Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Apr 2012
Prehospital HMG Co-A reductase inhibitor use and reduced mortality in hemorrhagic shock due to trauma.
3-Hydroxy-3-methyl-glutaryl Co-A reductase inhibitors (HMG Co-A reductase inhibitors, statins) are commonly used medications for the control of serum cholesterol. Recent data suggests that these medications also modify the inflammatory pathways in sepsis, septic shock, and hemorrhagic shock due to ruptured abdominal aortic aneurysms. Statin use in hemorrhagic shock due to trauma, however, has conflicting data, with one study showing improvement, but only in certain subsets of patients. ⋯ Prehospital HMG Co-A reductase use was associated with improved survival in a population with severe trauma and evidence of ongoing hemorrhagic shock.
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Eur J Trauma Emerg S · Apr 2012
Delays in diagnosis in early trauma care: evaluation of diagnostic efficiency and circumstances of delay.
Trauma centers, trauma management concepts, damage control surgery and the integration of whole-body CT scanning into early trauma care have reduced mortality in traumatized patients significantly. However, some injuries are still initially missed. In this study, the diagnostic efficiency of early trauma care and the circumstances of delays in diagnosis were evaluated. ⋯ Although diagnostic quality in early trauma care has improved, some diagnoses are initially missed. Severely injured patients with life-threatening or potentially life-threatening injuries arriving at the ER during on-call hours were at higher risk for delays in diagnosis. A secondary evaluation of acquired CT data and repetitive examinations are essential.