Articles: trauma.
-
Comparative Study
Evaluation of noninvasive hemoglobin measurements in trauma patients.
Reliable, accurate, noninvasive, and continuous determination of hemoglobin would be an important advance in the care of trauma patients. The aim of this study was to evaluate the utility of the Masimo Radical 7 device in severely injured trauma patients. ⋯ The Masimo Radical 7 system evaluated in this study holds promise, but it is not ready to be used as an initial noninvasive evaluation tool in the acute treatment of severely injured trauma patients. There was a poor correlation between Masimo hemoglobin and laboratory hemoglobin and large numbers of missing data. On the basis of the poor correlation, the Masimo Radical 7 device cannot currently be used to guide transfusion therapy.
-
Hypovolaemic shock that results through traumatically inflicted haemorrhage can have disastrous consequences for the victim. Initially the body can compensate for lost circulating volume, but as haemorrhage continues compensatory mechanisms fail and the patient's condition worsens significantly. Hypovolaemia results in the lethal triad, a combination of hypothermia, acidosis and coagulopathy, three factors that are interlinked and serve to worsen each other. ⋯ This method is easy to implement requiring simple protocols and contributes significantly to interrupting the lethal triad. However, the future of trauma care appears to lie with clinically induced therapeutic hypothermia. This new treatment provides optimism that in the future the number of deaths resulting from catastrophic haemorrhaging may be significantly lessened.
-
J. Pharmacol. Exp. Ther. · Dec 2013
Nerve injury increases GluA2-lacking AMPA receptor prevalence in spinal cords: functional significance and signaling mechanisms.
The glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors (AMPARs) are critically involved in the excitatory synaptic transmission, and blocking AMPARs at the spinal level reverses neuropathic pain. However, little is known about changes in the composition of synaptic AMPARs in the spinal dorsal horn after peripheral nerve injury. AMPARs lacking the GluA2 subunit are permeable to Ca(2+), and their currents show unique inward rectification. ⋯ In addition, blocking GluA2-lacking AMPARs at the spinal cord level reduced nerve injury-induced pain hypersensitivity. Our study suggests that nerve injury increases GluA2 internalization and the prevalence of GluA2-lacking AMPARs in the spinal dorsal horn to maintain chronic neuropathic pain. Increased prevalence of spinal GluA2-lacking AMPARs in neuropathic pain is mediated by NMDARs and subsequent stimulation of calpain and calcineurin signaling.
-
Comparative Study Observational Study
Epidemiology of paediatric minor head injury: Comparison of injury characteristics with Indices of Multiple Deprivation.
Head injury (HI) is a common presentation to Child Emergency Departments (CEDs), but the actual number of children attending with minor HI is unclear. Most research has focussed on admitted patients, often relying on hospital-coded admission data. We studied the incidence of minor HI presenting to the CED of a major teaching hospital in Coventry and Warwickshire. HI attendances were compared with population data to identify injury patterns relating to deprivation. ⋯ Young children are particularly at risk of HI and parents should be offered information on injury prevention. More children from deprived areas attended with HI and these families may benefit most from targeted interventions.
-
Comparative Study
Post-extubation dysphagia in trauma patients: it's hard to swallow.
There is a significant incidence of unrecognized postextubation dysphagia in trauma patients. The purpose of this study was to evaluate the incidence, ascertain the risk factors, and identify patients with postextubation dysphagia who will require clinical swallow evaluation. ⋯ Trauma patients requiring mechanical ventilation for ≥2 days are at increased risk for dysphagia and should undergo routine swallow evaluations after extubation.