Trauma surgery & acute care open
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Trauma Surg Acute Care Open · Jan 2019
Extended resuscitative endovascular balloon occlusion of the aorta (REBOA)-induced type 2 myocardial ischemia: a time-dependent penalty.
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) increases cardiac-afterload and is used for patients in hemorrhagic shock. The cardiac tolerance of prolonged afterload augmentation in this context is unknown. The aim of this study is to quantify cardiac injury, if any, following 2, 3 and 4 hours of REBOA. ⋯ II.
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Trauma Surg Acute Care Open · Jan 2019
Resuscitative endovascular balloon occlusion of the aorta (REBOA): indications: advantages and challenges of implementation in traumatic non-compressible torso hemorrhage.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is regaining popularity in the treatment of traumatic non-compressible torso bleeding. Advances in invasive radiology coupled with new damage control measures assisted in the refinement of the technique with promising outcomes. The literature continues to have substantial heterogeneity about REBOA indications, applications, and the challenges confronted when implementing the technique in a level I trauma center. Scoping reviews are excellent platforms to assess the diverse literature of a new technique. It is for the first time that a scoping review is adopted for this topic. Advances in invasive radiology coupled with new damage control measures assisted in the refinement of the technique with promising outcomes. The literature continues to have substantial heterogeneity about REBOA indications, applications, and the challenges confronted when implementing the technique in a level I trauma center. Scoping reviews are excellent platforms to assess the diverse literature of a new technique. It is for the first time that a scoping review is adopted for this topic. ⋯ Level III.
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Trauma Surg Acute Care Open · Jan 2019
Trauma Embolic Scoring System in military trauma: a sensitive predictor of venous thromboembolism.
Clinical decision support tools capable of predicting which patients are at highest risk for venous thromboembolism (VTE) can assist in guiding surveillance and prophylaxis decisions. The Trauma Embolic Scoring System (TESS) has been shown to model VTE risk in civilian trauma patients. No such support tools have yet been described in combat casualties, who have a high incidence of VTE. The purpose of this study was to evaluate the utility of TESS in predicting VTE in military trauma patients. ⋯ Level III.
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Trauma Surg Acute Care Open · Jan 2019
Firearm assault in Philadelphia, 2005-2014: a comparison of police and trauma registry data.
Firearm injury is a major public health burden in the USA. Absent a single, reliable data source, researchers have attempted to describe firearm injury epidemiology using trauma registry data. To understand the implications of this approach, we compared trends in firearm assault incidence and case-fatality in Philadelphia over 10 years from two sources: the Pennsylvania Trauma Outcomes Study (PTOS), Pennsylvania's state-mandated trauma registry, and the Philadelphia Police Department database (PPD) of firearm assaults. ⋯ Level III, epidemiological.
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Trauma Surg Acute Care Open · Jan 2018
Blunt rupture of the thoracic duct after severe thoracic trauma.
A 53-year-old man was admitted to our trauma center after sustaining thoracoabdominal injuries, secondary to a rear-end motor vehicle collision. As he stepped out of his vehicle, he was struck by a tractor trailer at 55 mph. The following were the initial vital signs on his arrival: heart rate 140 beats/min, blood pressure 142/80 mm Hg, respiratory rate 28 breaths/min, temperature 36.8°C, and oxygen saturation 93%. ⋯ It revealed contrast extravasation at the level of T3 to T4. An MRI was also performed to better define the anatomic course of the thoracic duct. Figure 2Postoperative chest X-ray demonstrating left chest wall reconstruction.