J Trauma
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The percutaneous common femoral vein catheter for volume replacement in critically injured patients.
The acquisition of venous access with the potential for massive volume infusion can be a major determinant in the survival of a critically injured patient. A percutaneously placed 8.5 Fr common femoral vein catheter (CFVC) was inserted in 366 patients in whom upper extremity veins were unavailable or inadequate for volume resuscitation. ⋯ Although 90% of trauma patients can be managed with a peripheral vein catheter, venous access in patients with the potential need for massive volume infusion can be achieved in a rapid, safe, and efficient manner using the CFVC in conjunction with the GIT. We conclude that this system can be used effectively in trauma patients with hemodynamic instability, unavailable or inaccessible upper extremity veins, suspected cervicothoracic major vascular injury and when massive volume or blood replacement is anticipated.
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Comparative Study
Supracondylar fractures of the humerus--results of surgical treatment.
Forty-eight patients with supracondylar fractures of the humerus have been treated at St. Michael's Hospital in the past 10 years. ⋯ The results of this comparison suggested that the specifically designed plate provided superior fixation and better anatomic restoration of the distal humerus. Anatomic reduction, rigid fixation, and early surgery provide the best results.
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To assess the utility of a routine pelvic X-ray in resuscitation of blunt trauma patients, 669 patients were studied prospectively over a 2-year period. One hundred twelve patients (16.7%) had positive pelvic X-rays (PPX). ⋯ When compared with five standard resuscitative assessment variables, a pelvic X-ray performed as an additional predictor of injury severity and 24-hour blood requirement. A pelvic X-ray should be performed routinely in victims of blunt trauma as part of the early resuscitation X-ray protocol since a positive finding has immediate prognostic and therapeutic implications.