European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Dec 2022
Endotracheal intubation in trauma patients with isolated shock: universally recommended but rarely performed.
The indication for pre-hospital endotracheal intubation (ETI) must be well considered as it is associated with several risks and complications. The current guidelines recommend, among other things, ETI in case of shock (systolic blood pressure < 90 mmHg). This study aims to investigate whether isolated hypotension without loss of consciousness is a useful criterion for ETI. ⋯ Decision making for pre-hospital intubation in trauma patients is challenging in front of a variety of factors. Despite the presence of a guideline recommendation, ETI is not always executed. Patients presenting with shock as remaining indication and subsequent intubation showed a decreased outcome. Thus, isolated shock does not appear to be an appropriate indication for pre-hospital ETI, but clearly remains an important surrogate of trauma severity and the need for trauma team activation.
-
Eur J Trauma Emerg Surg · Dec 2022
A validation study for a clinical decision rule for acute wrist injury.
Acute wrist injury is a common reason for visiting the emergency department. To date, there are no implemented clinical decision rules to predict a fracture in this group of patients. We previously identified six clinical predictors in adult patients with acute wrist trauma. The aim of this study was to validate these predictors as a decision rule in a validation cohort. ⋯ The decision rule showed a high sensitivity and low specificity, possible due to the high pre-test probability of a wrist fracture in the cohort. Our study needs further validation in other populations.
-
Eur J Trauma Emerg Surg · Dec 2022
Observational StudyEvaluation of validity and reliability of video analysis and live observations to assess trauma team performance.
A trauma resuscitation is dynamic and complex process in which failures could lead to serious adverse events. In several trauma centers, evaluation of trauma resuscitation is part of a hospital's quality assessment program. While video analysis is commonly used, some hospitals use live observations, mainly due to ethical and medicolegal concerns. The aim of this study was to compare the validity and reliability of video analysis and live observations to evaluate trauma resuscitations. ⋯ Video analysis of trauma resuscitations may be more valid and reliable compared to evaluation by live observers. These outcomes may guide the debate to justify video review instead of live observations.
-
Eur J Trauma Emerg Surg · Dec 2022
Observational StudyTemporary external fixation versus direct ORIF in complete displaced intra-articular radius fractures: a prospective comparative study.
In complex distal radius fractures (DRF), both direct osteosynthesis (one-stage approach) and temporary external fixation as a bridge to definitive osteosynthesis (two-stage approach) are used. Studies directly comparing these two management options are lacking. This study aims to compare the two procedures with regard to complications, and radiological and functional outcomes. ⋯ No differences were found in clinical, functional, and radiological outcome between one- and two-staged surgical techniques. It may be concluded that a two-stage approach is a viable and safe alternative.
-
Eur J Trauma Emerg Surg · Dec 2022
Trauma-Angio score as a predictor of urgent angioembolization for blunt trauma: development and validation using independent cohorts.
This research aimed to establish a scoring system for selecting candidates for urgent angioembolization (AE). ⋯ The Trauma-Angio scoring system can be used as a trigger to suggest the possibility of urgent AE.