Articles: trauma.
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Although most neurovascular diseases can be treated either by microsurgical or endovascular means, a subset of patients may require a combined approach. Patient transfer from the operating room (OR) to the angiosuite has been a fundamental drawback of this type of approach. ⋯ A combined endovascular and surgical approach conducted in a hybrid OR provides a new strategy for the treatment of complex neurovascular diseases.
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To assess the improvement of knowledge and skills of trauma management among participant of Primary Trauma Care (PTC) workshop. ⋯ Primary Trauma Care workshop could be an effective course for gaining of knowledge and skills of initial management of trauma patients. However, some modifications need to be done for training of skills components to maximize the output of this interactive workshop.
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This paper provides an insight into Croatian health system with special focus on trauma care. The current situation is explained from a domestic point of view, but an independent review by foreign observers is also included. ⋯ A good start is definitely a reorganization of existing knowledge on the basis of internationally licesed courses and the adoption of trauma registry as a standard for future discussion. Individual components of the trauma system can not be separately "optimized" so clinical and financial decisions should be planned exclusively on the integral level.
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Successful screw fixation of reduced posterior facet fragments to the unexposed, nondisplaced sustentaculum tali avoids breaching the subtalar joint or disrupting surrounding soft tissue structures. Safe passage for screw fixation through this narrow bony corridor has not been rigorously defined. ⋯ The operative guidelines described in this study may assist surgeons in the placement of screws for the fixation of posterior facet fragments to the sustentaculum tali.
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Increased risk of pneumonia among ventilated patients with traumatic brain injury: every day counts!
Patients with traumatic brain injury (TBI) frequently require mechanical ventilation (MV). The objective of this study was to examine the association between time spent on MV and the development of pneumonia among patients with TBI. ⋯ Patients who have sustained TBIs and require MV are at higher risk for VAP than individuals extubated earlier; therefore, shortening MV exposure will likely reduce the risk of VAP. As patients with TBI frequently require MV because of neurologic impairment, it is key to develop aggressive strategies to expedite ventilator independence.