Eur J Trauma Emerg S
-
Eur J Trauma Emerg S · Feb 2013
Occult hemopneumothorax following chest trauma does not need a chest tube.
The increasing use of thoracic computed tomography (CT) in trauma patients has led to the recognition of intrapleural blood and air that are not initially evident on admission plain chest X-ray, defining the presence of occult hemopneumothorax. The clinical significance of occult hemopneumothorax, specifically the role of the tube thoracostomy, is not clearly defined. ⋯ Occult hemopneumothorax can be successfully managed without tube thoracostomy in most cases. Patients with a high ISS score, need for mechanical ventilation, and CT-detected blood collection measuring >1.5 cm increased the likelihood of need for tube thoracostomy. The size of the pneumothorax did not appear to be significant in determining the need for tube thoracostomy.
-
Cervical tuberculosis (CTB) is a relatively rare entity, even in endemic countries. Currently, management ranges from conservative to radical surgical approaches. We report our experience in diagnosing and treating 66 cases of CTB in the past eight years using our CTB therapeutic protocol. ⋯ The use of our proposed scoring system and management protocol allowed speedy management of CTB.
-
Eur J Trauma Emerg S · Feb 2013
Serial lactate and admission SOFA scores in trauma: an analysis of predictive value in 724 patients with and without traumatic brain injury.
Arterial lactate, base excess (BE), lactate clearance, and Sequential Organ Failure Assessment (SOFA) score have been shown to correlate with outcome in severely injured patients. The goal of the present study was to separately assess their predictive value in patients suffering from traumatic brain injury (TBI) as opposed to patients suffering from injuries not related to the brain. ⋯ Lactate showed the best performance in predicting sepsis or death in all trauma patients except those with isolated TBI, and the differences were greatest in patients with substantial bleeding. Following isolated TBI, SOFA score was the only parameter which could differentiate survivors from non-survivors on admission, although the SOFA score, too, was not an independent predictor of death following multivariate analysis.
-
Eur J Trauma Emerg S · Feb 2013
Whole body imaging in the diagnosis of blunt trauma, ionizing radiation hazards and residual risk.
Ever since the introduction of radiographic imaging, its utility in identifying injuries has been well documented and was incorporated in the workup of injured patients during advanced trauma life support algorithms [American College of Surgeons, 8th ed. Chicago, 2008]. ⋯ During the last several years, a significant amount of research has been published on this topic, most of it being incorporated in the BEIR VII Phase 2 report, published by the National Research Council of the National Academies [National Academy of Sciences, Washington DC, 2006]. The current review will analyze the scientific basis for the concerns over the ionizing radiation associated with the use of CT scanning and will examine the accuracy of the typical advanced trauma life support work-up for diagnosis of injuries.
-
To investigate the clinical effect of a new fixation method for Hoffa fractures. ⋯ The new fixation method for Hoffa fracture is effective, and may provide a new way to treat Hoffa fractures.