Injury
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This retrospective study was performed to investigate the utility of high-flow nasal cannula (HFNC) therapy in patients with chest trauma and identify the risk factors associated with treatment failure. ⋯ HFNC therapy was safe and effective in patients with chest trauma, and more than 50% of the patients successfully recovered from acute respiratory failure without invasive ventilation. A high TTSS could be a significant risk factor for HFNC treatment failure and had a high predictive performance.
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Trauma patients are often required to make an informed decision about surgery within a short space of time. Coming to terms with their injury may mean they have limited bandwidth for absorbing information, and it may be that they don't appreciate the risks and benefits of surgery discussed during consent. Current consent practice puts the emphasis on the clinician to ensure that all reasonable steps have been taken to explain risks and benefits to patients. We propose the use of video animations that patients can watch prior to surgery as a means of improving their understanding and overall experience. ⋯ The video was well received by patients with subjective improvements being made to their understanding, retention and sharing of technical detail. The face-to-face discussion between patient and doctor remains very important to them and the video should look to augment this.
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In an open fracture, the external fixator is one of the definitive treatment options as it could provide the initial stabilisation of the fractured bone. Limited literature discussing on the biomechanical stability between unilateral, hybrid and Ilizarov configurations, principally in treating a femoral fracture. Thus, this study aims to analyse the biomechanical stability of different external fixators via the finite element method (FEM). ⋯ The unilateral configuration also produced the least interfragmentary movement (0.48 mm) as compared to hybrid (0.62 mm) and Ilizarov (0.61 mm) configurations. Besides, the strain and stress of the unilateral configuration were superior in terms of stability compared to the other two configurations. As a conclusion, the unilateral configuration had the best biomechanical stability as it was able to assist the bone healing process as well as minimising the risk of pin tract infection while treating a femoral fracture.
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Trauma is the leading cause of death for children and adolescents. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive method of hemorrhage control used primarily in adults. We aimed to characterize REBOA use in pediatric patients. ⋯ REBOA is used in patients <18 years old, but all reported patients in this registry were adolescents. No REBOA-related complications were reported. Identifying pediatric patients who may benefit from REBOA and modifying currently existing technology for this group of patients is an area of ongoing research.
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To determine patient demographics, associated primary diagnoses, mortality risk, and inpatient mortality of admitted drowning patients in the U.S. ⋯ Younger, male, and white patients accounted for the majority of drowning admissions and deaths. A significantly larger proportion of Medicaid patients died compared to inpatient mortality of those with other insurance. Recognizing those most impacted by drowning could help better tailor prevention efforts.