Eur J Trauma Emerg S
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Blunt thoracic trauma resulting in lung contusion with severe diffuse pulmonary hemorrhage and massive hemoptysis is rare and has a poor prognosis. Treatment options are limited. We report a case of the successful use of recombinant activated factor VII (NovoSeven™) in the treatment of life-threatening diffuse pulmonary hemorrhage secondary to an isolated blunt force thoracic injury without relevant traumatic coagulopathy.
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Eur J Trauma Emerg S · Jun 2008
Posttraumatic Intrasplenic Pseudoaneurysm with High-Flow Arteriovenous Fistula: New Lessons to Learn.
Intrasplenic pseudoaneurysm is a potentially lethal complication of abdominal trauma. We present the case of a 33-year-old patient with this particular complication diagnosed by CT-scan. Selective embolization was not possible due to its extraordinarily large size and finally splenectomy was performed. ⋯ The interventional radiologist is the specialist who better estimates the success of embolization or the risk and possibility of delayed splenic rupture. Embolization of the arterial tributary to the pseudoaneurysm should be considered as the treatment of choice only when the diagnosis is made before rupture of the spleen and only in selected cases. Splenectomy always remains as an alternative treatment for high-risk pseudoaneurysms.
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Eur J Trauma Emerg S · Jun 2008
Predicting Health-related Quality of Life of Severely Injured Patients: Sociodemographic, Economic, Trauma, and Hospital Stay-related Determinants.
Due to remarkable improvements in emergency and intensive care medicine in the recent past, the mortality rate for severely injured patients is decreasing. Outcome research therefore should no longer focus only on questions of survival, but also on aspects of the quality of life after severe trauma. This study examined the long-term effect of different sociodemographic, economic, trauma, and hospital-related factors on the health-related quality of life (SF-36) of severely injured patients. ⋯ All in all, it is important to identify trauma- patients who will suffer a reduced quality of life. In so doing, it will be possible to take into account the specific circumstances of their recovery during medical treatment, care, and rehabilitation.
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Eur J Trauma Emerg S · Jun 2008
Late Erosion of the Aorta after Dorsal-Ventral Care of a L1 Fracture with Prominent Chip Position.
Due to results of biomechanical examinations, the dorsal-ventral stabilization of thoracic spine and lumbar spine fractures is an acknowledged method. Different possible complications - among them life-threatening ones- of this method have been published already. ⋯ However, due to a postoperative course of infection the chip position has been accepted as such and not been changed. But this difficult and complex etiopatology has shown that chip and respectively material positions with contact to adjacent soft tissue structure are not acceptable.
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Suicide bombing attacks have emerged as a lethal weapon in the hands of terrorist groups. Our aim was to review the medical experience acquired in Israel, Spain, the United Kingdom and the United States in managing terrorist attacks, and prepare medical systems for the difficult task of managing these events. EMS protocols are amended to deal with a large number of victims in an urban setting who must be rapidly evacuated to a medical center where resuscitative as well as definitive care is delivered. ⋯ Professional personnel and resources are recruited and re-directed away from routine tasks towards treating the victims. This is achieved by deferring non-urgent operations, procedures and imaging studies. Victims are frequently re-assessed and re-evaluated to control chaos, minimize missed injuries and ensure delivery of an adequate level of care.