Trauma surgery & acute care open
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Trauma Surg Acute Care Open · Jan 2020
Effects of humeral intraosseous epinephrine in a pediatric hypovolemic cardiac arrest porcine model.
Aims of the study were to determine the effects of humerus intraosseous (HIO) versus intravenous (IV) administration of epinephrine in a hypovolemic, pediatric pig model. We compared concentration maximum (Cmax), time to maximum concentration (Tmax), mean concentration (MC) over time and return of spontaneous circulation (ROSC). ⋯ Based on the results of our study, the IV route is more effective than the HIO route.
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Trauma Surg Acute Care Open · Jan 2020
Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal.
Thoracoabdominal trauma presents a diagnostic challenge for the emergency physician. The introduction of bedside ultrasonography (USG) provides a screening tool to detect hemoperitoneum, hemothorax, pneumothorax and pericardial effusion in torso injuries. ⋯ Level I.
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Trauma Surg Acute Care Open · Jan 2020
Dilemma of crystalloid resuscitation in non-exsanguinating polytrauma: what is too much?
Aggressive crystalloid resuscitation increases morbidity and mortality in exsanguinating patients. Polytrauma patients with severe tissue injury and subsequent inflammatory response without major blood loss also need resuscitation. This study investigated crystalloid and blood product resuscitation in non-exsanguinating polytrauma patients and studied possible adverse outcomes. ⋯ Population-based cohort study.
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Trauma Surg Acute Care Open · Jan 2020
Attenuation of MODS-related and ARDS-related mortality makes infectious complications a remaining challenge in the severely injured.
The recent decrease in multiple organ dysfunction syndrome (MODS)-associated and adult respiratory distress syndrome (ARDS)-associated mortality could be considered a success of improvements in trauma care. However, the incidence of infections remains high in patients with polytrauma, with high morbidity and hospital resources usage. Infectious complications might be a residual effect of the decrease in MODS-related/ARDS-related mortality. This study investigated the current incidence of infectious complications in polytrauma. ⋯ Population-based cohort study.
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Trauma Surg Acute Care Open · Jan 2019
Effect of prehospital tourniquets on resuscitation in extremity arterial trauma.
Timely tourniquet placement may limit ongoing hemorrhage and reduce the need for blood products. This study evaluates if prehospital tourniquet application altered the initial transfusion needs in arterial injuries when compared with a non-tourniquet control group. ⋯ Therapeutic study, level IV.