The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Jun 2012
Comparative StudyThe association between positive screen for future persistent posttraumatic stress symptoms and injury incident variables in the pediatric trauma care setting.
Posttraumatic stress (PTS) disorder after injury is a significant yet underaddressed issue in the trauma care setting. Parental anxiety may impact a child's risk of future, persistent PTS symptoms after injury. This study aimed to: (1) identify injury incident and demographic variables related to a positive screen for future, persistent PTS symptoms in children; and (2) examine the relationship between parental anxiety and a positive screen for future, persistent PTS symptoms in children. ⋯ Epidemiological study, level II.
-
J Trauma Acute Care Surg · Jun 2012
Comparative StudyMotion generated in the unstable cervical spine during the application and removal of cervical immobilization collars.
Many studies have compared the restriction of motion that immobilization collars provide to the injured victim. No previous investigation has assessed the amount of motion that is generated during the fitting and removal process. The purpose of this study was to compare the three-dimensional motion generated when one-piece and two-piece cervical collars are applied and removed from cadavers intact and with unstable cervical spine injuries. ⋯ There were statistically significant differences in motion between the one-piece and two-piece collars during the application process, but it was only 1.2 degrees in flexion/extension and 0.2 mm in anterior/posterior translation. Overall, the greatest amount of angulation and displacement observed during collar application was 3.4 degrees and 4.4 mm. Although the exact amount of motion that could be deleterious to a cervical spine-injured patient is unknown, collars can be placed and removed with manual in-line stabilization without large displacements. Only trained practitioners should do so and with great care given that some motion in all planes does occur during the process.
-
J Trauma Acute Care Surg · Jun 2012
Prone positioning improves oxygenation in adult burn patients with severe acute respiratory distress syndrome.
Prone positioning (PP) improves oxygenation and may provide a benefit in patients with acute respiratory distress syndrome (ARDS). This approach adds significant challenges to patients in intensive care by limiting access to the endotracheal or tracheostomy tube and vascular access. PP also significantly complicates burn care by making skin protection and wound care more difficult. We hypothesize that PP improves oxygenation and can be performed safely in burn patients with ARDS. ⋯ Therapeutic study, level IV.
-
J Trauma Acute Care Surg · Jun 2012
Neuron-specific enolase and S100BB as outcome predictors in severe diffuse axonal injury.
Diffuse axonal injury (DAI) is a common type of traumatic brain injury, mostly associated with mild changes on computed tomography (CT) scan. Serum biomarkers might be used in the diagnosis and prognosis of this injury type. Our purpose was to determine temporal profile and predictive values of serum concentrations of protein S100BB and neuron-specific enolase (NSE) after DAI. ⋯ Prognostic study, level III.