J Trauma
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Analyses were conducted to estimate the effectiveness of airbags in reducing driver fatalities in motor vehicle crashes. ⋯ Various estimates of airbag effectiveness are beginning to yield consistent results. These analyses confirm that driver airbags are reducing fatalities in the frontal crashes for which they are designed.
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Triage decisions must be based on accurate information with a valid understanding of injury patterns and their sources. Only a data base that includes both medical and collision factors can best provide the breadth of information required to achieve this goal. In the study reported here we assessed the accuracy of automobile collision data collected by emergency physicians compared with Police Accident Reports. ⋯ When data obtained by emergency physicians are compared with the information in Police Accident Reports, there are notable differences on several collision factors. Triage decisions must be based on accurate information with a valid understanding of injury patterns and their sources. Only a data base that includes both medical and collision factors can best provide the breadth of information required to achieve this goal.
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Comparative Study
Hypertonic acetate dextran achieves high-flow-low-pressure resuscitation of hemorrhagic shock.
For resuscitation of hemorrhagic hypovolemia, we compared the effectiveness of (1) isotonic lactated Ringer's solution (LRS), (2) 2400 mOsm of 7.5% NaCl:6% dextran 70 (HSD), and (3) 2400 mOsm of 7.9% sodium acetate:1.9% NaCl:6% dextran 70 (HAD). ⋯ Small-volume infusion with HAD resulting in "high-flow-low-pressure" resuscitation may offer unique hemodynamic and metabolic advantages for the initial treatment of hemorrhage from trauma.
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Reconstruction of soft tissue defects on the lower half of the leg. ⋯ The distally based medial adipofascial flap was a reliable and effect local flap for the reconstruction of soft tissue defects on the lower half of the leg.