European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2016
Observational StudyPercutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure.
Percutaneous dilatational tracheostomy (PDT) is a standard procedure routinely performed on intensive care units. While complication rates and long-term outcomes have been studied in different patient populations, there are few studies known to these authors involving PDT in trauma patients and the complications which may result. ⋯ PDT is a safe procedure in trauma patients. When considering the severity of complications such as major blood loss, pneumothorax, or death, this evidence suggests that PDT is safer in trauma patients compared to other patient cohorts.
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Eur J Trauma Emerg Surg · Oct 2016
Evaluation of hematological markers in minor head trauma in the emergency room.
A rule exists regarding the use of computed tomography (CT) for patients presenting to the emergency department with head trauma and a Glasgow coma score (GCS) of 15; however, it can be difficult to make this decision due to overcrowded emergency rooms or exaggerated patients complaints. We evaluated patients who presented to the emergency room with minor head trauma, and we aimed to investigate the relationship between brain pathology on CT and hematological markers in order to find markers that help us identify brain pathology in patients with a GCS of 15. ⋯ MPV, NLR, and troponin T can be used as parameters that indicate brain pathologies on CT scans of patients presenting to the emergency department with isolated minor head trauma and GCS of 15 when the necessity of a CT scan is otherwise unclear.
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Eur J Trauma Emerg Surg · Oct 2016
Cervical collar effect on pulmonary volumes in patients with trauma.
According to Advanced Trauma Life Support (ATLS) for trauma patients, a cervical collar should be applied initially. Patients on backboards with a cervical collar mostly complain of dyspnea and tend to take the collar off or roll themselves off the backboard. The purpose of this study is to investigate the effect of collar removal on lung volumes and dyspnea in patients with GCS 15. ⋯ Cervical collar applications in trauma patients cause a significant decrease in lung capacity and spirometry parameters. Patients suffering from lung diseases and respiratory distress require special attention which means that the cervical collar should be removed as soon as cervical injuries are ruled out so as to avoid hypoxia.
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Eur J Trauma Emerg Surg · Oct 2016
ReviewEssential bariatric emergencies for the acute care surgeon.
Bariatric surgery is the most effective treatment for morbid obesity. Due to the high volume of weight loss procedures worldwide, the general surgeon will undoubtedly encounter bariatric patients in his or her practice. Liberal use of CT scans, upper endoscopy and barium swallow in this patient population is recommended. ⋯ Laparoscopic-assisted gastric band complications are usually approached with band deflation and referral to a bariatric surgeon. However, if acute slippage that results in gastric strangulation is suspected, the band should be removed immediately. This manuscript provides a high-level overview of all essential bariatric complications that may be encountered by the acute care surgeon.
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Eur J Trauma Emerg Surg · Oct 2016
ReviewGeriatric hip fracture management: keys to providing a successful program.
Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program. ⋯ To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.