The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Aug 2018
The use of ABC score in activation of massive transfusion: The yin and the yang.
Hemorrhage is the most common cause of early death in trauma patients. Massive transfusion protocols (MTPs) have been designed to accelerate the release of blood products but can result in waste if activated inappropriately. The Assessment of Blood Consumption (ABC) score has become a widely accepted score for MTP activation. In this study, we compared the use of ABC criteria to physician judgment in MTP activation. ⋯ Prognostic, level III.
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J Trauma Acute Care Surg · Aug 2018
Multicenter Study Observational StudyIndependent predictors of survival after traumatic atlanto-occipital dissociation.
Atlanto-occipital dissociation (AOD) occurs when the skull base is forcibly separated from the vertebral column. Existing literature on AOD is sparse and risk factors for mortality are unknown. This study determined independent predictors of survival after AOD. ⋯ Progonostic/Epidemiological, level III; Therapeutic, level IV.
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J Trauma Acute Care Surg · Aug 2018
ReviewOn the complexity of shark bite wounds: From associated bacteria to trauma management and wound repair.
The mouth of a shark is a breeding ground for a large variety of bacteria which can easily get transferred onto a human body in the event of a shark bite. Here, we review infections originating from shark oral bacterial flora, which originate from the microbiome of its prey, as well as from the surroundings where an incident takes place. We use the example of an incident which occurred in an aquarium involving a sandtiger shark, Carcharias taurus. In addition to a succinct analysis and interpretation of the wound and recovery process, an overview of currently known bacteria associated with shark bite wounds is given, as well as a summary of the effects of various previously tested antibiotics on bacteria derived from blacktip sharks, Carcharhinus limbatus, bull sharks, C. leucas, and tiger sharks, Galeocerdo cuvier.
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J Trauma Acute Care Surg · Aug 2018
Observational StudyThe impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical intensive care unit patients.
Advancing age is a strong risk factor for adverse outcomes across multiple disease processes. However, septic surgical and trauma patients are unique in that they incur two or more inflammatory insults. The effects of advanced age on sepsis pathophysiology and outcomes remain unclear. ⋯ Prognostic, level II.