and satisfaction questions...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28101655/percutaneous-vertebral-augmentation-in-fragility-fractures-indications-and-limitations
#10
O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
January 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28101038/successful-management-in-a-case-of-traumatic-retinal-detachment-due-to-open-globe-injury-using-microincisional-vitrectomy
#11
Wei-Yu Lai, Tsung-Tien Wu
BACKGROUND: Retinal detachment (RD) following ocular trauma often results in guarded visual prognosis and sometimes leads to loss of the eye. With the advent of microincisional vitrectomy surgery and the development of surgical techniques, the management of ocular trauma has been transformed. CASE PRESENTATION: A 34-year-old man sustained an open globe injury from fragmented glass at work. He received primary repair and another follow-up surgery 9 days later, including vitrectomy, silicone oil tamponade, and lensectomy for RD and traumatic cataract at another medical center...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28100944/ostomy-in-nontraumatic-conditions-our-experience-and-review-of-the-literature
#12
Kenan Büyükaşık, Bünyamin Gürbulak, Emre Özoran, Yiğit Düzköylü, Esin Kabul Gürbulak, Aziz Arı, Hasan Bektaş
A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann's procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100939/management-of-liver-trauma-in-minia-university-hospital-egypt
#13
Abdel Fattah Saleh, Emad Al Sageer, Amr Elheny
The aim of this study is to present the outcome of operative and non-operative management of patients with liver injury treated in a single institution depending on imaging. This study was conducted at the Causality Unit of Minia University Hospital, and included 60 patients with hepatic trauma from March 2012 to January 2013. In our study, males represent 80 % while females represent 20 % of the traumatized patients. The peak age for trauma found was 11-30 years. Blunt trauma is the most common cause of liver injury as it was the cause in 48 patients (80 %)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28099390/to-nearly-come-full-circle-nonoperative-management-of-high-grade-iv-v-blunt-splenic-trauma-is-safe-utilizing-a-protocol-with-routine-angioembolization
#14
Indermeet S Bhullar, Joseph J Tepas, Daniel Siragusa, Todd Loper, Andrew Kerwin, Eric R Frykberg
INTRODUCTION: Nonoperative management (NOM) of hemodynamically stable high grade (IV-V) blunt splenic trauma (BST) remains controversial given the high failure rates (19%) that persist despite angioembolization (AE) protocols. The NOM protocol was modified in 2011 to include mandatory AE of all grade (IV-V) injuries without CB along with selective AE of grade (I-V) with CB. The purpose of this study was to determine if this new AE protocol significantly lowered the failure rates for grade (IV-V) injuries allowing for safe observation without surgery and if the exclusion of grade III injuries allowed for the prevention of unnecessary angiograms without affecting the overall failure rates...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099387/use-of-an-evidence-based-algorithm-for-patients-with-traumatic-hemothorax-reduces-need-for-additional-interventions
#15
Bradley M Dennis, Stephen P Gondek, Richard A Guyer, Susan E Hamblin, Oliver L Gunter, Oscar D Guillamondegui
BACKGROUND: Concerted management of the traumatic hemothorax is ill-defined. Surgical management of specific hemothoraces may be beneficial. A comprehensive strategy to delineate appropriate patients for additional procedures does not exist. We developed an evidence-based algorithm for hemothorax management. We hypothesize the use of this algorithm will decrease additional interventions. METHODS: A pre/post study was performed on all patients admitted to our trauma service with traumatic hemothorax from August 2010 to September 2013...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099382/failure-of-nonoperative-management-of-pediatric-blunt-liver-and-spleen-injuries-a-prospective-atomac-study
#16
Maria E Linnaus, Crystal S Langlais, Nilda M Garcia, Adam C Alder, James W Eubanks, R Todd Maxson, Robert W Letton, Todd A Ponsky, Shawn D St Peter, Charles Leys, Amina Bhatia, Daniel J Ostlie, David W Tuggle, Karla A Lawson, Alexander R Raines, David M Notrica
BACKGROUND: Nonoperative management (NOM) is standard of care for most pediatric blunt liver and spleen injuries (BLSI); only 5% of patients fail NOM in retrospective reports. No prospective studies examine failure of NOM of BLSI in children. The aim of this study was to determine the frequency and clinical characteristics of failure of NOM in pediatric BLSI patients. METHODS: A prospective observational study was conducted on patients ≤18 years presenting to any of ten level 1 pediatric trauma centers April 2013 and January 2016 with BLSI on computed tomography...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099379/systemic-intraoperative-anticoagulation-during-arterial-injury-repair-implications-for-patency-and-bleeding
#17
Zoё Maher, Brian Frank, Noelle Saillant, Anna Goldenberg, Elizabeth Dauer, Joshua P Hazelton, Andrea Lubitz, Huaqing Zhao, Jeremy W Cannon, Mark J Seamon
BACKGROUND: The role of systemic intraoperative anticoagulation (SIAC) during surgical repair of major arterial injuries is controversial. Any potential improvement in arterial patency must be weighed against the risk of hemorrhage in these critically injured patients. We hypothesized that SIAC would increase arterial patency without increasing bleeding complications. METHODS: We conducted a multi-institution, retrospective cohort study of trauma patients with major vascular injury from 2005-2013 in 3 level I centers...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099378/acs-level-i-trauma-centers-outcomes-do-not-correlate-with-patients-perception-of-hospital-experience
#18
Bellal Joseph, Asad Azim, Terence O'Keeffe, Kareem Ibraheem, Narong Kulvatunyou, Andrew Tang, Gary Vercruysse, Randall Friese, Rifat Latifi, Peter Rhee
INTRODUCTION: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a data collection methodology for measuring a patient's perception of his/her hospital experience, and it has been selected by the Centers of Medicare and Medicaid Services (CMS) as the validated and transparent national survey tool with publicly available results. Since 2012, hospital reimbursements rates have been linked to HCAHPS data based on patient satisfaction scores. The aim of this study was, therefore, to assess whether HCAHPS scores of Level-1 trauma centers correlate with actual hospital performance...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#19
Paul R Lewis, Casey E Dunne, James D Wallace, Jason B Brill, Richard Y Calvo, Jayraan Badiee, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: The Brain Trauma Foundation guidelines provide indications for neurosurgical intervention in traumatic brain injury (TBI) with moderate or severe intracranial hemorrhage (ICH). In TBI patients with less severe ICH, the utility of neurosurgical consultation remains unclear. We sought to determine if routine neurosurgical consultation is necessary for mild blunt TBI patients with ICH. METHODS: A retrospective cohort study was conducted on 500 consecutive blunt TBI patients aged 15 years or older with Glasgow Coma Scale score ≥13 and ICH on initial head computed tomography (CT) admitted to a Level 1 trauma center over 28 months...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28097295/association-of-systemic-medication-use-with-intraocular-pressure-in-a-multiethnic-asian-population-the-singapore-epidemiology-of-eye-diseases-study
#20
Henrietta Ho, Yuan Shi, Jacqueline Chua, Yih-Chung Tham, Sing Hui Lim, Tin Aung, Tien Yin Wong, Ching-Yu Cheng
Importance: There is limited understanding of the associations between systemic medication use and intraocular pressure (IOP) in the general population. Objective: To examine the association between systemic medication use and IOP in a multiethnic Asian population. Design, Setting, and Participants: In this post hoc analysis of the Singapore Epidemiology of Eye Diseases study, a population-based study of 10 033 participants (78.7% response rate) from 3 racial/ethnic groups (Chinese [recruited from February 9, 2009, through December 19, 2011], Malays [recruited from August 16, 2004, though July 10, 2006], and Indians [recruited from May 21, 2007, through December 29, 2009]), participants with glaucoma, previous ocular surgery, or trauma and an IOP asymmetry greater than 5 mm Hg between eyes were excluded...
January 12, 2017: JAMA Ophthalmology
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