Journal of emergencies, trauma, and shock
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J Emerg Trauma Shock · Oct 2011
Designing, managing and improving the operative and intensive care in polytrauma.
Polytrauma is a leading cause of mortality in the developing countries and efforts from various quarters are required to deal with this increasing menace. ⋯ There is an urgent need for proper implementation ofpre-hospital and advanced trauma life support measures at grass-root level. Analyzing the profile of polytrauma victims at a national level and simultaneously improving the trauma care services at every health center are very essential to decrease the mortality and morbidity. The improvement can be augmented further by strengthening the rural health infrastructure, strict traffic rules, increasing public awareness and participation and coordination among the various public and private agencies in dealing with polytrauma.
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Trauma and injury severity score (TRISS), introduced in 1981 is a combination index based on revised trauma score (RTS), injury severity score (ISS) and patient's age. In this study we have used TRISS method to predict the outcome in trauma cases. ⋯ The revised trauma score (RTS) ranged from 2.746 to 7.8408.There was a graded increase in mortality with decreasing RTS score.
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J Emerg Trauma Shock · Oct 2011
Malposition of central venous catheter in a small tributary of left brachiocephalic vein.
Erroneous positioning of central venous catheters in small tributaries of large central veins is a rare occurrence. We describe two such unusual incidents involving cannulation of the small tributaries of left brachiocephalic vein. Malposition was suspected when the central venous waveform could not be obtained despite all attempts. Unusual central venous waveforms may indicate central venous catheter malposition, and these waveforms have not previously been described.
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J Emerg Trauma Shock · Oct 2011
Damage control in severely injured trauma patients - A ten-year experience.
This study reviews our 10-year institutional experience with damage control management and investigates risk factors for early mortality. ⋯ Several risk factors for early mortality such as severe head injury and the lethal triad (coagulopathy, acidosis and hypothermia) in patients undergoing damage control procedures were identified and should trigger the trauma surgeon to maintain aggressive resuscitation in the intensive care unit.
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Critically ill patients are common in emergency medicine, and require expert care to maximize patient outcomes. However, little data is available on the provision of critical care in the ED. The goal of this study is to describe the management of critically ill patients in the ED via a survey of Canadian emergency physicians. ⋯ Our survey demonstrates that critically ill patients are common in Canadian ED's, and that EMP's are often responsible to provide care for prolonged period of time. In addition, the use of invasive procedures other then direct laryngoscopy was variable. Further research is warranted to determine the impact of delayed transfer and ED physician management of critically ill patients in the ED.