collection
https://read.qxmd.com/read/27401440/integrating-efast-in-the-initial-management-of-stable-trauma-patients-the-end-of-plain-film-radiography
#1
Sophie Rym Hamada, Nathalie Delhaye, Sebastien Kerever, Anatole Harrois, Jacques Duranteau
BACKGROUND: The initial management of a trauma patient is a critical and demanding period. The use of extended focused assessment sonography for trauma (eFAST) has become more prevalent in trauma rooms, raising questions about the real "added value" of chest X-rays (CXRs) and pelvic X-rays (PXR), particularly in haemodynamically stable trauma patients. The aim of this study was to evaluate the effectiveness of a management protocol integrating eFAST and excluding X-rays in stable trauma patients...
December 2016: Annals of Intensive Care
https://read.qxmd.com/read/20078434/sensitivity-of-bedside-ultrasound-and-supine-anteroposterior-chest-radiographs-for-the-identification-of-pneumothorax-after-blunt-trauma
#2
REVIEW
R Gentry Wilkerson, Michael B Stone
OBJECTIVES: Supine anteroposterior (AP) chest radiographs in patients with blunt trauma have poor sensitivity for the identification of pneumothorax. Ultrasound (US) has been proposed as an alternative screening test for pneumothorax in this population. The authors conducted an evidence-based review of the medical literature to compare sensitivity of bedside US and AP chest radiographs in identifying pneumothorax after blunt trauma. METHODS: MEDLINE and EMBASE databases were searched for trials from 1965 through June 2009 using a search strategy derived from the following PICO formulation of our clinical question: patients included adult (18 + years) emergency department (ED) patients in whom pneumothorax was suspected after blunt trauma...
January 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://read.qxmd.com/read/15345974/hand-held-thoracic-sonography-for-detecting-post-traumatic-pneumothoraces-the-extended-focused-assessment-with-sonography-for-trauma-efast
#3
COMPARATIVE STUDY
A W Kirkpatrick, M Sirois, K B Laupland, D Liu, K Rowan, C G Ball, S M Hameed, R Brown, R Simons, S A Dulchavsky, D R Hamiilton, S Nicolaou
BACKGROUND: Thoracic ultrasound (EFAST) has shown promise in inferring the presence of post-traumatic pneumothoraces (PTXs) and may have a particular value in identifying occult pneumothoraces (OPTXs) missed by the AP supine chest radiograph (CXR). However, the diagnostic utility of hand-held US has not been previously evaluated in this role. METHODS: Thoracic US examinations were performed during the initial resuscitation of injured patients at a provincial trauma referral center...
August 2004: Journal of Trauma
https://read.qxmd.com/read/12478025/pelvic-radiography-in-blunt-trauma-resuscitation-a-diminishing-role
#4
COMPARATIVE STUDY
Oscar D Guillamondegui, John P Pryor, Vincente H Gracias, Rajan Gupta, Patrick M Reilly, C William Schwab
BACKGROUND: An anteroposterior pelvic radiograph (PXR) continues to be recommended by Advanced Trauma Life Support protocol as an early diagnostic adjunct in the resuscitation of blunt trauma patients. At the same time, computed tomographic (CT) scanning has become a practice standard for diagnosis of most abdominal and pelvic injury. The objective of this study was to determine the necessity of obtaining an early PXR in stable trauma patients who will undergo CT scanning during the initial resuscitation...
December 2002: Journal of Trauma
https://read.qxmd.com/read/25853745/age-of-transfused-blood-in-critically-ill-adults
#5
RANDOMIZED CONTROLLED TRIAL
Jacques Lacroix, Paul C Hébert, Dean A Fergusson, Alan Tinmouth, Deborah J Cook, John C Marshall, Lucy Clayton, Lauralyn McIntyre, Jeannie Callum, Alexis F Turgeon, Morris A Blajchman, Timothy S Walsh, Simon J Stanworth, Helen Campbell, Gilles Capellier, Pierre Tiberghien, Laurent Bardiaux, Leo van de Watering, Nardo J van der Meer, Elham Sabri, Dong Vo
BACKGROUND: Fresh red cells may improve outcomes in critically ill patients by enhancing oxygen delivery while minimizing the risks of toxic effects from cellular changes and the accumulation of bioactive materials in blood components during prolonged storage. METHODS: In this multicenter, randomized, blinded trial, we assigned critically ill adults to receive either red cells that had been stored for less than 8 days or standard-issue red cells (the oldest compatible units available in the blood bank)...
April 9, 2015: New England Journal of Medicine
https://read.qxmd.com/read/27774838/tranexamic-acid-in-patients-undergoing-coronary-artery-surgery
#6
RANDOMIZED CONTROLLED TRIAL
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
BACKGROUND: Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. METHODS: In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo...
January 12, 2017: New England Journal of Medicine
https://read.qxmd.com/read/25647203/transfusion-of-plasma-platelets-and-red-blood-cells-in-a-1-1-1-vs-a-1-1-2-ratio-and-mortality-in-patients-with-severe-trauma-the-proppr-randomized-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
John B Holcomb, Barbara C Tilley, Sarah Baraniuk, Erin E Fox, Charles E Wade, Jeanette M Podbielski, Deborah J del Junco, Karen J Brasel, Eileen M Bulger, Rachael A Callcut, Mitchell Jay Cohen, Bryan A Cotton, Timothy C Fabian, Kenji Inaba, Jeffrey D Kerby, Peter Muskat, Terence O'Keeffe, Sandro Rizoli, Bryce R H Robinson, Thomas M Scalea, Martin A Schreiber, Deborah M Stein, Jordan A Weinberg, Jeannie L Callum, John R Hess, Nena Matijevic, Christopher N Miller, Jean-Francois Pittet, David B Hoyt, Gail D Pearson, Brian Leroux, Gerald van Belle
IMPORTANCE: Severely injured patients experiencing hemorrhagic shock often require massive transfusion. Earlier transfusion with higher blood product ratios (plasma, platelets, and red blood cells), defined as damage control resuscitation, has been associated with improved outcomes; however, there have been no large multicenter clinical trials. OBJECTIVE: To determine the effectiveness and safety of transfusing patients with severe trauma and major bleeding using plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio...
February 3, 2015: JAMA: the Journal of the American Medical Association
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