World journal of emergency surgery : WJES
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Review
Resuscitative thoracotomies and open chest cardiac compressions in non-traumatic cardiac arrest.
Since the popularisation of closed chest cardiac compressions in the 1960s, open chest compressions in non-traumatic cardiac arrest have become a largely forgotten art. Today, open chest compressions are only rarely performed outside operating theatres. ⋯ Numerous studies demonstrate how open chest cardiac compressions are superior to closed chest compressions in regards to physiological parameters and outcomes. Thus, by incorporating resuscitative thoracotomies and open chest compressions in our algorithms for non-traumatic cardiac arrest we may improve outcomes.
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Prothrombin complex concentrate (PCC) and recombinant Factor VIIa (rFVIIa) have been used for emergent reversal of warfarin anticoagulation. Few clinical studies have compared these agents in warfarin reversal. We compared warfarin reversal in patients who received either 3 factor PCC (PCC3) or low-dose rFVIIa (LDrFVIIa) for reversal of warfarin anticoagulation. ⋯ Based on achieving a goal INR of 1.5 or less, LDrFVIIa was more likely than PCC3 to reverse warfarin anticoagulation. Thromboembolic events were equivalent in patients receiving PCC3 and LDrFVIIa.
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Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. ⋯ Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients. Hemodynamically Unstable Pelvic Trauma is a frequent death cause among people who sustain blunt trauma. We present the results of the First Italian Consensus Conference.
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Computed tomography (CT) can detect subtle organ injury and is applicable to many body regions. However, its interpretation requires significant skill. In our hospital, emergency physicians (EPs) must interpret emergency CT scans and formulate a plan for managing most trauma cases. CT misinterpretation should be avoided, but we were initially unable to completely accomplish this. In this study, we proposed and implemented a precautionary rule for our EPs to prevent misinterpretation of CT scans in blunt trauma cases. ⋯ Our rule was easy to practice and effective in preventing EPs from missing major organ injuries. We would like to propose further large-scale multi-center trials to corroborate these results.