Injury
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Recent terrorist attacks and mass shooting incidents in major European and North American cities have shown the unexpected influx of large volumes of patients with complex multi-system injuries. The rise of subspecialisation and the low violence-related penetrating injuries among European cities, show the reality that most surgical programs are unable to provide sufficient exposure to penetrating and blast injuries. The aim of this study is to describe and create a collaborative program between a major South African trauma service and a NATO country military medical service, with synergistic effect on both partners. This program includes comprehensive cross-disciplinary training & teaching, and scientific research. ⋯ This study has shown a significant volume of penetrating trauma in South Africa, that can provide substantial exposure over a relatively short period. This help to prepare civilian and military surgeons and deployable military medical personnel for casualties with blast - and/or penetrating injuries. The aforementioned findings and the willingness to shape the mutual benefits, create a platform for trauma electives, research, education and training.
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Multicenter Study
Elevated blood alcohol impacts hospital morality following motorcycle injury: A National Trauma Data Bank analysis.
Motorcyclists who drink and drive are at a higher risk of death and disability than other types of drivers. The purpose of this study was to query a national trauma database to evaluate the impact of elevated blood alcohol concentration (BAC) on outcomes in patients who sustained injury following a motorcycle crash. ⋯ Patients who tested with a BAC above the legal limit sustained a higher injury severity score and higher in-hospital mortality compared to patients who tested negative.
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Indications for nonoperative management (NOM) after penetrating renal injury remain ill-defined. Using a national database, we sought to describe the experience of operative and nonoperative management in the United States and retrospectively examine risk factors for failure of NOM. ⋯ NOM is highly successful in selected patients. Concomitant abdominal injuries and higher grade AAST injuries predict NOM failure and should be considered when selecting patients for IO or NOM.
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Evaluation of immediate total-body CT (iTBCT) scouts during primary trauma care could be clinically relevant for early detection and treatment of specific major injuries. The aim of this study was to determine the diagnostic usefulness of TBCT scouts in detecting life-threatening chest and pelvic injuries. ⋯ iTBCT scouts can be useful for early detection of pneumo- and/or hemothorax and severe pelvic fractures. Decision for chest tube placement based on iTBCT scouts alone is not recommended.
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Multicenter Study
Over view of major traumatic injury in Australia--Implications for trauma system design.
Trauma registries are known to drive improvements and optimise trauma systems worldwide. This is the first reported comparison of the epidemiology and outcomes at major centres across Australia. ⋯ Australia has the capability to identify national injury trends to target prevention and reduce the burden of injury. Quality of care following injury can now be benchmarked across Australia and with the planned enhancements to data collection and reporting, this will enable improved management of trauma victims.