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Trauma

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By Richard Gough Paramedic tutor, Post Qualification Manager
https://www.readbyqxmd.com/read/28511807/does-the-novel-lateral-trauma-position-cause-more-motion-in-an-unstable-cervical-spine-injury-than-the-logroll-maneuver
#1
Per Kristian Hyldmo, MaryBeth Horodyski, Bryan P Conrad, Sindre Aslaksen, Jo Røislien, Mark Prasarn, Glenn R Rechtine, Eldar Søreide
OBJECTIVE: Prehospital personnel who lack advanced airway management training must rely on basic techniques when transporting unconscious trauma patients. The supine position is associated with a loss of airway patency when compared to lateral recumbent positions. Thus, an inherent conflict exists between securing an open airway using the recovery position and maintaining spinal immobilization in the supine position. The lateral trauma position is a novel technique that aims to combine airway management with spinal precautions...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28280639/delayed-stroke-following-blunt-neck-trauma-a-case-illustration-with-recommendations-for-diagnosis-and-treatment
#2
Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28337350/seat-belt-compression-appendicitis-following-motor-vehicle-collision
#3
Muhammad Faisal Khilji, Qazi Zia Ullah
Appendicitis and trauma both present in emergency department commonly but their presentation together in the same patient is unusual. We present a case of a middle-aged man brought by emergency medical services (EMS) to the emergency department with complaints of abdominal pain after he was involved in motor vehicle collision. He was perfectly fine before the accident. His primary survey was normal. Secondary survey revealed tenderness in right iliac fossa with seat belt mark overlying it. Computerized tomography (CT) of the abdomen and pelvis was performed which showed 8 mm thickening of appendix with minimal adjacent fat stranding...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28139311/fluid-resuscitation-of-trauma-patients-how-much-fluid-is-enough-to-determine-the-patient-s-response
#4
Yasuaki Mizushima, Shota Nakao, Koji Idoguchi, Tetsuya Matsuoka
No abstract text is available yet for this article.
June 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#5
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27654000/guidelines-for-the-management-of-severe-traumatic-brain-injury-fourth-edition
#6
Nancy Carney, Annette M Totten, Cindy O'Reilly, Jamie S Ullman, Gregory W J Hawryluk, Michael J Bell, Susan L Bratton, Randall Chesnut, Odette A Harris, Niranjan Kissoon, Andres M Rubiano, Lori Shutter, Robert C Tasker, Monica S Vavilala, Jack Wilberger, David W Wright, Jamshid Ghajar
The scope and purpose of this work is 2-fold: to synthesize the available evidence and to translate it into recommendations. This document provides recommendations only when there is evidence to support them. As such, they do not constitute a complete protocol for clinical use. Our intention is that these recommendations be used by others to develop treatment protocols, which necessarily need to incorporate consensus and clinical judgment in areas where current evidence is lacking or insufficient. We think it is important to have evidence-based recommendations to clarify what aspects of practice currently can and cannot be supported by evidence, to encourage use of evidence-based treatments that exist, and to encourage creativity in treatment and research in areas where evidence does not exist...
January 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/27211834/impact-brain-apnoea-a-forgotten-cause-of-cardiovascular-collapse-in-trauma
#7
REVIEW
Mark H Wilson, John Hinds, Gareth Grier, Brian Burns, Simon Carley, Gareth Davies
OBJECTIVE: Early death following cranial trauma is often considered unsurvivable traumatic brain injury (TBI). However, Impact Brain Apnoea (IBA), the phenomenon of apnoea following TBI, may be a significant and preventable contributor to death attributed to primary injury. This paper reviews the history of IBA, cites case examples and reports a survey of emergency responder experience. METHODS: Literature and narrative review and focused survey of pre-hospital physicians...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/26643236/prehospital-care-for-multiple-trauma-patients-in-germany
#8
EDITORIAL
Marc Maegele
For the German speaking countries, Tscherne's definition of "polytrauma" which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/26334607/guidelines-for-the-management-of-a-pregnant-trauma-patient
#9
Venu Jain, Radha Chari, Sharon Maslovitz, Dan Farine, Emmanuel Bujold, Robert Gagnon, Melanie Basso, Hayley Bos, Richard Brown, Stephanie Cooper, Katy Gouin, N Lynne McLeod, Savas Menticoglou, William Mundle, Christy Pylypjuk, Anne Roggensack, Frank Sanderson
OBJECTIVE: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence-based systematic approach to the pregnant trauma patient. OUTCOMES: Significant health and economic outcomes considered in comparing alternative practices...
June 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26598629/the-changing-face-of-major-trauma-in-the-uk
#10
A Kehoe, J E Smith, A Edwards, D Yates, F Lecky
AIM: Major trauma (MT) has traditionally been viewed as a disease of young men caused by high-energy transfer mechanisms of injury, which has been reflected in the configuration of MT services. With ageing populations in Western societies, it is anticipated that the elderly will comprise an increasing proportion of the MT workload. The aim of this study was to describe changes in the demographics of MT in a developed Western health system over the last 20 years. METHODS: The Trauma Audit Research Network (TARN) database was interrogated to identify all cases of MT (injury severity score >15) between 1990 and the end of 2013...
December 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26377296/crush-injury-by-an-elephant-life-saving-prehospital-care-resulting-in-a-good-recovery
#11
Alice M Young, Anthony P Joseph, Alicia Jackson
No abstract text is available yet for this article.
September 21, 2015: Medical Journal of Australia
https://www.readbyqxmd.com/read/26362582/confirmation-of-suboptimal-protocols-in-spinal-immobilisation
#12
Mark Dixon, Joseph O'Halloran, Ailish Hannigan, Scott Keenan, Niamh M Cummins
BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass...
December 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25760358/images-in-clinical-medicine-penile-fracture
#13
Robert J Hartman
A healthy 42-year-old man presented to the emergency department after the acute onset of penile pain during sexual intercourse. The erect penis had inadvertently collided with his partner's perineum. He heard a snap, noticed a rush of blood from the meatus, had immediate detumescence, and had..
March 12, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/24439608/infant-car-safety-seats-and-risk-of-head-injury
#14
Camille L Stewart, Megan A Moscariello, Kristine W Hansen, Steven L Moulton
BACKGROUND/PURPOSE: We observed a high incidence of traumatic brain injuries (TBI) in properly restrained infants involved in higher speed motor vehicle crashes (MVCs). We hypothesized that car safety seats are inadequately protecting infants from TBI. METHODS: We retrospectively queried scene crash data from our State Department of Transportation (2007-2011) and State Department of Public Health data (2000-2011) regarding infants who presented to a trauma center after MVC...
January 2014: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/25542727/prehospital-use-of-blood-and-plasma-in-pediatric-trauma-patients
#15
D Dean Potter, Kathleen S Berns, Terri A Elsbernd, Scott P Zietlow
OBJECTIVE: Our rural trauma center uses packed red blood cells (PRBCs) and plasma onboard our helicopter to offset the delay of transport. We summarize our initial experience with prehospital blood use in pediatric trauma patients. METHODS: Our air ambulance service began carrying PRBCs in 1987 and plasma in 2009. We performed a 9-year retrospective review including patients (< 18 years) who received blood during helicopter transports. Only patients transported to our level 1 trauma center were included to ensure complete follow-up...
January 2015: Air Medical Journal
https://www.readbyqxmd.com/read/25542726/rural-trauma-patients-cannot-wait-tranexamic-acid-administration-by-helicopter-emergency-medical-services
#16
May Mrochuk, Domhnall ÓDochartaigh, Eddie Chang
OBJECTIVE: Tranexamic acid (TXA) administration has been shown to reduce mortality in bleeding trauma patients if given in the hospital within 3 hours of injury. Its use has been theorized to be of benefit in the prehospital environment. This study evaluates the timing of TXA administration in a critical care helicopter emergency medical service (HEMS) versus that of the destination trauma hospital. METHODS: We performed a retrospective chart review of consecutive trauma patients who were given TXA during HEMS transfer...
January 2015: Air Medical Journal
https://www.readbyqxmd.com/read/25487830/pain-management-in-trauma-patients-in-pre-hospital-based-emergency-care-current-practice-versus-new-guideline
#17
A C Scholten, S A A Berben, A H Westmaas, P M van Grunsven, E T de Vaal, P P M Rood, N Hoogerwerf, C J M Doggen, L Schoonhoven
INTRODUCTION: Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was developed. The aim of this study was to assess whether current practice is in compliance with the guideline 'Pain management for trauma patients in the chain of emergency care' from the Netherlands Association for Emergency Nurses (in Dutch NVSHV), and to evaluate early and initial pain management for adult trauma patients in emergency care...
May 2015: Injury
https://www.readbyqxmd.com/read/17958899/tourniquets-for-the-control-of-traumatic-hemorrhage-a-review-of-the-literature
#18
Stephen L Richey
No abstract text is available yet for this article.
October 24, 2007: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/25425230/prehospital-identification-of-trauma-patients-with-early-acute-coagulopathy-and-massive-bleeding-results-of-a-prospective-non-interventional-clinical-trial-evaluating-the-trauma-induced-coagulopathy-clinical-score-ticcs
#19
Martin L Tonglet, Jean Marc Minon, Laurence Seidel, Jean Louis Poplavsky, Michel Vergnion
INTRODUCTION: Identifying patients who need damage control resuscitation (DCR) early after trauma is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been developed to identify such patients, but most of them are not simple enough to be used in prehospital settings in the early post-traumatic phase. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure and strictly clinical trauma score developed to meet this medical need...
November 26, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/24641269/an-evidence-based-prehospital-guideline-for-external-hemorrhage-control-american-college-of-surgeons-committee-on-trauma
#20
REVIEW
Eileen M Bulger, David Snyder, Karen Schoelles, Cathy Gotschall, Drew Dawson, Eddy Lang, Nels D Sanddal, Frank K Butler, Mary Fallat, Peter Taillac, Lynn White, Jeffrey P Salomone, William Seifarth, Michael J Betzner, Jay Johannigman, Norman McSwain
This report describes the development of an evidence-based guideline for external hemorrhage control in the prehospital setting. This project included a systematic review of the literature regarding the use of tourniquets and hemostatic agents for management of life-threatening extremity and junctional hemorrhage. Using the GRADE methodology to define the key clinical questions, an expert panel then reviewed the results of the literature review, established the quality of the evidence and made recommendations for EMS care...
April 2014: Prehospital Emergency Care
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