J Trauma
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To identify a population of trauma patients in the emergency department (ED) that do not require emergent blood transfusion via a combination of clinical risk factors that are readily accessible and easily obtained. ⋯ Trauma patients with no risk factors at presentation were less likely to require emergent blood transfusion, especially in the setting of the ED.
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Prolonged use of spinal precautions in unconscious trauma patients is associated with significant morbidity. The trauma service of the John Radcliffe Hospital uses full-length radiography, computed tomographic scanning, and dynamic screening of the cervical spine to clear the spine at the earliest opportunity. ⋯ Full length spinal radiography and dynamic cervical screening may allow early and safe discontinuation of spinal precautions in the unconscious trauma patient in whom clinical signs are absent or unreliable.
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Existing shock models do not address the patient with massive hemorrhage (> 1 blood volume). Such patients often die from irreversible shock. This model simulates the clinical scenario of massive hemorrhage and resuscitation (MHR) to determine if irreversible shock can be reversed. ⋯ This MHR model is much more lethal than a traditional severe hemorrhage model and reproduces the clinical picture of irreversible shock. This irreversible shock can be reversed with very large volumes of resuscitation.