J Trauma
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Historically, contrast venography has been used to determine renal vein location and assist with vena cava filter placement. This technique, however, exposes the patient to nephrotoxic contrast and radiation. For trauma patients in the intensive care unit (ICU), inferior vena cava filters should ideally be placed without contrast at the bedside to avoid nephrotoxic agents, radiation, and transport of a critically injured patient to the operating room or x-ray department. Previously, the authors have shown that intravascular ultrasound is a safe and accurate method for locating renal veins and assisting with vena cava filter placement. The purpose of this study was to evaluate bedside vena cava filter placement prospectively using only intravascular ultrasound for imaging. ⋯ Intravascular ultrasound is a safe and effective imaging method that may be used for the bedside placement of vena cava filters in the ICU. This technique avoids the use of nephrotoxic intravenous contrast and eliminates the risk of transporting a critically injured patient to the operating room or x-ray department.
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Air transport of burn patients is plagued by frequent "overtriage." We examined the use of air transport and the feasibility of using alternative methods such as telemedicine to assist in evaluation and treatment of burn patients within our region. ⋯ Frequent discrepancies in burn assessment contribute to overuse of air transport. The ability to evaluate burn patients by telemedicine may have the potential to assist decisions regarding transfer, avoid errors in initial care, and reduce costs. We are currently attempting to develop and test such a system.
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Comparative Study
Application of the poly-N-acetyl glucosamine-derived rapid deployment hemostat trauma dressing in severe/lethal Swine hemorrhage trauma models.
The Rapid Deployment Hemostat (RDH) Bandage was developed for the rapid control of bleeding caused by trauma. ⋯ The RDH Bandage was superior to a commercially available fibrin bandage in controlling hemorrhage, decreasing blood loss, and increasing survival.
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This study tests whether the hemostatic action of poly-N-acetyl glucosamine (p-GlcNAc) fiber material involves vasoconstrictor release leading to closure of an aortic laceration. ⋯ The mechanism of hemostasis by poly-N-acetyl glucosamine involves endothelin release independent of formed elements of blood.
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Nonmotorized scooters have increased rapidly in popularity over the past year. However, the morbidity associated with this new type of recreational vehicle is poorly defined. This study examined the pattern of scooter-related injuries sustained in children admitted to a level 1 pediatric trauma center. ⋯ Scooters are an increasingly popular form of recreational vehicle among children. However, they can result in serious injury, particularly to the head and extremities. The authors recommend that all children riding scooters wear protective equipment and avoid riding in areas that have moving motor vehicles.