Injury
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Extrication of entrapped patients from car accidents takes time. To save time a new technique based on reversing the forces of the original crash by anchoring the rear of the vehicle and pulling the steering wheel and the front window pillars forward with chains is developed. ⋯ It took significantly longer (s) with the standard than the new technique to start extrication [(60 (45, 70) versus 30 (30, 40), confidence interval (CI) 5-40, P=0.009], to patient free in the front seat [514+/-102 versus 238+/-72, CI 163-389, P=0.001], backboard in place [543+/-102 versus 295+/-76, CI 132-363, P=0.001], and patient on the stretcher ready for transport to the hospital [617+/-112 versus 387+/-65, CI 112-347, P=0.001]. Avoiding uncontrolled movements in the wreck was not more difficult with the new than the standard technique.
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Randomized Controlled Trial Clinical Trial
Assessment of the trauma evaluation and management (TEAM) module in Australia.
To assess the immediate effect on trauma-related knowledge of the trauma evaluation and management (TEAM) program applied to medical students in Australia. ⋯ After the TEAM program there was significant improvement in cognitive skills. The students strongly supported its introduction in the undergraduate curriculum.
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Randomized Controlled Trial Clinical Trial
Effects of hypertonic dextran in hypovolaemic shock: a prospective clinical trial.
The aim of this paper is to report the results of prospective clinical trials of hypertonic saline dextran (HSD) in the resuscitation of hypovolaemic shock in critically injured patients. There are many types of fluids, which can be administered intravenously. ⋯ The plasma osmolarity, sodium and potassium levels were significantly elevated in patients resuscitated with HSD. Urine output recovered rapidly and was well maintained throughout.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intramedullary hip screw versus sliding hip screw for unstable intertrochanteric femoral fractures in the elderly.
We report a randomised, prospective study comparing a standard sliding hip screw and the intramedullary hip screw for the treatment of unstable intertrochanteric fractures in the elderly. One hundred and two patients were randomised on admission to two treatment groups. Fifty-two patients were treated with a compression hip screw (CHS), and fifty had intramedullary fixation with an intramedullary hip screw (IMHS). ⋯ There were two technical complications in the CHS group and three in the IMHS group. There was no significant difference between the two groups in radiological or functional outcome at 12 months. It remains to be shown whether the theoretical advantages of intramedullary fixation of extracapsular hip fractures bring a significant improvement in eventual outcome.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tibial intramedullary nail distal interlocking screw placement: comparison of the free-hand versus distally-based targeting device techniques.
Intramedullary nailing is the standard treatment for closed and some open unstable diaphyseal tibia fractures. Fluoroscopy, while essential for proper nail placement can subject the surgical team and patient to substantial radiation. A new targeting system for tibia nail distal interlocking was developed by Orthofix to limit fluoroscopy. ⋯ Neither was there a statistically significant difference in the mean fluoroscopy time prior to distal interlocking (69 vs. 81 s, p=0.22) nor in the total fluoroscopy time (84 vs. 117 s). There was however, a statistically significant difference between the Orthofix and free-hand groups with regards to the mean fluoroscopy time during distal interlocking (15 vs. 36 s, P=0.01, respectively). This study demonstrates that the distally based distal targeting device by Orthofix for tibial nailing can significantly decrease the mean fluoroscopy time necessary to complete distal interlocking versus free-hand technique.