Journal of emergencies, trauma, and shock
-
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.
-
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.
-
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.
-
J Emerg Trauma Shock · Oct 2011
Diagnostic accuracy of bedside emergency ultrasound screening for fractures in pediatric trauma patients.
Bedside ultrasound (BUS) can effectively identify fractures in the emergency department (ED). ⋯ BUS can be utilized by emergency physicians after brief training to accurately identify long bone fractures in the pediatric age-group.
-
J Emerg Trauma Shock · Oct 2011
Influence of prehospital fluid resuscitation on patients with multiple injuries in hemorrhagic shock in patients from the DGU trauma registry.
Severe bleeding as a result of trauma frequently leads to poor outcome by means of direct or delayed mechanisms. Prehospital fluid therapy is still regarded as the main option of primary treatment in many rescue situations. Our study aimed to assess the influence of prehospital fluid replacement on the posttraumatic course of severely injured patients in a retrospective analysis of matched pairs. ⋯ The high amounts of intravenous fluid replacement was related to early traumatic coagulopathy, organ failure, and sepsis rate.