The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Nov 2013
Comparative StudyFrom the barn to the operating room and back: the Amish way of life leads to improved throughput and outcomes following trauma.
The Amish culture is known for simple living, reluctance to use modern technology, and a heavy emphasis on church and family relationships. We hypothesized that the strong work ethic and social structure of the Amish would lead to improved outcome following trauma. ⋯ Epidemiologic, level III.
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J Trauma Acute Care Surg · Nov 2013
Randomized Controlled Trial Comparative StudyBrain-type natriuretic peptide and right ventricular end-diastolic volume index measurements are imprecise estimates of circulating blood volume in critically ill subjects.
Surrogate indicators have often been used to estimate intravascular volume to guide fluid management. Brain-type natriuretic peptide (BNP) has been used as a noninvasive adjunct in the diagnosis of fluid overload and as a marker of response to therapy, especially in individuals with congestive heart failure. Similarly, right ventricular end-diastolic volume index (RVEDVI) measurements represent another parameter used to guide fluid resuscitation. The aim of this study was to evaluate whether BNP and RVEDVI are clinically valuable parameters that can distinguish among hypovolemia, euvolemia, and hypervolemia, as measured by blood volume (BV) analysis in critically ill surgical subjects. ⋯ Diagnostic study, level III.
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J Trauma Acute Care Surg · Nov 2013
Comparative StudyThe value of digital rectal examination in assessing for pelvic fracture-associated urethral injury: what defines a high-riding or nonpalpable prostate?
The Advanced Trauma Life Support Manual (8th ed.) recommend a digital rectal examination (DRE) as part of the initial evaluation of all trauma patients. A "high-riding" or "nonpalpable" prostate is a contraindication to urethral catheterization and an indication for urethrography. However, there are no published guidelines on, definitions of, or predictive values for high riding. Moreover, prostate evaluation can be difficult in the supine/trauma position. ⋯ Epidemiologic study, level V.