European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2022
Observational StudySubstitution of ROTEM FIBTEM A5 for A10 in trauma: an observational study building a case for more rapid analysis of coagulopathy.
Rotational thromboelastometry (ROTEM®) allows guided blood product resuscitation to correct trauma-induced coagulopathy in bleeding trauma patients. FIBTEM amplitude at 10 min (A10) has been widely used to identify hypofibrinogenaemia; locally a threshold of < 11 mm has guided fibrinogen replacement. Amplitude at 5 min (A5) carries an inherent time advantage. The primary aim was to explore the relationship between FIBTEM A5 and A10 in a trauma. Secondary aim was to investigate the use of A5 as a surrogate for A10 within a fibrinogen-replacement algorithm. ⋯ ROTEM FIBTEM A5 reliably predicts A10 in trauma. This further validates use of the A5 result over A10 allowing faster decision-making in time-critical resuscitation of trauma patients. A modification of -1 to the A10 threshold might be appropriate for use with the A5 value in trauma patients.
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Eur J Trauma Emerg Surg · Apr 2022
Emergency surgery workforce and its inverse relationship with multidimensional poverty in Colombia.
General surgeons, anesthesiologists, obstetricians and gynecologists (ob-gyns), and orthopedic surgeons are the vital disciplines to provide emergency surgery within a healthcare system. This paper aims to examine the relationship (if any) between multidimensional poverty (MDP) and GDP per-capita with the emergency surgery workforce density in Colombia. ⋯ This study found that Colombian trauma and emergency surgery workforce density was inversely and directly correlated with multidimensional poverty and GDP per-capita levels, respectively. The relationship of these economic indicators with the surgical capacity deserves further investigation.
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Eur J Trauma Emerg Surg · Apr 2022
Repeat CT after blunt head trauma and Glasgow Coma Scale score 13-15 without neurological deterioration is very low yield for intervention.
Due to the increase in accessibility of computed tomography (CT), repeat head CT scans are routinely ordered for patients with minor head injuries. The aim of this study is to evaluate the necessity and outcomes of routine repeat head CT in patients with GCS score of 13-15 who presented to the emergency department (ED) of Antalya University Hospital in Turkey with blunt head trauma. ⋯ In patients with minor head injuries, those without neurological deterioration have a very low risk of need for medical or surgical intervention. Routinely ordering repeat head CT scans in this group may not be routinely indicated.
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Eur J Trauma Emerg Surg · Apr 2022
Therapeutic management of traumatic tension hematoma with potential skin necrosis: a retrospective review of 180 patients.
Tension hematoma is a frequent traumatic condition in elderly population under anticoagulation treatments. However, scarce literature exists focused in the management of this condition. In this article, a retrospective study of patients that suffered from traumatic tension hematomas treated at a plastic surgery department is reported. The objective was to evaluate the approach that provided better clinical outcomes, and the establishment of an evidence-based protocol. ⋯ Treatment of tension hematomas through early drainage should be performed as soon as possible from the time of injury. An evidence-based protocol should be established in every emergency department to improve patient clinical outcomes. When debridement and coverage surgery are required, they should be performed in one stage, to reduce length of hospital stay and the incidence of medical complications.
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Eur J Trauma Emerg Surg · Apr 2022
Single versus double tendon transfer for foot drop due to post-traumatic common fibular nerve palsy.
To compare functional outcomes of single versus double tendon transfer for foot drop correction and toe drop prevention in posttraumatic common fibular nerve palsy. ⋯ Double transfer of TP and FDL tendons is a reliable method to restore balanced ankle dorsiflexion and prevent toe drop. However, recovery of active toe extension was inconsistent and Carayon scores were not superior to those obtained with a single TP tendon transfer.