Eur J Trauma Emerg S
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Medical technology has benefited many types of patients, but trauma care has arguably benefited more from technologic development than almost any other field. ⋯ The advances in trauma care are in great measure due to the integration of many different systems. Medical technology impacts care in the field at the site of the trauma, in the transport to trauma facilities, and care at the trauma center itself. Once at the hospital, technology has impacted care in the trauma bay, intensive care units, the operating room, and in postoperative and long-term care settings. The integration of advancements, however, needs to be examined in a careful systematic fashion to insure that patients will actually derive benefit.
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Trauma remains the leading cause of death in the world in patients under 45 years of age. The evaluation, resuscitation, and appropriate management of polytraumatized patients are paramount to successful outcomes. The advance of evidence-based medicine has had a powerful and positive impact on trauma care, even though the nature of many traumatic injuries lends itself poorly to study in a randomized fashion. ⋯ For abdominal trauma, the concept of damage control surgery, while popular, has never been put to the test in a randomized controlled trial. Numerous randomized trials in the field of critical care have affected the management of severely injured patients, including intensive insulin therapy and low tidal volume ventilation in patients with compromised respiratory function. Finally, a multidisciplinary approach to trauma care in designated trauma centers allows for improved outcomes in polytraumatized patients.
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Eur J Trauma Emerg S · Jun 2012
Patient influx and trauma types in a front-line hospital and a secondary referral hospital after the Wenchuan earthquake: a retrospectively comparative study.
To better understand the differences of patient influx and types of trauma between front-line and referral hospitals after the Wenchuan earthquake, so as to improve the efficiency of injury management. ⋯ There were dramatically different features in terms of quake-related patient influx and types of injury between the epicenter and less-affected hospitals.
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The organization of trauma care has different perspectives that depend on regional aspects. Among these, geographical peculiarities, historical developments regarding development of medical subspecialties and resident education appear to be the most relevant factors. ⋯ This manuscript deals with the differences of several trauma systems in certain European countries, the USA and Australia. It aims to provide an overview of the peculiarities and influences of these systems on the clinical management. However, the effect of differences in organization in different countries on patient outcome is difficult to assess. There appears to be consensus on the fact that structured treatment for acute trauma care is beneficial for trauma patients. Thus, any kind of organization contributes to improved patient outcome.
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Rectal injuries, which are rarely encountered because of the anatomic characteristics, occur due to penetrating traumas. In the current study, we aimed to present experiences gleaned from our clinic concerning rarely encountered unusual rectal injuries, including those cases presented for the first time. ⋯ The results of the current study suggested that primary repair is adequate in the patients with low-energy injuries and early presentation, whereas an ostomy is required for those with late presentation and for those with high-energy and destructive injuries.