J Trauma
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Despite numerous studies analyzing this topic, specific advantages of helicopter transport of blunt polytrauma patients as compared with ground ambulances have not yet been identified unequivocally. ⋯ Primary transfer by HEMS into a Level I trauma center reduces mortality markedly. In principle, this benefit can be attributed to superior preclinical therapy, primary admission to a Level I trauma center, or both. However, the identical probability of survival of the AMB-UNI and HEMS-UNI groups in this and comparable studies does not confirm generally better survival rates on account of a more aggressive on-site approach.
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This study compares young (< 65 years old) and elderly (> or = 65 years old) patients who fall secondary to syncope and seeks to determine whether syncope workups are being appropriately performed and whether they contribute new information that results in a change in management. ⋯ Syncope workups were erratically performed in both young and older groups. These workups frequently resulted in abnormal findings that required intervention. Protocols are currently being developed at our institution to ensure complete assessment of trauma patients who fall for unknown reasons.
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Tracheobronchial injuries are relatively uncommon, and few data are available on the long-term effects of their treatment. ⋯ Laryngotracheal and MSB injuries often had less than optimal outcomes on long-term observation. Tracheal injuries treated by resection and end-to-end repairs had excellent outcomes. The data should be useful in counseling patients/families and planning follow-up strategies for patients with tracheobronchial injuries.
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Randomized Controlled Trial Clinical Trial
The long-term effect of oxandrolone on hepatic acute phase proteins in severely burned children.
Acute phase protein production is a hallmark of severe burns. We wondered whether anabolic treatment with oxandrolone would affect these proteins. ⋯ Treatment with oxandrolone in severe burns significantly increases constitutive protein and reduces acute phase protein levels.
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The resources needed and those available to support trauma care for a given region are currently unknown. Resource use and availability were evaluated for injured subjects across a large sample of the United States. ⋯ A substantial minority of major trauma patients in the United States are treated in nondesignated trauma centers. The variability in the availability of trauma resources indicates a lack of consensus with respect to the resources required for trauma system implementation.