European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2020
Cerebral effects of resuscitation with either epinephrine or vasopressin in an animal model of hemorrhagic shock.
The use of epinephrine (EN) or vasopressin (VP) in hemorrhagic shock is well established. Due to its specific neurovascular effects, VP might be superior in concern to brain tissue integrity. The aim of this study was to evaluate cerebral effects of either EN or VP resuscitation after hemorrhagic shock. ⋯ Both vasopressors were effective in restoring hemodynamics and CPP and in maintaining brain oxygenation. With regards to the cerebral metabolism, we cannot support beneficial effects of VP in this model of hemorrhagic shock.
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Eur J Trauma Emerg Surg · Dec 2020
Educational impact of hand motion analysis in the evaluation of fast examination skills.
Increasing pressure pushes towards the objective competence assessment of clinical operators. Hand motion analysis (HMA) was introduced to measure surgical and clinical procedures; its recent application to FAST examinations leaves unsolved issues. This study aimed at determining optimal HMA parameters to discriminate between operators' skill levels, and which FAST tasks are experience-dependent. ⋯ HMA identified kinematic parameters discriminating between proficiency level and critical subtasks in the FAST examination. These findings could be the base for a focused HMA-based evaluation of performances following a proctored training period. There is room to incorporate HMA into simulation metrics and evidence-based credentialing standards for clinical ultrasound applications.
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Eur J Trauma Emerg Surg · Dec 2020
Mobile wireless monitoring system for prehospital emergency care.
Latest achievement technologies allow engineers to develop medical systems that medical doctors in the health care system could not imagine years ago. The development of signal theory, intelligent systems, biophysics and extensive collaboration between science and technology researchers and medical professionals, open up the potential for preventive, real-time monitoring of patients. With the recent developments of new methods in medicine, it is also possible to predict the trends of the disease development as well the systemic support in diagnose setting. Within the framework of the needs to track the patient health parameters in the hospital environment or in the case of road accidents, the researchers had to integrate the knowledge and experiences of medical specialists in emergency medicine who have participated in the development of a mobile wireless monitoring system designed for real-time monitoring of victim vital parameters. Emergency medicine responders are first point of care for trauma victim providing prehospital care, including triage and treatment at the scene of incident and transport from the scene to the hospital. Continuous monitoring of life functions allows immediate detection of a deterioration in health status and helps out in carrying out principle of continuous e-triage. In this study, a mobile wireless monitoring system for measuring and recording the vital parameters of the patient was presented and evaluated. Based on the measured values, the system is able to make triage and assign treatment priority for the patient. The system also provides the opportunity to take a picture of the injury, mark the injured body parts, calculate Glasgow Coma Score, or insert/record the medication given to the patient. Evaluation of the system was made using the Technology Acceptance Model (TAM). In particular we measured: perceived usefulness, perceived ease of use, attitude, intention to use, patient status and environmental status. ⋯ The study results show that the proposed system is well accepted by the EM personnel and can be used as a complementary system in EM department for continuous monitoring of patients' vital signs.
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Eur J Trauma Emerg Surg · Dec 2020
Comparative StudyComparison of new design locked intramedullary nails and plate osteosynthesis in adult isolated diaphyseal radius fractures.
In this study, we retrospectively evaluated patients with isolated diaphyseal radius fractures treated with plates or IMNs and compared their radiological and functional results. ⋯ With similar union rates, functional results, and shorter operating times, locked IMNs are a suitable alternative to plate osteosynthesis in adult isolated diaphyseal radius fractures.
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Eur J Trauma Emerg Surg · Dec 2020
Comparative StudyBiomechanical aspects of the posteromedial split in bicondylar tibial plateau fractures-a finite-element investigation.
To gain principal insight into fixation techniques of a posteromedial split fragment in bicondylar tibial plateau fractures. ⋯ The results indicate that the additional fixation of a posteromedial split fracture by plate osteosynthesis might be advantageous in bicondylar tibial plateau fractures treated with lateral plating. This might be even more important in patients with low bone quality.