The American journal of emergency medicine
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The purpose of this study was to define whether the semiquantitative analysis of hemoperitoneum increases the accuracy of early prediction of massive transfusion (MT). ⋯ The assessment of the size of hemoperitoneum on admission substantially improves the prediction of MT in trauma patients and should be used to trigger and guide initial haemostatic resuscitation.
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Comparative Study
Anterior-posterior compression pelvic fracture increases the probability of requirement of bilateral embolization.
Transarterial embolization has become an effective method in the management of pelvic fracture-related retroperitoneal hemorrhage. However, the selection of bilateral embolization or selective unilateral embolization remains controversial. The anterior-posterior compression (APC) pelvic fracture creates a complete diastasis of the anterior pelvis, which might be associated with bilateral sacroiliac joint injuries and further bilateral arterial injuries. In the current study, we evaluated the correlation between APC pelvic fracture and the need for bilateral internal iliac artery (IIA) embolization. ⋯ In the management of APC pelvic fracture, more attention should be paid to the higher probability of bilateral hemorrhage. Bilateral IIA embolization should be considered in patients with APC pelvic fracture.
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Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events. ⋯ Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties.
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Review Case Reports
Empty toe: a unique type of closed degloving injury with dismal outcome.
Closed degloving injury is characterized by the development of soft tissue separated from underlying structure without outer skin disruption. “Empty toe” is one of the most unique types of closed degloving injuries. Only 4 such injuries have been reported previously. We demonstrate a case of this entity in a 20-year-old scooter passenger. ⋯ The fifth toe was eventually amputated. An empty toe implies that the injured site has experienced severe compressive and shearing force with potential neurovascular damage. Health care providers should be fully aware of the high risk of the probability of vascular insufficiency, and the viability would be associated with vascular capability.
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Multicenter Study
Gender differences in emergency stroke care and hospital outcome in acute ischemic stroke: a multicenter observational study.
We aimed to investigate the effect of gender difference on the accessibility to emergency care, hospital mortality and disability in acute stroke care. ⋯ The adjusted model for risk factors showed no significant difference on hospital mortality and disability between the 2 genders for stroke patients.