J Trauma
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Significant controversy surrounds the prehospital management of trauma patients. ⋯ Most trauma practitioners believe that emergency medical services providers should attempt intubation for a patient with a severe traumatic brain injury, should treat decompensated shock in a patient with penetrating torso trauma but maintain the patient in a relatively hypotensive state, and should apply and inflate the pneumatic antishock garment for a suspected pelvic fracture accompanied by decompensated shock if the patient is 20 to 40 minutes from a trauma center. The recommendations of trauma practitioners regarding appropriate prehospital care are significantly influenced by the time required for transport to the trauma center.
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This study sought to determine the time from hospital presentation to surgical intervention for hemodynamically stable patients with abdominal stab wounds. The objective was to identify the optimal time for observation of these asymptomatic patients before safe hospital discharge. ⋯ It appears that asymptomatic patients with abdominal stab wounds may be discharged from the hospital after 12 hours of observation with little likelihood of missed injury.
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Comparative Study
The current status of road user injuries among the elderly in Germany: a medical and technical accident analysis.
The incidence and treatment of injuries involving the elderly road user are of increasing importance for all fields of trauma care to ensure the best possible outcomes. ⋯ A high rate of motor injuries is associated with vehicle accidents and increased levels of severity among the elderly population. This finding is especially evident for elder pedestrians and bicyclists. Also of note, the elderly even appear to be at risk for sustaining an increased level of injury severity when they are restrained or belt protected.
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Substance abuse is associated with injuries, but these associations have not been well characterized by type of substance and injury type. ⋯ Alcohol and cocaine use is independently associated with violence-related injuries, whereas opiate use is independently associated with nonviolent injuries and burns.