Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2012
Assessment of hospital disaster plans for conventional mass casualty incidents following terrorist explosions using a live exercise based upon the real data of actual patients.
The National Committee for Hospital Preparedness for Conventional Mass Casualty Incidents and the Hospital Preparedness Division of the Home Front Command are in charge of preparing live exercises held yearly in public hospitals in Israel. Our experience is that live exercises are limited in their ability to test clinical decision making and its influence upon incident management. A live exercise was designed upon real patient data and tested in several public hospitals. The aim of the manuscript is to describe the impact of this new format on clinical decision making in large-scale live exercises. ⋯ Previous knowledge of patient diagnoses and resource needs allow the identification and quantification of deficiencies and problems identified in clinical decision making, resource utilisation and incident management.
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Eur J Trauma Emerg S · Apr 2012
Do stable multiply injured patients with bilateral femur fractures have higher complication rates? An investigation by the EPOFF study group.
Polytrauma patients with bilateral femur shaft fractures are known to have a higher rate of complications when compared with those who have sustained unilateral fractures. The current study tests the hypothesis that the high incidence of posttraumatic complications in patients who do not have a severe head or chest injury is caused by accompanying injuries rather than by the additional femur fracture. ⋯ In the absence of major head or chest injuries, patients with multiple injuries and bilateral femur shaft fractures have a similar complication rate to polytrauma patients with unilateral fractures. Moreover, an uncertain condition preoperatively was associated with an increased stay in the intensive care unit. The results support the idea that associated injuries rather than the additional femur fracture are responsible for complications during the clinical stay.
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Eur J Trauma Emerg S · Apr 2012
Overview of polytrauma patients in the first 10 days after the Sichuan earthquake: a report from the No. 903 Military Hospital, Jiangyou.
The purpose of this study was to investigate the profile of traumas, the severity, and mortality of polytrauma patients in a front-line hospital after the 2008 Sichuan earthquake. ⋯ The mortality rate of the polytrauma patients in this rescue operation was high. The ISS was a feasible tool to estimate the severity of polytrauma patients. Specialists in orthopedics, critical care, and respiratory disorders were in great demand during the management of these patients in such conditions.
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Eur J Trauma Emerg S · Apr 2012
Delays in diagnosis in early trauma care: evaluation of diagnostic efficiency and circumstances of delay.
Trauma centers, trauma management concepts, damage control surgery and the integration of whole-body CT scanning into early trauma care have reduced mortality in traumatized patients significantly. However, some injuries are still initially missed. In this study, the diagnostic efficiency of early trauma care and the circumstances of delays in diagnosis were evaluated. ⋯ Although diagnostic quality in early trauma care has improved, some diagnoses are initially missed. Severely injured patients with life-threatening or potentially life-threatening injuries arriving at the ER during on-call hours were at higher risk for delays in diagnosis. A secondary evaluation of acquired CT data and repetitive examinations are essential.
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The aim of our study was to analyze the pattern of injuries, hospital care, and outcome of the victims of suicide bomb attacks in Pakistan. ⋯ Most of the problems encountered were logistic in nature. Early evacuation of the victims remains pivotal in saving lives. The major causes of death in peripheral patients was hypovolemic shock, sepsis, and hypothermia. Mortality and morbidity can be enhanced by ample fluid resuscitation, tetanus prophylaxis, and proficient first aid at the site of injury.