Ulus Travma Acil Cer
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Penetrating cardiac trauma represents an increasingly important form of trauma due to the frequent use of firearms and bombs in civilian violence. We report our experience over the past 16 years with missile-induced cardiac injuries. ⋯ In missile cardiac injuries, results are best if operated early, and outcome depends upon multiple factors including clinical status at arrival, time interval till management, nature of injury, and associated injuries.
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Ulus Travma Acil Cer · Jul 2009
[Penetrating cardiac injuries: analysis of the mortality predictors].
Penetrating cardiac injuries are a dramatic and lethal form of trauma. Most of these patients reach the hospital already dead or in severe shock. The prognosis is determined by early diagnosis and operation. In this study, we discuss the effects of the etiology of trauma, the state of presentation in the emergency department, and the treatment approaches on the morbidity and mortality in penetrating cardiac trauma treated in our clinic. ⋯ Penetrating cardiac injuries lead to shock in a very short period of time because of bleeding and/or pericardial tamponade. Early diagnosis and prompt thoracotomy are the fundamental factors affecting patient outcome after penetrating cardiac injury.
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We aimed to compare different fluids indicated in volume replacement in multiple trauma patients, enlightening the indications, mechanisms of action and side effects. An extensive review of references (indexed journals) between 1997 and 2008 was performed. There is not yet a consensus about which fluids should be used in trauma patients. ⋯ Gelatins are no longer used in developed countries due to their insignificant ability regarding volume expansion when compared to crystalloids and the potential risks of anaphylactic reactions. The crystalloids are used more in trauma, even if some authors prefer the use of colloids, which can produce a quicker restoration of the intravascular volume. No convincing evidence shows a clear superiority of colloids over crystalloids for restoration of the volume depletion.
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Blunt colonic injuries are rare but can complicate the management of the blunt trauma patient and worsen the outcome. We analyzed in this study the colonic injuries caused by blunt abdominal trauma. ⋯ We conclude that in patients with shock at presentation, severe fecal contamination and higher CIS grade, two-staged operation is appropriate.
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Ulus Travma Acil Cer · Jul 2009
[Analysis of motorcycle accident victims presenting to the emergency department].
Motorcycle accidents are one of the major causes of traumatic injuries and deaths. The purpose of this study was to analyze the features of the victims presenting with motorcycle-related injuries. ⋯ Motorcycle accidents result in more serious injuries than motor vehicle accidents due to the limited safety precautions and the difference in injury mechanism. The frequency of accidents, higher admission rates, longer periods of admissions, and higher total hospital costs highlight motorcycle accidents as a major public health issue and an economical burden. To prevent accidents, compliance with the legal requirements should be regularly audited. Studies should be done to increase motorcycle safety precautions, and education programs should be organized for motorcyclists. The effects of these interventions should be analyzed.