J Trauma
-
Randomized Controlled Trial Clinical Trial
Primary repair of colon injuries: a prospective randomized study.
Due to the results of a 6-year experience with civilian penetrating colon injuries at Mount Carmel/Grace Hospital, in Detroit, Michigan, which had favored primary repair of colon injuries, a prospective randomized study was performed. Seventy-one patients with penetrating colon injuries were entered in a prospective randomized study. Forty-three patients were treated with primary repair or resection and anastomosis, and 28 patients were treated with diversion. ⋯ An analysis was also made within the primary repair group comparing the subgroups of primary repair with, and without, resection of colon. It appears that the primary repair with resection of colon may have fewer complications; however, this conclusion is based on a statistically insufficient sample size. The authors contend that primary repair or resection with anastomosis is the method of choice for treatment of all penetrating colon injuries in the civilian population despite any associated risk factors for adverse outcomes.
-
To determine the efficacy and safety of a two-tier trauma response, using prehospital criteria for matching trauma center assets with severity of injury. ⋯ Utilization of a two-tier response to trauma patients is effective, safe, and results in substantial cost savings.
-
A patient with head injury presented with computed tomography findings of a diffuse severe infarction of the left cerebral hemisphere in which the cerebral hemodynamics can be evaluated by transcranial Doppler sonography. Serial angiograms revealed a carotid-cavernous fistula, with a complete steal phenomenon. The unusual complication of a traumatic carotidcavernous fistula is discussed.
-
The aim of this study was to assess Advanced Trauma Life Support (ATLS) training status of general surgeons, its perceived utility, and its relation to clinical trauma practice. ⋯ The ATLS course represents a standard of initial trauma care education in which only one-third of surgeons report current participation. Many view ATLS as not relevant or useful, yet take trauma call. To ensure standard education and patient care, an ATLS course curriculum specifically geared to the general surgeon should be developed and made a mandatory component of residency training or a requirement for board certification and trauma call credentialing.
-
The goal of this study was to determine patient and injury characteristics that predict undertriage and overtriage. ⋯ In a developed trauma system, severely injured elderly trauma patients (especially females) are at risk for undertriage. The characteristics of patients at risk for overtriage reflect the difficulties of prospective out-of-hospital triage.