Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2012
Optic nerve sheath measurement and raised intracranial pressure in paediatric traumatic brain injury.
The optimal management of children ventilated for more than 4 h with traumatic brain injury (TBI) necessitates invasive intracranial pressure (ICP) monitoring, though some patients never have raised ICP. If non-invasive screening can reliably rule out elevated ICP, invasive devices can be limited to those in whom neuro-intensive care measures are indicated. ⋯ All children with clinically significantly raised ICP had abnormal ONSD, whereas those with normal ICP did not. Despite the small numbers, this study suggests that the ONSD may be useful in identifying children with TBI and normal ICP and, so, help avoid the insertion of unnecessary ICP monitors.
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Eur J Trauma Emerg S · Feb 2012
Ultrasonographic evaluation of costal cartilage fractures unnoticed by the conventional radiographic study and multidetector computed tomography.
Rib fractures are the most common injuries resulting from blunt chest trauma. However, costal cartilage fractures are almost invisible on chest X-rays unless they involve calcified cartilage. The sensitivity of conventional radiography and computed tomography for detecting rib fractures is limited, especially in cases where rib cartilage is involved. Therefore, this study was designed to evaluate the sensitivities of chest wall ultrasonography, clinical findings, and radiography in the detection of costal cartilage fractures. ⋯ The results of this study suggest that ultrasonography may be a useful imaging method for detecting costal cartilage fractures overlooked on conventional radiographs and computed tomography in patients with minor blunt chest trauma. Early ultrasonographic evaluation can give more accurate information than clinical and radiologic evaluation in detecting costal cartilage fractures and sternal fractures that are overlooked on conventional radiography and computed tomography after minor blunt chest trauma.
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Eur J Trauma Emerg S · Feb 2012
Hip fracture surgery and performance indicators: an analysis of 941 patients operated in a large teaching hospital.
In the Netherlands, two performance indicators for the treatment of hip fracture patients have been recently implemented. Both indicators state that surgery within 24 h after admission improves the outcome with regard to 1-year mortality and the amount of re-operations within 1 year. To determine the value of these performance indicators, we conducted a retrospective analysis of 941 hip fracture patients. ⋯ We conclude that hip fracture surgery within 24 h does not provide significantly better results in terms of 1-year mortality and the amount of re-operations within 1 year.
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Eur J Trauma Emerg S · Feb 2012
Regionalisation of trauma care in Germany: the "TraumaNetwork DGU(®)-Project".
The care for severely injured patients is a demanding task for all medical professionals involved in both the pre-clinical and the clinical setting. While the overall quality of care in Germany is high, regional differences remain. These are due to geographical and infrastructural variations, as well as different personnel and equipment situations in the hospitals. ⋯ The TraumaNetwork DGU(®) audits all hospitals participating in the care for severely injured patients and establishes a structured network between all the players involved in trauma care. Thirty TNWs will be certified by the end of 2011, covering 75% of Germany. The nationwide covering will be completed by the middle of 2012.
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Eur J Trauma Emerg S · Feb 2012
Open to laparoscopic conversion in hemoperitoneum of unknown origin.
Demonstrating the potential, in spite of the current trend, of closing an open emergency surgical procedure and to convert it to a minimally invasive approach. ⋯ For selected cases, the conversion of an open procedure to a laparoscopic approach offers a real benefit for the patient, avoiding a large laparotomy and its associated morbidity.