The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2012
Multicenter Study Comparative StudyEvaluation of multidetector computed tomography for penetrating neck injury: a prospective multicenter study.
The purpose of this prospective multicenter study was to evaluate a clinical protocol integrating multidetector computed tomographic angiography (MDCTA) as the initial screening examination for the work-up of penetrating neck injury. ⋯ II, prospective study.
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J Trauma Acute Care Surg · Mar 2012
ReviewEffects on mortality, treatment, and time management as a result of routine use of total body computed tomography in blunt high-energy trauma patients.
Currently, total body computed tomography (TBCT) is rapidly implemented in the evaluation of trauma patients. With this review, we aim to evaluate the clinical implications-mortality, change in treatment, and time management-of the routine use of TBCT in adult blunt high-energy trauma patients compared with a conservative approach with the use of conventional radiography, ultrasound, and selective computed tomography. ⋯ Current literature has predominantly suboptimal design to prove terminally that the routine use of TBCT results in improved survival of blunt high-energy trauma patients. TBCT can give a change of treatment and improves time intervals in the emergency department as compared with its selective use.
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J Trauma Acute Care Surg · Mar 2012
Multicenter Study Comparative StudyHomicide as a medical outcome: racial disparity in deaths from assault in US Level I and II trauma centers.
Since 1900, thousands of medical journal articles have been published on the topic of racial disparities in health and medical outcomes in the United States, including overlapping disparities based on health insurance status. But research on the question of such disparities in the medical treatment of injury from assault-matters of public safety, considerable public expense, and policy debate-is lacking. ⋯ I, prognostic study.
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J Trauma Acute Care Surg · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyImpact of prehospital mode of transport after severe injury: a multicenter evaluation from the Resuscitation Outcomes Consortium.
There is ongoing controversy about the relative effectiveness of air medical versus ground transportation for severely injured patients. In some systems, air medical crews may provide a higher level of care but may require longer transport times. We sought to evaluate the impact of mode of transport on outcome based on analysis of data from two randomized trials of prehospital hypertonic resuscitation. ⋯ III.
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J Trauma Acute Care Surg · Mar 2012
Comparative StudyThe value of cervical magnetic resonance imaging in the evaluation of the obtunded or comatose patient with cervical trauma, no other abnormal neurological findings, and a normal cervical computed tomography.
The value of magnetic resonance imaging (MRI) in the evaluation of the obtunded or comatose patient with a potential neck injury is a controversial subject. Some authors have suggested that MRI of the cervical spine adds no value in the evaluation of patients with a normal computed tomography (CT) of the neck. However, others have suggested that MRI is the gold standard for clearing the cervical spine in a clinically suspicious or unevaluatable blunt trauma patient. The purpose of this study is to evaluate our data in regard to these conflicting hypotheses. ⋯ The addition of a cervical MRI to the evaluation protocol of obtunded or comatose patients with an otherwise normal neurologic examination and a normal cervical CT did not provide any additional useful information to change the management of these patients.