Journal of emergencies, trauma, and shock
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J Emerg Trauma Shock · Oct 2013
Risk factors for cervical spine injury among patients with traumatic brain injury.
Diagnosis of cervical spine injury (CSI) is difficult in patients with an altered level of consciousness as a result of a traumatic brain injury (TBI). Patients with TBI and older adults are at increased risk for CSI. This study examined the various risk factors for CSI among trauma patients with TBI and whether adults who were older (≥55 years) were at higher risk for CSI when they sustained a fall-related TBI. ⋯ The identification of associated injuries and factors may assist physicians in evaluating CSI in patients with TBI.
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Coagulopathy frequently occurs following traumatic brain injury (TBI) and usually occurs 6-72 hour post-trauma. The incidence and the probable risk factors for development of coagulopathy and poor outcome following TBI are largely unknown and vary considerably. ⋯ There is a high incidence of coagulopathy following TBI. The presence of coagulopathy as well as of severity of TBI are strong predictors of in-hospital mortality in these patients.
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J Emerg Trauma Shock · Jul 2013
Blood levels of histone-complexed DNA fragments are associated with coagulopathy, inflammation and endothelial damage early after trauma.
Tissue injury increases blood levels of extracellular histones and nucleic acids, and these may influence hemostasis, promote inflammation and damage the endothelium. Trauma-induced coagulopathy (TIC) may result from an endogenous response to the injury that involves the neurohumoral, inflammatory and hemostatic systems. ⋯ Excessive release of extracellular histones and nucleic acids seems to contribute to the hypocoagulability, inflammation and endothelial damage observed early after trauma.
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J Emerg Trauma Shock · Jul 2013
Bedside ultrasonography by emergency physicians for anterior talofibular ligament injury.
Our objective was to study the accuracy of emergency physician (EP) performed bedside ultrasonography (BUS) in patients with suspected anterior talofibular ligament (ATFL) injury. ⋯ BUS for the diagnosis of ATFL injury is another application of BUS in the ED. EPs can diagnose ATFL injury using BUS with a high degree of accuracy.
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J Emerg Trauma Shock · Jul 2013
Pattern, presentation and management of vascular injuries due to pellets and rubber bullets in a conflict zone.
Rubber bullets and pellet guns are considered non-lethal low-velocity weapons. They are used to disperse a mob during street protests. The present study was undertaken to analyze the pattern, presentation and management of vascular injuries caused by these weapons. ⋯ Pellet and rubber bullets can cause serious life-threatening injuries. Vascular injury caused by these weapons need no different approach than other vascular injuries. Early revascularization and prompt resuscitation prevents the loss of limb or life.