European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2014
The exponential function transforms the Abbreviated Injury Scale, which both improves accuracy and simplifies scoring.
We present here the exponential function which transforms the Abbreviated Injury Scale (AIS). It is called the Exponential Injury Severity Score (EISS), and significantly outperforms the venerable but dated New Injury Severity Score (NISS) and Injury Severity Score (ISS) as a predictor of mortality. ⋯ The EISS may be used as the standard summary measure of human trauma.
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Motor vehicle collisions account for the majority of blunt vascular trauma. Much of the literature describes the management of these injuries in isolation, and there is little information concerning the incidence and outcome in patients suffering multiple trauma. This study was undertaken to describe the spectrum of blunt vascular injuries in polytrauma patients. ⋯ Blunt vascular injury is uncommon in the patient with multiple trauma but confers substantial morbidity and mortality. In those cases with peripheral injuries, delays in referral to definitive care frequently exceed the ischaemic time, resulting in a high rate of amputations. Central injuries, especially those of the vena cava, account for the majority of directly attributable deaths.
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Eur J Trauma Emerg Surg · Jun 2014
More adverse events than expected in the outcome after use of the reamer-irrigator-aspirator.
The reamer-irrigator-aspirator (RIA) system is described as having high success rates and only few complications. The RIA was originally designed to ream the intramedullary canal in a single step prior to the placement of an intramedullary nail for femur fixation. Its purpose was to collect and evacuate marrow contents during reaming to prevent embolism into the systemic circulation. Marrow evacuation is also used to stimulate healing in nonunion fractures, segmental bone defects, and osteomyelitis. Despite the described success rates, we experienced severe adverse events. Our aim was to describe these events and point out possible complications. ⋯ The RIA system has benefits in the treatment of nonunion and osteomyelitis defect, but is not without risk. Meticulous surgical technique is mandatory and peroperative constant monitoring of patients and the assembled device is mandatory.
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The concealment of packets of illegal substances within body cavities is a common technique for drug smuggling worldwide. The goal of our study was to analyze the results of conservative treatment of "body packers", indications for surgical intervention, and postoperative morbidity. ⋯ Conservative management was effective in 94 % of symptomatic patients. A laparotomy was required in only 3.5 % of cases. The mortality rate in this series was low, resulting from either severe cocaine poisoning from ruptured packets or bowel perforation.
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Eur J Trauma Emerg Surg · Jun 2014
Should prehospital resuscitative thoracotomy be incorporated in advanced life support after traumatic cardiac arrest?
The survival of traumatic cardiac arrest patients poses a challenge for Emergency Medical Services initiating advanced life support on-scene, especially with regard to having to decide immediately whether to initiate prehospital emergency thoracotomy. Although the necessity for carrying out the procedure remains a cause for debate, it can be life-saving when performed with the correct indications and approaches.