Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2008
Vacuum-Assisted Closure for Successful Treatment of a Major Contaminated Gunshot Chest-Wound: A Case Report.
Vacuum-assisted closure (VAC) is a well-established treatment for complicated wound infections and chronic wounds, including poststernotomy mediastinitis. The use of VAC in treating high-energy trauma has been more limited. We present a case where VAC was successfully used to treat a contaminated self-inflicted gunshot-wound of the chest and abdomen.
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Eur J Trauma Emerg S · Oct 2008
Preparedness of German Paramedics and Emergency Physicians for a Mass Casualty Incident: A National Survey.
Paramedics and physicians are important components of our emergency medical system. To date, no survey has been carried out assessing physicians and paramedics regarding their preparedness for a mass casualty incident (MCI) resulting from a terrorist attack in Germany. The aim of this study was to assess the current state of preparedness of emergency physicians and paramedics for an MCI. ⋯ Emergency physicians and paramedics are still insufficiently prepared for nuclear, chemical, and biological as well as conventional terrorism attacks. The emergency training of emergency physicians and paramedics must be modified to accommodate the increased risk of catastrophes and terrorist attacks.
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Eur J Trauma Emerg S · Oct 2008
Lateral Radiograph of the Hip in Fracture Neck of Femur: Is it a Ritual?
Historically routine work up of a patient with a fracture neck of femur has always included an antero-posterior (AP) and a lateral view of the hip. The aim of the study was to know whether a lateral view of hip influenced the decision of an Orthopedic Surgeon regarding management at a District General Hospital. ⋯ We can conclude that unless required for management a lateral X-ray of hip should be avoided routinely in all patients with fracture neck of femur as it would not only be cost effective but will also reduce radiation exposure to patient and relieve work pressure on radiographers, nursing and portering staff.
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Eur J Trauma Emerg S · Oct 2008
Wound Complications from the Tsunami Disaster: A Reminder of Indications for Delayed Closure.
To illustrate the character, clinical course and late complications of wounds caused by high energy with severe contamination during a natural disaster, as a basis for designing principles for primary treatment under these conditions. ⋯ The patterns of injury and clinical courses in these patients illustrate the risk of complications in wounds caused by high energy, with severe contamination and which arrive late for primary treatment by staff who are not fully aware of the risk of secondary complications under these conditions. Recommendations for primary treatment should include extensive cleaning, excision of dead tissue and delayed primary closure, according to the well-established principles of management of war wounds, where the conditions are similar.
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In the Netherlands, major incidents are sparse, and so there is a general feeling of a relatively low risk. Upon evaluating multiple casualty events (MCEs) in the Netherlands over the last 60 years, it is worth noting 39 major events. Our objective was to report the experiences from a mass casualty incident in an urban area, performing a critical evaluation of the response and outcome related to the scenario in order to learn from our past and to train for the future. ⋯ Triage supported by one person and two trauma teams worked well. The amount of over- and undertriage was in line with the literature. Numbering the patients worked well but also caused enormous problems with the supporting facilities. Centralizing the trauma care yielded certain advantages; however, we must respect our surge capacity of 20 patients. When the number of patients surpasses 20, an alternative plan must be followed. This event has been an eye-opener for our organization; it has given us new tools to prepare for a potential new disaster.