Articles: trauma.
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Multicenter Study
Tourniquet use for peripheral vascular injuries in the civilian setting.
Haemorrhage in peripheral vascular injuries may cause life-threatening exsanguination. Tourniquets are used extensively by the military, with increased interest in the civilian setting to prevent deaths. This is a retrospective study of trauma patients at two large Canadian trauma centres with arterial injury after isolated extremity trauma. We hypothesized that tourniquet use may decrease mortality rate and transfusion requirements if applied early. ⋯ Tourniquets may prevent exsanguination in the civilian setting for patients suffering either blunt or penetrating trauma to the extremity. Future studies will help determine the utility of deploying tourniquets in the civilian setting, given the rarity of exsanguinating haemorrhage from isolated extremity trauma in this setting.
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The aim of this study was to describe the evolution and nature of self-destructive metabolic responses observed in critically ill patients, and to analyze therapeutic principles on how best to avoid or diminish these responses. ⋯ Minor surgical trauma is associated with a beneficial adaptive metabolic response. After a severe insult, however, emergence of self-destructive responses will be unavoidable if the patient survives the acute phase. Effective treatment is only possible by an aggressive therapy of underlying pathologies (such as shock, trauma or infection) thereby interrupting secondary metabolic trigger mechanisms at an early stage.
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Thoracic Surgery PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Video-assisted thoracic surgery (VATS) sympathectomy is the definitive therapy for primary palmar hyperhidrosis with high success rates and low recurrence. Classically, a 3-port bilateral VATS approach is utilized. We report our novel application and experience of single-port VATS sympathectomy with the VasoView® endoscopic vein harvesting devices. ⋯ The following authors have nothing to disclose: Rainbow Lau, Calvin Ng, Randolph Wong, Eugene Yeung, Micky Kwok, Innes Wan, Malcolm UnderwoodNo Product/Research Disclosure Information.
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Pleural Disease/Pneumothorax PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Primary spontaneous pneumothorax (PSP) occurs in patients with no clinically apparent underlying lung disease. Those aged less than 50 year with no significant smoking history are also included in this group according to the British Thoracic Society (BTS) pneumothorax management algorithm. There is paucity of data on treatment outcomes based on age criteria. We aimed to compare treatment outcomes including successful re-inflation rates in patients aged <30 and 31-50. ⋯ The following authors have nothing to disclose: Muhammad Ganaie, Shiva Bikmalla, Masood Khalil, Muhammad Afridi, Mohammed Haris, Imran HussainNo Product/Research Disclosure Information.
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The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as "low-acuity" by initial EMS protocols. ⋯ While this EMS system did not well predict overall resource utilization, it safely identified most low-acuity patients, with a low under-triage rate. This study identifies subgroups of patients that could be managed without emergent transport and can be used to further refine current protocols or establish secondary triage systems.