Eur J Trauma Emerg S
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A compartment syndrome is an increased tissue pressure within a closed osteofascial compartment. This compromises blood flow to the muscles and nerves within that compartment, which -if not treated adequately in an early stage-results in permanent tissue and nerve damage. It most frequently occurs in the lower leg, but can also occur elsewhere when muscles are enclosed in tight fascial compartments, such as the forearm and hand. ⋯ Possibly a wet-suit or dry-suit offers some protection. However, the duration of strangulation determines much of the damage. Although diagnosis of a compartment syndrome can be difficult, a high index of suspicion combined with fast and adequate treatment with a fasciotomy improve outcome and prognosis.
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Eur J Trauma Emerg S · Feb 2009
Evaluation of Quality of Trauma Care in a Local Hospital Using a Customization of ASCOT.
Evaluating processes of care and outcomes of injured patients are important if improvements in the quality of care delivered to injured patients are to be accomplished. We applied a customized ASCOT model developed from our database as a tool to criticize the quality of care in a local hospital. ⋯ We believe that a customization of ASCOT model when used for evaluation of quality of care in a local hospital can be useful for detection of defects and improvement of the process of care delivered to the patients.
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Eur J Trauma Emerg S · Feb 2009
Clinical Risk Factors for Hip Fracture in Young Adults Under 50 Years Old.
Established risk factors for hip fracture exist for older individuals. Young adults (less than 50 years old) presenting with hip fractures have received little attention. ⋯ Our data suggest that intravenous drug abusers under 50 are a particular group that we should be targeting for intervention strategies.
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Eur J Trauma Emerg S · Feb 2009
Cost-Drivers in Acute Treatment of Severe Trauma in Europe: A Systematic Review of Literature.
Throughout the world, trauma is a leading cause of morbidity and mortality in the young and most active group of society. While specialist trauma centers play a critical role in the survival after severe trauma, the assessment of trauma-related costs, budgeting for adequate trauma capacity, and determining the cost-effectiveness of interventions in critical care are fraught with difficulties. Through a systematic review of the European literature on severe trauma, we aimed to identify the key elements that drive the costs of acute trauma care. ⋯ Irrespective of the idiosyncrasies of the national healthcare systems in Europe, severity of injury, length of stay in ICU, surgical interventions and transfusion requirements represent the key drivers of acute trauma care for severe injury.
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Eur J Trauma Emerg S · Feb 2009
Hemorrhage is More Prevalent than Brain Injury in Early Trauma Deaths: The Golden Six Hours.
Under the trimodal distribution, most trauma deaths occur within the first hour. Determination of cause of death without autopsy review is inaccurate. The goal of this study is to determine cause of death, in hourly intervals, in trauma patients who died in the first 24 h, as determined by autopsy. ⋯ The temporal distribution of the cause of death varies in the first 24 h after admission. Hemorrhage should not be overlooked as the cause of death, even after survival beyond 1 h. Understanding the temporal relationship of causes of early death can aid in the targeting of management and surgical training to optimize patient outcome.