J Trauma
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Comparative Study
Blast injuries: bus versus open-air bombings--a comparative study of injuries in survivors of open-air versus confined-space explosions.
To compare injury patterns resulting from explosions in the open air versus within confined spaces. ⋯ Explosions in confined spaces are associated with a higher incidence of primary blast injuries, with more severe injuries and with a higher mortality rate in comparison with explosions in the open air.
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Thoracic trauma victims commonly sustain visceral pleural injury with resultant pneumothorax. These injuries usually respond to standard tube thoracostomy decompression and drainage. However, a subset of these patients develop recurrent and/or loculated pneumothoraces or pneumatoceles that are not readily accessible by tube thoracostomy. Percutaneous catheter drainage of these collections provides a safe and reliable method of management in critically ill patients.
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Motorcycle drivers have the highest frequency of alcohol use among all road users. This study examines alcohol use among a large sample of injured motorcycle drivers and examines how crash characteristics differ with the use of alcohol. ⋯ Alcohol use remains a significant factor in motorcycle crashes and is an important area for injury prevention efforts.
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Critical care consumes a significant portion of health care costs. Although there are currently increasing pressures to limit expenditures, data are not always available to allow physicians and patients to make informed therapeutic or triage decisions regarding prolonged intensive care unit (ICU) stays. The purpose of this study was to evaluate long-term outcome, quality of life, and charges in surgical patients requiring prolonged ICU stays (> 14 days). ⋯ In this population, prolonged ICU stays resulted in acceptable quality of life and a relatively high survival rate despite significant economic investment. This study does not support withdrawal of therapy or triage decisions based solely or primarily on age or length of ICU stay.
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Impalement occurs when a portion of the body is penetrated by a rigid object. These injuries incorporate aspects of both blunt and penetrating type injuries in that the object or the body at time of impact is traveling at relatively low velocity and the energy is dissipated over a short distance. ⋯ Evaluation of these injuries can be uniquely challenging. We present a case of impalement of the neck from an object previously unreported in the literature, a golf club shaft.