The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Sep 2016
Multicenter StudyA multi-institutional study of hemostatic gauze and tourniquets in rural civilian trauma.
Life-threatening hemorrhage is a leading cause of preventable mortality in trauma patients. Since publication of the Hartford Consensus statement, there has been intense interest in civilian use of commercial hemostatic gauze and tourniquets. Although the military has studied their use on soldiers with wartime injuries, there are limited data on patient outcomes following civilian prehospital use and no data on the use in rural trauma. ⋯ Therapeutic study, level V.
-
J Trauma Acute Care Surg · Sep 2016
Posterior paramedian subrhomboidal analgesia versus thoracic epidural analgesia for pain control in patients with multiple rib fractures.
Rib fractures are common in trauma admissions and are associated with an increased risk of pulmonary complications, intensive care unit admissions, and mortality. Providing adequate pain control in patients with multiple rib fractures decreases the risk of adverse events. Thoracic epidural analgesia is currently the preferred method for pain control. This study compared outcomes in patients with multiple acute rib fractures treated with posterior paramedian subrhomboidal (PoPS) analgesia versus thoracic epidural analgesia (TEA). ⋯ Therapeutic study, level IV.
-
J Trauma Acute Care Surg · Sep 2016
Shorter Times to Packed Red Blood Cell Transfusion are Associated with Decreased Risk of Death in Traumatically Injured Patients.
Hemorrhage is a leading cause of death in traumatically injured patients. Currently, the importance of earlier administration of packed red blood cells (pRBC) to improve outcomes is limited. We evaluated the association of earlier pRBC administration and mortality when compared with later transfusion initiation. ⋯ Therapeutic/care management study, level III.