Injury
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Observational Study
Blunt cardiac injury in critically ill trauma patients: A single centre experience.
This study describes the incidence and outcomes of blunt cardiac injury (BCI) in a single trauma intensive care unit (TICU), together with the spectrum of thoracic injuries and cardiac abnormalities seen in BCI. ⋯ BCI was associated with an increased mortality and a trend towards a longer length of stay in this study. It is a clinically relevant diagnosis which requires a high index of suspicion. Screening of high risk patients with significant blunt thoracic trauma for BCI with serum troponins should be routine practise. Patients diagnosed with BCI should undergo more advanced imaging such as TTE or TOE to exclude significant cardiac structural injury.
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The majority of ankle fractures seen in clinic are stable, will not displace and do not require plaster casting to achieve union in a good position. Nevertheless, many patients with stable ankle fractures are advised that they need a cast. In this study we counseled patients regarding the different options for conservative management of their stable ankle fracture. We then encouraged them to make an informed decision on which method of treatment they would like to pursue. ⋯ Using a shared decision making approach to these injuries is a useful method of providing patients with the most suitable treatment for their personal treatment goals.
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Gastrointestinal complications occur frequently in intensive care patients with severe burns. Intestinal infarction and its deleterious consequences result in high mortality despite rapid surgical intervention. Our objective was to evaluate the aetiology of gastrointestinal infarction in intensive care patients with severe burns. ⋯ The results of our study clearly demonstrate that in severe-burn intensive care patients, non-occlusive mesenteric ischaemia is the most frequent cause of gastrointestinal infarction and that the decisive factor for survival is the patient's age.
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Surfing is a popular UK water-sport. Previous studies investigating surfing injuries have been principally based on trauma from large waves and reef breaks in the US and Australia. Subsequent conclusions and recommendations for the use of protective equipment in surfing may therefore not be relevant in the UK. ⋯ Surfing injuries in the UK are common. They appear of a similar aetiology to those reported in the literature in countries with a high surfing population, but generally of a lower severity, with few requiring professional treatment, hospital admission or operative intervention. Concussion appears rare and in this study there were no head injuries that required neurosurgical intervention. Surfing helmets aim to prevent such serious head injuries; whilst they should be considered for injury prevention their routine use is unlikely to be warranted whilst surfing in the UK.