1/594. Massive prehospital transfusion in multiple blunt trauma.A 15-year-old male passenger in a motor vehicle accident was transfused 15 units of blood products and 8.5 litres of polygeline while still trapped in the wreckage. This and other advanced interventions at the scene contributed to the patient's survival. This first case report of massive prehospital transfusion highlights some of the advantages of senior physician staffed emergency medical services in the prehospital phase of trauma management.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
2/594. Analysis of blunt trauma injuries: vertical deceleration versus horizontal deceleration injuries.There are several similarities found in blunt trauma injuries to humans sustained as a result of vertical deceleration (falling) and those sustained as a result of deceleration in a horizontal plane (automobile accidents). However, examination of the patterns of traumatic skeletal injuries can distinguish those injuries associated with falling from heights from those associated with automobile accidents. While there is considerable variation within each type of blunt trauma injury dependent on the angle at which one falls or is struck, there are several characteristic skeletal features associated with each type of trauma. In this study we review both the current literature and human skeletal remains from the University of new mexico's Documented Collection known to have been subjected to blunt trauma. This collection is used to characterize and differentiate the pattern of skeletal injuries to various parts of the body for each type of trauma. These assessments are applied to investigate the traumatic skeletal lesions observed in a forensic case where the manner of death is unknown. Analyses suggest two possible scenarios that would explain the death of the individual investigated, with death most likely related to a vehicular-pedestrian accident.- - - - - - - - - - ranking = 2.5828933500547keywords = injury, trauma (Clic here for more details about this article) |
3/594. Complete pyelo-calyceal avulsion as a result of blunt abdominal trauma.We present a rare case of complete avulsion of the kidney collecting system as a result of blunt abdominal trauma. Emergency celiotomy precluded radiographic studies. Perinephric hematoma was mild, the lesion was not detected and this later led to a nephrectomy. pelvis disruption diagnosis is frequently delayed, and this compromises surgical reconstruction.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
4/594. Inferomedial (subsustentacular) dislocation of the navicular: a case report.A unique case of subsustentacular dislocation of the navicular is presented. The authors propose that such a severe displacement cannot occur until there is complete instability across the whole midfoot. The mechanism of injury and the treatment options are discussed. In the present case, there was late collapse of the foot into abduction because the lateral column was not primarily stabilized. Avascular necrosis is a common complication which leads to navicular collapse. A midfoot arthrodesis gave a good result in our patient.- - - - - - - - - - ranking = 0.38289335005469keywords = injury (Clic here for more details about this article) |
5/594. Fat necks: modification of a standard surgical airway protocol in the pre-hospital environmental.We report two cases of trauma where a surgical airway was required. In both cases soft tissue swelling of the neck made modification of the Advanced Trauma life Support (ATLS) airway guidelines necessary. A gum elastic bougie was used to guide a standard endotracheal tube into a cricothyroidotomy incision and secure the airway. Slight departure from standard techniques may be required in difficult circumstances to achieve a definitive airway.- - - - - - - - - - ranking = 0.2keywords = trauma (Clic here for more details about this article) |
6/594. The abdominal compartment syndrome: a report of 3 cases including instance of endocrine induction.Three patients with the abdominal compartment syndrome are presented and discussed. In one of the patients the condition was induced in an endocrine fashion, since trauma was sustained exclusively by the middle third of the left leg. The development of the syndrome as a remote effect of local trauma has never been reported previously. In all three instances only insignificant amounts of intraperitoneal fluid was found and the increase in abdominal pressure was due to severe edema of the mesentery and retroperitoneum. Since the condition is highly lethal, early diagnosis is imperative, and this starts by carrying a high index of suspicion. Measurement of the intraperitoneal pressure easily confirms this diagnosis. It is emphasized that measurements at various sites, like bladder and stomach, in each patient is essential to confirm the diagnosis, since one of the sites may be rendered unreliable due to intraperitoneal processes impinging on the affected site and affecting its distensibility.- - - - - - - - - - ranking = 0.4keywords = trauma (Clic here for more details about this article) |
7/594. resuscitation of the multitrauma patient with head injury.head injury remains the leading cause of death from trauma. The definitive method for eliminating preventable death from traumatic brain injury remains elusive. New research underscores the danger of inadequate or inappropriate support of oxygenation, ventilation, and perfusion to cerebral tissues. The belief that sensitivity to hypotension makes the patient with head injury fundamentally different is critical to nursing strategies. The conventional concept that fluid restriction decreases cerebral edema in patients with head injury must be weighed against mounting evidence that aggressive hemodynamic support decreases the incidence of subsequent organ system failure and secondary brain injury. New evidence has triggered a scrutiny of conventional interventions. A search for optimal treatments based on prospective randomized trials will continue. Development of neuroprotective drugs and use of hypertonic saline may be on the horizon. In an effort to ensure optimal outcome, contemporary trauma nursing must embrace new concepts, shed outmoded therapy, and ensure compliance with the basic tenets of critical care for the multitrauma patient with head injury.- - - - - - - - - - ranking = 5.8448746753834keywords = injury, trauma, brain injury, traumatic brain injury, traumatic brain, brain (Clic here for more details about this article) |
8/594. High-energy bilateral talar neck fractures secondary to motocross injury.The authors present a case of bilateral Hawkins type II talar neck fractures sustained during a motocross race in a 23 year old man. Due to the complexity of the injuries, open reduction with internal fixation and primary subtalar joint arthrodesis was performed bilaterally. This is one of the few cases of bilateral talar neck fractures reported in the literature in the past 15 years and one of the first utilizing open reduction and internal fixation with concomitant subtalar joint arthrodesis as a primary treatment.- - - - - - - - - - ranking = 1.5315734002188keywords = injury (Clic here for more details about this article) |
9/594. Multivascular trauma on an adolescent. Perioperative management.Penetrating vascular injury, in particular at the neck, is a life-threatening trauma not only of the nature and the anatomic proximity of cardiovascular, aerodigestive, glandular and neurologic system but also of the development of early and late complications. The following case report describes our experience with a penetrating wound patient, who was admitted to our emergencies twelve hours after the accident. The only demonstrable objective signs included a large hematoma at the right-side of the neck and distended mediastinum on the chest X-ray. As the patient was cardiovascularly unstable he was immediately transported to the theater without any angiography. The mandatory operative exploration was initially unsuccessful and a median sternotomy with a standard cardiopulmonary bypass and deep hypothermia circulatory arrest was established to restore all the vascular lesions. Actually, the patient was in critical condition with a rupture of the right internal jugular vein, a large pseudoaneurysm of the innominate artery and an avulsion of the ascending aorta with the suspicion of a cardiac tamponade. The postoperative period lasted two full months, while complications appeared. The substantial message from this multivascular trauma is the early diagnosis of the life-threatening complications as exsanguinations, ventricular fibrillation and the ability to minimize postoperative complications, which will impair the normal functional life of the patient.- - - - - - - - - - ranking = 1.5828933500547keywords = injury, trauma (Clic here for more details about this article) |
10/594. aortic rupture as a result of low velocity crush.A case of aortic disruption in a 35 year old lorry driver is described. This occurred as a result of a low velocity crushing force. Clinicians should be aware that this mechanism of injury may result in aortic disruption as well as the more commonly mentioned severe deceleration force.- - - - - - - - - - ranking = 0.38289335005469keywords = injury (Clic here for more details about this article) |
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