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https://read.qxmd.com/read/30760302/does-injury-pattern-among-major-road-trauma-patients-influence-prehospital-transport-decisions-regardless-of-the-distance-to-the-nearest-trauma-centre-a-retrospective-study
#1
Helen Fagerlind, Lara Harvey, Stefan Candefjord, Johan Davidsson, Julie Brown
BACKGROUND: Prehospital undertriage occurs when the required level of care for a major trauma patient is underestimated and the patient is transported to a lower-level emergency care facility. One possible reason is that the pattern of injuries exceeding a certain severity threshold is not easily recognizable in the field. The present study aims to examine whether the injury patterns of major road trauma patients are associated with trauma centre transport decisions in Sweden, controlling for the distance from the crash to the nearest trauma centre and other patient characteristics...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30756247/augmenting-denver-criteria-yields-increased-bcvi-detection-with-screening-showing-markedly-increased-risk-for-subsequent-ischemic-stroke
#2
Frank V Bensch, Elina A Varjonen, Tuomo T Pyhältö, Seppo K Koskinen
PURPOSE: BCVI may lead to ischemic stroke, disability, and death, while being often initially clinically silent. Screening criteria for BCVI based on clinical findings and trauma mechanism have improved detection, with Denver criteria being most common. Up to 30% of patients do not meet BCVI screening criteria. The aim of this study was to analyze the effect of augmented Denver criteria on detection, and to determine the relative risk for ischemic stroke. METHODS: Denver screening criteria were augmented by any high-energy trauma of the cervical spine, thorax, abdomen, or pelvis...
February 12, 2019: Emergency Radiology
https://read.qxmd.com/read/30725101/development-and-validation-of-a-prediction-model-for-prehospital-triage-of-trauma-patients
#3
Eveline A J van Rein, Rogier van der Sluijs, Frank J Voskens, Koen W W Lansink, R Marijn Houwert, Rob A Lichtveld, Mariska A de Jongh, Marcel G W Dijkgraaf, Howard R Champion, Frank J P Beeres, Luke P H Leenen, Mark van Heijl
Importance: Prehospital trauma triage protocols are used worldwide to get the right patient to the right hospital and thereby improve the chance of survival and avert lifelong disabilities. The American College of Surgeons Committee on Trauma set target levels for undertriage rates of less than 5%. None of the existing triage protocols has been able to achieve this target in isolation. Objective: To develop and validate a new prehospital trauma triage protocol to improve current triage rates...
February 6, 2019: JAMA Surgery
https://read.qxmd.com/read/30683031/total-cervical-tracheal-rupture-following-blunt-trauma
#4
Ahmet Dumanlı, Adem Gencer, Neşe Nur User, Abdulkadir Bucak, Ersin Günay, Gürhan Öz
Tracheal ruptures are rarely seen and potentially high life-threatening injuries. Cervical tracheal injuries occur due to the penetrant trauma rather than the blunt trauma. On the other hand, total cervical tracheal rupture due to the blunt trauma is so rare. A 32 year-old male patient was admitted to the emergency service with complaints of breathlessness and stridor resulting from a traffic accident. Thorax computed tomography of the patient revealed total cervical tracheal rupture under the cricoid cartilage level...
December 2018: Tüberküloz Ve Toraks
https://read.qxmd.com/read/30664817/bullet-caliber-and-type-categorization-from-gunshot-wounds-in-sus-scrofa-linnaeus-long-bone
#5
Bailey J Henwood, Tracy S Oost, Scott I Fairgrieve
Studies on ballistic trauma to the ribs and thorax, cranium, and long bones demonstrate the potential of obtaining a bullet caliber from an entrance wound. In order to validate prior research on caliber estimation in bone tissue and assess the viability of bullet type determination based on the macroscopic evidence at the entrance wound, thirty fleshed pork (Sus scrofa) shoulders (humeri) were shot with either lead or copper jacketed bullets in one of three calibers; 0.22, 9 mm, or 0.38. Overall, our findings are consistent with previous research indicating that calibers can be grouped into "small" and "large" categories...
January 21, 2019: Journal of Forensic Sciences
https://read.qxmd.com/read/30587210/the-final-assessment-and-its-association-with-field-assessment-in-patients-who-were-transported-by-the-emergency-medical-service
#6
Carl Magnusson, Christer Axelsson, Lena Nilsson, Anneli Strömsöe, Monica Munters, Johan Herlitz, Magnus Andersson Hagiwara
BACKGROUND: In patients who call for the emergency medical service (EMS), there is a knowledge gap with regard to the final assessment after arriving at hospital and its association with field assessment. AIM: In a representative population of patients who call for the EMS, to describe a) the final assessment at hospital discharge and b) the association between the assessment in the field and the assessment at hospital discharge. METHODS: Thirty randomly selected patients reached by a dispatched ambulance each month between 1 Jan and 31 Dec 2016 in one urban, one rural and one mixed ambulance organisation in Sweden took part in the study...
December 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30539073/pilot-evaluation-of-an-objective-structured-assessment-of-technical-skills-tool-for-chest-tube-insertion
#7
Mirco Friedrich, Julian Ober, Patrick Haubruck, Christian Bergdolt, Thomas Bruckner, Karl-Friedrich Kowalewski, Martina Kadmon, Beat-Peter Müller-Stich, Michael Christopher Tanner, Felix Nickel
Background: Chest tube insertion is a standard intervention for management of various injuries of the thorax. Efficient clinical training of this and similar bed-side procedures is equally demanded and improvable. Here, we propose a nouveau means of assessment and feedback using an Objective Structured Assessment of Technical Skills (OSATS) tool. The modified OSATS for chest drain insertion is evaluated in a pilot trial focusing on chest drain insertion. Methods: Participants in the pilot trial were medical students (3rd -6th year of studies, n=9), junior residents (1st -3rd post-graduate year, n=12), senior residents (4th -6th post-graduate year, n=14), and attending surgeons (n=6) from Heidelberg University...
2018: GMS Journal for Medical Education
https://read.qxmd.com/read/30516261/distribution-characteristics-of-combat-related-shrapnel-and-relationship-to-weapon-type-and-conflict-location-experience-of-an-operational-field-hospital
#8
Sinan Akay, Mehmet Burak Aşık, Sami Eksert
BACKGROUND: The aim of this study was to investigate the characteristics of shrapnel distribution in the body and a possible relationship to the type of weapon and type of location of the conflict. METHODS: The records of 246 patients admitted to a level-III trauma center with any kind of firearm injury were examined retrospectively. Ninety patients who had at least 1 radiologically-proven piece of shrapnel in their body were included in the study. For the purposes of the study, the body was divided into 5 regions (head/neck, thorax/back, abdomen/pelvis/waist, upper extremities, and lower extremities) and shrapnel distribution was noted according to these divisions...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://read.qxmd.com/read/30484078/imaging-of-thoracic-hernias-types-and-complications
#9
REVIEW
Abhishek Chaturvedi, Prabhakar Rajiah, Alexender Croake, Sachin Saboo, Apeksha Chaturvedi
Thoracic hernias are characterised by either protrusion of the thoracic contents outside their normal anatomical confines or extension of the abdominal contents within the thorax. Thoracic hernias can be either congenital or acquired in aetiology. They can occur at the level of the thoracic inlet, chest wall or diaphragm. Thoracic hernias can be symptomatic or fortuitously discovered on imaging obtained for other indications. Complications of thoracic hernias include incarceration, trauma and strangulation with necrosis...
November 27, 2018: Insights Into Imaging
https://read.qxmd.com/read/30482587/ct-lung-volume-estimates-in-trauma-patients-undergoing-stabilizing-surgery-for-flail-chest
#10
Eva-Corina Caragounis, Monika Fagevik Olsén, Hans Granhed, Rauni Rossi Norrlund
AIM: To estimate and compare lung volumes from pre- and post-operative computed tomography (CT) images and correlate findings with post-operative lung function tests in trauma patients with flail chest undergoing stabilizing surgery. PATIENTS AND METHODS: Pre- and post-operative CT images of the thorax were used to estimate lung volumes in 37 patients who had undergone rib plate fixation at least 6 months before inclusion for flail chest due to blunt thoracic trauma...
October 16, 2018: Injury
https://read.qxmd.com/read/30456417/penetrating-trauma-and-invasive-management-of-thorax-trauma
#11
EDITORIAL
L P H Leenen
No abstract text is available yet for this article.
December 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/30425598/incidences-and-factors-associated-with-perioperative-cardiac-arrest-in-trauma-patients-receiving-anesthesia
#12
Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem
Purpose: The aim of this study was to determine the incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Patients and methods: This retrospective cohort study was approved by the medical ethical committee, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Thailand. Data of 19,683 trauma patients who received anesthesia between January 2007 and December 2016, such as patient characteristics, surgery procedures, anesthesia information, anesthetic drugs, and cardiac arrest outcomes, were analyzed...
2018: Risk Management and Healthcare Policy
https://read.qxmd.com/read/30424691/-cme-significance-of-thoracic-sonography-in-thoracic-trauma
#13
Susanne Morf
CME: Significance of Thoracic Sonography in Thoracic Trauma Abstract. Trauma patients should be treated according to international guidelines. Depending on the severity of the trauma, an immediate threat to life must be ruled out and sonography is part of the complementation of diagnostics. The EFAST investigation includes the exclusion of fluid in the thorax, the exclusion of pneumothorax and the exclusion of fluid in the pericardium. Thorax ultrasound is becoming increasingly important in the evaluation of the outcome in thoracic trauma patients as well as in the control of the initiated therapy...
November 2018: Praxis
https://read.qxmd.com/read/30418008/the-effect-of-aerosolized-indomethacin-on-lung-inflammation-and-injury-in-a-rat-model-of-blunt-chest-trauma
#14
Raymond L. Kao, Weixiong Huang, Claudio M. Martin, Tao Rui
Background: Acute lung contusion from blunt chest trauma (BCT) is characterized by an intense inflammatory response in the pulmonary parenchyma, which is associated with acute lung injury (ALI), acute respiratory distress syndrome and ventilator-associated pneumonia. We hypothesized that aerosolized indomethacin may reduce pulmonary inflammation and ALI in a rat model of BCT. Methods: Sprague-Dawley rats were anesthetized and received a tracheotomy for administration of aerosolized medication through a catheter...
December 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://read.qxmd.com/read/30402559/improving-survival-after-an-emergency-resuscitative-thoracotomy-a-5-year-review-of-the-trauma-quality-improvement-program
#15
Bellal Joseph, Muhammad Khan, Faisal Jehan, Rifat Latifi, Peter Rhee
Background: Advancement in trauma care has led to the evolution of emergency resuscitative thoracotomy (ERT) for the revival of trauma patients. We now have more precise understanding of selecting suitable patients for achieving optimal outcomes. The aim of our study was to analyze the utilization and survival trends during the past 5 years, as well as factors that influence survival after ERT. Methods: A 5-year (2010-2014) analysis of all trauma patients ≥18 years who underwent ERT in the American College of Surgeons Trauma Quality Improvement Program...
2018: Trauma surgery & acute care open
https://read.qxmd.com/read/30341744/interaction-of-the-hydrogen-sulfide-system-with-the-oxytocin-system-in-the-injured-mouse-heart
#16
Tamara Merz, Britta Lukaschewski, Daniela Wigger, Aileen Rupprecht, Martin Wepler, Michael Gröger, Clair Hartmann, Matthew Whiteman, Csaba Szabo, Rui Wang, Christiane Waller, Peter Radermacher, Oscar McCook
BACKGROUND: Both the hydrogen sulfide/cystathionine-γ-lyase (H2 S/CSE) and oxytocin/oxytocin receptor (OT/OTR) systems have been reported to be cardioprotective. H2 S can stimulate OT release, thereby affecting blood volume and pressure regulation. Systemic hyper-inflammation after blunt chest trauma is enhanced in cigarette smoke (CS)-exposed CSE-/- mice compared to wildtype (WT). CS increases myometrial OTR expression, but to this point, no data are available on the effects CS exposure on the cardiac OT/OTR system...
October 19, 2018: Intensive Care Medicine Experimental
https://read.qxmd.com/read/30316107/imaging-of-acquired-transdiaphragmatic-fistulae-and-communications
#17
REVIEW
Abhishek Chaturvedi, Prabhakar Rajiah, Apeksha Chaturvedi
Acquired diaphragmatic defects occur secondary to trauma, infection, surgery or neoplasm. These defects can lead to abnormal thoraco-abdominal fistulous communications also. Examples of surgically created diaphragmatic defects are omental, colonic interposition and vascular grafts. Regardless of etiology, these transdiaphragmatic communications provide a direct path for spread of pathology between the abdomen and thorax. If left untreated and unrecognized, these fistulae portend a high morbidity and mortality...
October 6, 2018: Clinical Imaging
https://read.qxmd.com/read/30313033/a-case-report-of-a-polytrauma-patient-with-penetrating-iron-rods-in-thorax-and-head
#18
Xinpu Tang, Hongxu Chen, Chaoyue Chen, Jianguo Xu
INTRODUCTION: Impalement injury is an uncommon presentation, and penetrating chest injuries account for 1% to 13% of thoracic trauma hospital admissions. The vast majority of patients with penetrating thoracic trauma who survive to reach the hospital alive can be managed nonoperatively. Nevertheless, in 10% to 15% of cases, emergency operation is necessary due to the associated hemorrhagic shock and visceral injury. CASE PRESENTATION: Here, we report on a 39-year-old male, a construction worker, who fell down from a height of a construction site, landing ventrally on a clump of iron rods with 4 projecting heavy metallic rods penetrating into his thorax and head (scalp pierced only)...
October 2018: Medicine (Baltimore)
https://read.qxmd.com/read/30308018/location-dependent-effects-of-trauma-on-oxidative-stress-in-humans
#19
Luis Servia, José C E Serrano, Reinald Pamplona, Mariona Badia, Neus Montserrat, Manuel Portero-Otin, Javier Trujillano
Though circulating antioxidant capacity in plasma is homeostatically regulated, it is not known whether acute stressors (i.e. trauma) affecting different anatomical locations could have quantitatively different impacts. For this reason, we evaluated the relationship between the anatomical location of trauma and plasma total antioxidant capacity (TAC) in a prospective study, where the anatomical locations of trauma in polytraumatic patients (n = 66) were categorized as primary affecting the brain -traumatic brain injury (TBI)-, thorax, abdomen and pelvis or extremities...
2018: PloS One
https://read.qxmd.com/read/30289852/remote-intestinal-injury-early-after-experimental-polytrauma-and-hemorrhagic-shock
#20
Lisa Wrba, J Josephine Ohmann, Philipp Eisele, Shinjini Chakraborty, Sonja Braumüller, Christian K Braun, Bettina Klohs, Anke Schultze, Heike von Baum, Annette Palmer, Markus Huber-Lang, Rebecca Halbgebauer
Dysfunction of the gut-blood barrier plays an important role in many diseases, such as inflammatory bowel disease, hemorrhagic shock (HS) or burn injury. However, little is known about gut barrier dysfunction after hemodynamically instable polytrauma (PT). Therefore, we aimed to evaluate the effects of PT and HS on remote intestinal damage and barrier dysfunction, especially regarding the role of Zonula occludens protein 1 (ZO-1) as an important tight junction protein.Male C57BL/6 mice were subjected to either PT (thorax trauma, closed head injury, soft tissue injury and distal femoral fracture), 60 min of pressure-controlled HS (30 ± 5 mmHg), or PT+HS, or sham procedures...
October 4, 2018: Shock
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