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Ashley K Losing, Justin M Jones, Adis Keric, Steven E Briggs, David D Leedahl
Ketamine is a promising alternative agent for pain control that offers benefit to traditional strategies, particularly in the setting of rib fracture. Current pharmacologic therapies have clear adverse effects, and other options may be invasive, cost prohibitive, or marginally effective. We describe three consecutive patients with traumatic injuries including rib fracture for which a ketamine infusion was utilized as part of their pain control strategy.  For each patient, use of a ketamine infusion trended toward reduced opioid requirements with stable pain scores...
July 2016: Bulletin of Emergency and Trauma
Adnan Özpek, Metin Yücel, İbrahim Atak, Gürhan Baş, Orhan Alimoğlu
BACKGROUND: This study aimed to investigate the signs and prognosis of the patients hospitalized due to blunt trauma injuries and identify possible factors that affect mortality. METHODS: Between January 2009 and January 2013, a total of 237 patients admitted with blunt trauma injury were retrospectively analyzed. The age and gender of the patients, type of the trauma, injury site, Injury Severity Scores (ISS), Revised Trauma Scores (RTS), Focused Assessment with Sonography in Trauma (FAST) results, hemodynamic status, need for transfusion, treatment modalities, treatment outcomes, and mortality rates were recorded...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Jane Wu, Steven G Faux, Ian Harris, Christopher J Poulos, Tara Alexander
OBJECTIVES: 1) Describe probabilistic linkage (PL) for road trauma and rehabilitation records in New South Wales (NSW) Australia. 2) Determine the accuracy of linkage for these records. METHODS: Data were extracted from the NSW Trauma Registry for all road trauma admissions for the years 2009-2012 and from Australasian Rehabilitation Outcomes Centre for January 2009 to June 2013. PL was performed using: age; sex; residential postcode; and date of acute discharge = date of admission to rehabilitation...
June 2016: Australian and New Zealand Journal of Public Health
Alisher Tashbayev, Alexander Belenky, Sergey Litvin, Michael Knizhnik, Gil N Bachar, Eli Atar
BACKGROUND: Various vena cava filters (VCF) are designed with the ability to be retrieved percutaneously. Yet, despite this option most of them remain in the inferior vena cava (IVC). OBJECTIVES: To report our experience in the placement and retrieval of three different types of VCFs, and to compare the indications for their insertion and retrieval as reported in the literature. METHODS: During a 5 year period three types of retrievable VCF (ALN, OptEase, and Celect) were inserted in 306 patients at the Rabin Medical Center (Beilinson and Hasharon hospitals)...
February 2016: Israel Medical Association Journal: IMAJ
Chaim Frizis, Anastasios Papadopoulos, Georgios Akritidis, Renee-Hanna Frizis, Ioannis Sougkas, Georgios Chatzitheoharis
BACKGROUND: Old age is considered a risk factor; however, its effect on the prognosis of injured elderly patients remains uncertain. AIM: To find the effect of old age on final outcome of elderly patients withmultiple trauma and to determine whether a different therapeutic approach is needed. METHODS: All patients with at least two injured body regions, as defined by the ISS, of grade 4 in AIS, were included. RESULTS: We studied 165 patients up to 64 years (Y) of age and 56 patients older than 65 years (E) in a 10-year period...
June 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Rasmus Jakobsen, Troels Halfeld Nielsen, Asger Granfeldt, Palle Toft, Carl-Henrik Nordström
BACKGROUND: Cerebral cytoplasmatic redox state is a sensitive indicator of cerebral oxidative metabolism and is conventionally evaluated from the extracellular lactate/pyruvate (LP) ratio. In the present experimental study of global cerebral ischemia induced by hemorrhagic shock, we investigate whether the LP ratio obtained from microdialysis of cerebral venous blood may be used as a surrogate marker of global cerebral energy state. METHODS: Six female pigs were anesthetized and vital parameters were recorded...
December 2016: Intensive Care Medicine Experimental
Tülay Özvatan, Halis Akalın, Melda Sınırtaş, Gökhan Ocakoğlu, Emel Yılmaz, Yasemin Heper, Nermin Kelebek, Remzi İşçimen, Ferda Kahveci
BACKGROUND AND OBJECTIVE: Acinetobacter baumannii and A. baumannii/calcoaceticus complex are commonly encountered pathogens in nosocomial infections. This study aimed to evaluate the treatment and prognostic risk factors in nosocomial pneumonia caused by these microorganisms. METHODS: The study was conducted retrospectively in Uludag University Hospital and included 356 adult non-neutropenic patients with nosocomial pneumonia. RESULTS: Of the subjects, 94...
February 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Guy Ron, Dan Epstein, Peleg Ben-Galim, Yoram Klein, Alexander Kaban, Shaul Sagiv
PURPOSE: Traditional maneuvers aim to decrease retroperitoneal bleeding in hemodynamically unstable multi-trauma patients with unstable pelvic fractures, are reportedly successful in approximately only 50%. The life-saving effect of extra-peritoneal pressure packing (EPPP) is based on direct compression and control of both venous and arterial retroperitoneal bleeders. This study describes the safety and efficacy of emergent EPPP employment, as a stand-alone surgical treatment, that is, carried out without external pelvic fixation or emergent angiography...
October 2015: Journal of Emergencies, Trauma, and Shock
Jiřina Martínková, Manu L N G Malbrain, Eduard Havel, Petr Šafránek, Jan Bezouška, Milan Kaška
BACKGROUND: In critically ill patients, multi-trauma and intensive therapy can influence the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics with time-dependent bacterial killing. Consequently, PK/PD targets (%fT>MIC) - crucial for antimicrobial effects -may not be attained. METHODS: Two patients admitted to the surgical ICU of the University Hospital in Hradec Králove for multiple-trauma were given piperacillin/tazobactam by 1-hour IV infusion 4/0...
2016: Anaesthesiology Intensive Therapy
Rolf E Egberink, Harm-Jan Otten, Maarten J IJzerman, Arie B van Vugt, Carine J M Doggen
BACKGROUND: Tiered trauma team response may contribute to efficient in-hospital trauma triage by reducing the amount of resources required and by improving health outcomes. This study evaluates current practice of trauma team activation (TTA) in Dutch emergency departments (EDs). METHODS: A survey was conducted among managers of all 102 EDs in the Netherlands, using a semi-structured online questionnaire. RESULTS: Seventy-two questionnaires were analysed...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Daniel Simon, Rita Iara Moreira do Nascimento, Edison Moraes Rodrigues Filho, Jane Bencke, Andrea Regner
OBJECTIVE: Severe traumatic brain injury (TBI) is associated with a 30-70% mortality rate. Nevertheless, in clinical practice there are no effective biomarkers for the prediction of fatal outcome following severe TBI. Therefore, the aim was to determine whether brain-derived neurotrophic factor (BDNF) plasma levels are associated with intensive care unit (ICU) mortality in patients with severe TBI. METHODS: This prospective study enrolled 120 male patients who suffered severe TBI (Glasgow Coma Scale 3-8 at emergency room admission)...
2016: Brain Injury: [BI]
Elizabeth Hobson, Natasha A Lannin, Amelia Taylor, Michelle Farquhar, Jacqui Morarty, Carolyn Unsworth
BACKGROUND: People with mild traumatic brain injury (mTBI) commonly experience cognitive impairments. Occupational therapists working in acute general hospitals in Australia routinely access client Glasgow Coma Scale (GCS) scores, and assess cognitive status using standardized tools and by observing basic activity of daily living (ADL) performance. However, limited evidence exists to identify the best assessment(s) to determine client cognitive status. AIM/OBJECTIVES: To determine whether cognitive status assessed by GCS score and the Cognistat are predictive of basic ADL performance among clients with mTBI in an acute general hospital and make inferences concerning the clinical utility of these assessment tools...
2016: Scandinavian Journal of Occupational Therapy
Tal M Hörer, Dan Hebron, Forat Swaid, Alexander Korin, Offer Galili, Ricardo Alfici, Boris Kessel
PURPOSE: To describe the usage of aortic balloon occlusion (ABO), based on a multidisciplinary approach in severe trauma patients, emphasizing the role of the interventional radiologist in primary trauma care. METHODS: We briefly discuss the relevant literature, the technical aspects of ABO in trauma, and a multidisciplinary approach to the bleeding trauma patient. We describe three severely injured trauma patients for whom ABO was part of initial trauma management...
February 2016: Cardiovascular and Interventional Radiology
Subramanian Senthilkumaran, Suresh S David, Rishya Manikam, Ponniah Thirumalaikolundusubramanian
No abstract text is available yet for this article.
July 2015: Journal of Anaesthesiology, Clinical Pharmacology
Adham Abdelfattah, Michael Del Core, Lisa K Cannada, J Tracy Watson
BACKGROUND: The impact of orthopedic injuries in the elderly patient with multi-trauma and the effect of operative fixation on these injuries have not been thoroughly evaluated. METHODS: We reviewed geriatric patients (aged 65 and older) between 2004 and 2010 at a level 1 trauma center who sustained high-energy polytrauma (injury and severity score [ISS] ≥ 16) with associated orthopedic injuries. Patients were excluded if they had severe head and spine injuries, died on arrival, or had low-energy mechanisms of injury...
December 2014: Geriatric Orthopaedic Surgery & Rehabilitation
L Shannon, T Peachey, N Skipper, E Adiotomre, A Chopra, B Marappan, N Kotnis
AIM: To assess the accuracy of the trauma team leader's clinical suspicion of injury in patients who have undergone whole-body computed tomography (WBCT) for suspected polytrauma, and to assess the frequency of unsuspected injuries and specific patterns of injury at WBCT. MATERIALS AND METHODS: Requests for patients who underwent WBCT for suspected polytrauma from April 2011 to March 2014 were reviewed and each body area that was clinically suspected to be injured was recorded...
November 2015: Clinical Radiology
Cristian Udovicich, Dean Page, Molla Huq, Stephen Clifforth
BACKGROUND: Neck of femur (NOF) fractures are the most common injury among elderly patients and a significant burden on our healthcare system. AIMS: This study aimed toevaluate if an Australian rural hospital serviced by general surgeons can meet the established standards of care for the management of NOF fractures by undertaking surgery within 48 hours. METHODS: An audit of patients presenting to an Australian rural hospital with NOF fractures over a seven-year period...
2015: Australasian Medical Journal
Bret A Nicks, Kevin M Campons, William P Bozeman
BACKGROUND: Near-infrared spectroscopy (NIRS) non-invasively monitors muscle tissue oxygen saturation (StO2). It may provide a continuous noninvasive measurement to identify occult hypoperfusion, guide resuscitation, and predict the development of multiple organ dysfunction (MOD) after severe trauma. We evaluated the correlation between initial StO2 and the development of MOD in multi-trauma patients. METHODS: Patients presenting to our urban, academic, Level I Trauma Center/Emergency Department and meeting standardized trauma-team activation criteria were enrolled in this prospective trial...
2015: World Journal of Emergency Medicine
Howard Nelson-Williams, Lisa Kodadek, Joseph Canner, Eric Schneider, David Efron, Elliott Haut, Babar Shafiq, Adil Haider, Catherine Garrison Velopulos
BACKGROUND: Younger, multi-trauma patients have improved survival when treated at a trauma center. Many regions now propose that older patients be triaged to a higher level trauma centers (HLTCs-level I or II) versus lower level trauma centers (LLTCs-level III or nondesignated TC), even for isolated injury, despite the absence of an established benefit in this elderly cohort. We therefore sought to determine if older isolated hip fracture patients have improved survival outcomes based on trauma center level...
October 2015: Journal of Surgical Research
Gerben B Keijzers, Chris Del Mar, Leo M G Geeraedts, Joshua Byrnes, Elaine M Beller
BACKGROUND: Missed injury is commonly used as a quality indicator in trauma care. The trauma tertiary survey (TTS) has been proposed to reduce missed injuries. However a systematic review assessing the effect of the TTS on missed injury rates in trauma patients found only observational studies, only suggesting a possible increase in early detection and reduction in missed injuries, with significant potential biases. Therefore, more robust methods are necessary to test whether implementation of a formal TTS will increase early in-hospital injury detection, decrease delayed diagnosis and decrease missed injuries after hospital discharge...
2015: Trials
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