European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2014
The falling bullets: post-Libyan revolution celebratory stray bullet injuries.
To report our experience with the post-Libyan revolution celebratory stray bullet injuries by falling bullets. ⋯ Celebratory stray bullet injuries are an unusual form of injury not infrequently seen in some parts of the world. Lower limb and chest injuries especially among children are most commonly reported. Focus on prevention through education and weapon use regulations carries the best chance of reducing these injuries.
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Diagnosis of Triplane fractures remains difficult in common practice. Aim of the study was the evaluation of the fracture pattern and the benefit of cross-sectional imaging in classification of Triplane-fractures. ⋯ The additional information of cross-sectional imaging seems helpful for any physician in finding the right classification of a pediatric ankle fracture. However, the additive information appears especially viable for experienced surgeons to suggest the appropriate treatment.
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Eur J Trauma Emerg Surg · Feb 2014
The pediatric vs. the adolescent elbow. Some insight into age-specific treatment.
Almost 20 % of all long bone fractures in childhood and adolescents involve the elbow region. Physicians dealing with pediatric trauma cases on a regular basis must be familiar with the specific radiologic features of the elbow at every developmental stage. This includes the shape and the appearance of elbow ossification centers, and knowledge of age-specific injury patterns. ⋯ Treatment options depend on fracture type, age and demands and vary from immobilization to closed reduction and open reduction including internal fixation with different types of materials. Special circumstances to influence the treatment regimen in every single injury entity are discussed. Additionally, the most common malformations and nontraumatic diseases of the elbow region are mentioned.
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Eur J Trauma Emerg Surg · Feb 2014
Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department.
We sought to determine whether the introduction of a separate patient flow comprising patients with simple, non-complex health issues [Fast Track (FT)] in a Dutch emergency department setting (ED), without the introduction of additional staff, and treated by a physician assistant, would have favourable effects on waiting and turnaround times without deleterious effects for patients with a higher urgency. ⋯ The introduction of FT performed by a physician assistant resulted in a significant drop in waiting time and length of stay in a Dutch ED setting. This reduction was realised without the allocation of additional staff and even reduced waiting and turnaround times for the patients with a high urgency.
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Eur J Trauma Emerg Surg · Feb 2014
Blunt bowel and mesenteric injuries detected on CT scan: who is really eligible for surgery?
There is no consensually accepted approach to the management of blunt bowel and mesenteric injuries. Surgery is required urgently in the case of bowel perforation or haemodynamic instability, but several patients can be treated non-operatively. This study aimed to identify the risk factors for surgery in an initial assessment. ⋯ In blunt abdominal trauma, the association of a bowel and/or mesenteric injury with a peritoneal effusion without solid organ injury on an initial CT scan should raise the suspicion of an injury requiring surgical treatment. Additionally, this finding should lead to a clinical discussion of the benefit of explorative laparotomy to prevent delayed surgery. However, these findings need validation by larger studies.