J Trauma
-
During the 10-year period from 1975 to 1985 20 patients suffering from causalgia were treated. There were 15 men and five women. Ages ranged from 17 to 45 years (mean, 23). ⋯ The diagnosis of causalgia was based on the characteristic clinical picture and was confirmed by sympathetic blocks. All patients were treated by sympathectomy and all had complete dramatic relief in the immediate postoperative period. Followup ranged from 4 months to 10 years (mean, 5.3 yr).
-
Immobilization of the spine is of prime concern during transportation of trauma patients to prevent neurologic compromise. In an attempt to study certain techniques of prehospital thoracolumbar spine immobilization, we radiographically evaluated the motion of the thoracolumbar spine in a volunteer with a stable spine, a cadaver with an unstable thoracolumbar spine, and a patient with a T12-L1 fracture dislocation. Both the backboard and the Scoop stretcher offered adequate stabilization for thoracolumbar spine instability. The logroll maneuver presented the greatest possibility for movement of the spine at the unstable thoracolumbar segment.
-
Historical Article
Firearms as a cause of death in the United States, 1920-1982.
We present the epidemiologic history of firearms in the United States. Firearms are among the nation's ten leading causes of death. Nearly one million firearm deaths occurred in the half-century 1933-1982. ⋯ An individual's risk of suffering a firearm death has generally risen with age. Increased firearm availability is associated with increased rates of firearm homicide and suicide. Strategies to prevent firearm deaths and injuries should be formulated in light of these findings, and heightened efforts to design, implement, and evaluate preventive measures are urgently needed.
-
This study group comprises 73 patients who underwent emergency room resuscitative thoracotomy for cardiac arrest following penetrating chest and neck injuries. Overall, 12 patients (16.4%) were successfully resuscitated but only five (6.8%) left the hospital alive without neurologic defects. ⋯ Of 14 patients with cardiac arrest but with respiratory efforts and reactive pupils, three survived (21.4%). We suggest that patients with no vital signs on admission to the hospital should not be subjected to resuscitative thoracotomy.
-
Two multiple trauma patients with total rupture of the pericardium and luxation of the heart into the left pleural cavity after blunt trauma are presented. One of the patients also had rupture of the posterior wall of the left ventricle with abundant bleeding. ⋯ The pericardial injury in one patient was diagnosed and treated by immediate thoracolaparotomy, in the other by left thoracotomy within 1 hour after laparotomy: both patients recovered. Awareness of possible pericardial lesions in multiple trauma patients with symptoms of hemodynamic failure is stressed.