Current surgery
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Comparative Study
Forward surgical team (FST) workload in a special operations environment: the 250th FST in Operation ENDURING FREEDOM.
Forward Surgical Teams (FST) deploy to support conventional combat units of at least regimental size. This report examines the injuries and treatments of an FST in an environment of unconventional tactics, limited personal protection, and extended areas of responsibility during Operation ENDURING FREEDOM. ⋯ Despite the lack of personal protective gear, most patients had extremity wounds as their primary injuries. In this special operations environment, time to operative treatment was significantly longer than expected.
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Comparative Study
Feasibility of a novel veno-veno circuit as a central rewarming method in a severely hypothermic canine model.
Many victims of accidental hypothermia are successfully resuscitated, but questions remain regarding the optimum rewarming techniques. Most of the invasive warming techniques such as closed thoracic lavage, hemodialysis, peritoneal dialysis, and cardiopulmonary bypass require specialized personnel, equipment, and procedures that are not readily available in all facilities. The objective of this study was to investigate the technical feasibility of utilizing a novel veno-veno rewarming circuit to resuscitate severely hypothermic subjects. If this alternative invasive warming technique is successful, it could be available to treat hypothermic patients in virtually any emergency department setting. ⋯ From this pilot study, we conclude that our novel veno-veno circuit rewarming is a feasible method of rewarming hypothermic subjects and warrants further investigation and comparison with other active warming methods.
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To review a statewide experience of adrenal gland trauma (AGT), incidence, demographics, associated injuries, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), mechanisms of injury, and complications, associated with AGT. ⋯ Adrenal gland trauma is a rare and largely coincidental finding diagnosed either during an initial radiologic examination or surgical exploration for other injuries. Surgical exploration was carried out in 21.4% of patients, with adrenalectomy in 2.5% of cases and nephrectomy in 4.3% of cases. Adrenal injury is associated with high injury severity, and with mortality rates up to 5 times higher than non-AGT trauma.
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Comparative Study
Acute lung injury using oleic acid in the laboratory rat: establishment of a working model and evidence against free radicals in the acute phase.
To determine the optimal model of acute respiratory distress syndrome (ARDS) using oleic acid in our laboratory and to measure the presence or absence of free radicals in this model. ⋯ During this study, we successfully established a working animal model of ARDS for our laboratory. Our findings to date suggest that free radicals do not contribute to oleic acid lung injury in the early stages.