Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Nov 2012
ReviewSubmental endotracheal intubation as an alternative to tracheostomy in selected cases of facial fracture: literature review and technique report.
Intermaxillary fixation (IMF) is an essential guide to optimize the reduction and fixation of most facial fractures associated with occlusal alterations. To allow IMF, nasotracheal intubation is used in most cases. ⋯ Submental endotracheal intubation allows IMF to be used without resorting to nasal intubation or tracheostomy, and it does not interfere with reduction and fixation of fractures in most cases. The purpose of this article is to describe the indications, contraindications and the technique of submental endotracheal intubation as performed in our service.
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Ulus Travma Acil Cer · Nov 2012
Comparative Study Observational StudyPredicting the outcome in children with head trauma: comparison of FOUR score and Glasgow Coma Scale.
Because of the limitations of the Glasgow Coma Scale (GCS), many scoring systems have emerged and been compared with GCS. Herein, we investigated whether the Full Outline of Unresponsiveness (FOUR) score is better than GCS in predicting morbidity and mortality in children with head trauma. ⋯ FOUR score provides no significant advantage over GCS in predicting morbidity and mortality in children with head trauma.
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Ulus Travma Acil Cer · Nov 2012
Case ReportsUnexpected multiple intra-abdominal injuries after projectile fragmentation: report of three cases.
Explosives create and energize particles that act as projectiles prone to further fragmentation or create other secondary missiles in the body. These fragments may result in secondary injuries. This has been repeatedly described in the orthopedic and neurosurgical literature. ⋯ The overall mean number of peritoneal defects was 1.7, and a mean 6.8 intra-abdominal injuries for each peritoneal defect were found when through-and-through injuries were excluded. Despite a single peritoneal defect, there may be multiple intraperitoneal injuries due to further fragmentation of the projectile. Under mass casualties, wound exploration with a full-thickness fascial defect could serve as an indicator of possible intra-abdominal injuries, and consequently indicate exploratory laparotomy.
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Ulus Travma Acil Cer · Nov 2012
Major thoracic vessels and cardiac trauma: case series from a center in a developing country.
Seventy-five percent of all trauma-related deaths are related to thoracic trauma. Very few penetrating cardiac trauma patients arrive to the hospital alive. Due to its high prevalence, an understanding of the pathogenesis, manifestations and management of cardiac trauma by the medical personnel is becoming increasingly important. ⋯ We believe that, in the past, the inevitable delay in diagnosis led to unsuccessful thoracotomies, late transfers to the operating room and physiological deterioration of the patient. As the incidence of trauma is increasing worldwide, it is essential for surgeons to be prepared to handle cardiovascular and cardiac trauma injuries immediately, as delay can adversely affect the outcome in terms of both morbidity and mortality. All patients presenting with trauma to the chest should be assessed with a high index of suspicion for major cardiovascular injuries. Early diagnosis, prompt transfer to the operating room and speedy and perfect surgery influence a favorable outcome.
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Ulus Travma Acil Cer · Nov 2012
Case ReportsUrgent endovascular treatment of iatrogenic subclavian artery rupture: report of three cases.
The increased use of central venous catheters in modern medical practice has brought a proportional increase in the number of cases of iatrogenic vascular injuries. Concerning the subclavian artery, the site of the lesion and the vessel size demand urgent and effective treatment in order to obtain a favorable prognosis. It has been common practice for a long time to consider this type of lesion as a surgical emergency. ⋯ Hypovolemic shock (demonstrated in two patients) as well as brachial plexus palsy due to pseudoaneurysm of the subclavian artery (presented in another patient) were successfully managed by percutaneous brachial (in two patients) or right femoral (in the patient with the pseudoaneurysm) approach and placement of balloon expandable covered stents (4-9 mm x 38 mm). No procedure-related complications were observed. Short-term follow-up results in two of the three patients were quite satisfactory concerning patency.