World journal of surgery
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World journal of surgery · Jul 2014
Incidence and epidemiology of casualties treated at the Dutch role 2 enhanced medical treatment facility at multi national base Tarin Kowt, Afghanistan in the period 2006-2010.
To improve care for the injured service member, we have analyzed battle casualty patterns and mechanisms. This study is the first documented report of wounding patterns and mechanisms of battle casualties treated at the Dutch role 2 enhanced medical treatment facility at the multi-national base Tarin Kowt, Uruzgan, Afghanistan. ⋯ The wounding patterns seen at the Dutch role 2 enhanced medical treatment facility at the multi-national base Tarin Kowt resemble the patterns as recorded by other coalition partners. The wounding patterns differ with previous conflicts: a greater proportion of head and neck wounds, and a lower proportion of truncal wounds.
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Ethnic disparities in trauma mortality outcomes have been demonstrated in the United States according to the US National Trauma Data Bank. The aim of this study was to determine the effect of race/ethnicity on trauma mortality in Singapore. ⋯ Ethnicity is not an independent predictor of trauma mortality outcomes in the Singapore population. Our findings contrast with those from the United States, where race/ethnicity (Black and Hispanic) remains a strong independent risk factor for trauma mortality. This study attests to the success of the Singapore health care/trauma system in delivering the same quality of care regardless of ethnicity.
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World journal of surgery · Jul 2014
The utility of FAST for initial abdominal screening of major pelvic fracture patients.
Focused Assessment with Sonography for Trauma (FAST) is widely used in pelvic fracture patients. We examined the performance of FAST for detecting hemoperitoneum and predicting the need for intra-abdominal hemorrhage control in major pelvic fracture patients. ⋯ FAST had a good to excellent diagnostic accuracy, depending on the size of hemoperitoneum. A positive FAST result (even in HS patients) does not reliably predict the need for immediate intra-abdominal hemorrhage control but a negative FAST result renders the need for an intervention highly unlikely.
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World journal of surgery · Jul 2014
Minimizing preventable trauma deaths in a limited-resource setting: a test-case of a multidisciplinary panel review approach at the Komfo Anokye Teaching Hospital in Ghana.
Our objectives were to determine the proportion of preventable trauma deaths at a large trauma hospital in Kumasi, Ghana, and to identify opportunities for the improvement of trauma care. ⋯ A high proportion of trauma fatalities might have been preventable by decreasing pre-hospital delays, adequate resuscitation in hospital, and earlier initiation of care, including definitive surgical management. The study also showed that preventable death panel reviews are a feasible and useful quality improvement method in the study setting.
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World journal of surgery · Jul 2014
Transdiaphragmatic resuscitative open cardiac massage: description of the technique and a first case-series of an alternative approach to the heart.
The purpose of this paper is to describe the transdiaphragmatic approach to the heart for open CPR in patients that arrest at laparotomy and to present a first case series of patients that have undergone this procedure. ⋯ In patients suffering cardiac arrest during laparotomy, the transdiaphragmatic approach allows for a rapid, technically easy, and almost atraumatic access to the heart, with excellent CPR performance. After this potentially life-saving procedure, pulmonary or surgical site complications are expected to occur much less compared with the conventionally performed emergency department left-sided thoracotomy.