J Trauma
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Randomized Controlled Trial Comparative Study
An evaluation of two tourniquet systems for the control of prehospital lower limb hemorrhage.
Hemorrhage remains the main cause of preventable death on the modern battlefield. As Improvised Explosive Devices in Afghanistan become increasingly powerful, more proximal limb injuries occur. Significant concerns now exist about the ability of the windlass tourniquet to control distal hemorrhage after mid-thigh application. To evaluate the efficacy of the Combat Application Tourniquet (CAT) windlass tourniquet in comparison to the newer Emergency and Military Tourniquet (EMT) pneumatic tourniquet. ⋯ This study demonstrates that the CAT tourniquet is ineffective in controlling arterial blood flow when applied at mid-thigh level. The EMT was successful in a significantly larger number of participants.
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The organ supply shortage continues to be a public health care crisis, with nearly 20 people dying each day awaiting transplantation. Inability to obtain consent remains one of the major obstacles to converting potential donors into organ donors. We hypothesize that the presence of in-house coordinators (IHCs) from organ procurement organizations (OPOs) will improve organ donor conversion rates. ⋯ The presence of an IHC program significantly improves conversion rates for organ donation as well as organ yield. An IHC program should be considered as a viable option to bridge the gap between organ supply and organ demand.
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The purpose of our study was to evaluate the objective and subjective outcomes, as well as the radiographic results after elbow hemiarthroplasty (HA) for comminuted distal humerus fractures in elderly patients. ⋯ Elderly patients treated with elbow HA revealed good to excellent short-term clinical outcomes. A high rate of complications occurred but most complications found were minor and reoperation rate was low. Our results must be regarded as a report on our first experience with HA. As cartilage wear is just a question of time especially in active patients, we cautiously recommend HA only for elderly and multimorbid low-demand patients.
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The purpose of this study was to determine the functional outcomes and predictive factors of radial head and neck fractures. ⋯ A majority of radial head and neck fractures can be treated nonoperatively, achieving excellent or good results. Age, fracture classification, radiographic comminution, and treatment choice are important factors that determine recovery.