J Trauma
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Multicenter Study Comparative Study
Scottish urban versus rural trauma outcome study.
Outcome following trauma and health care access are important components of health care planning. Resources are limited and quality information is required. We set the objective of comparing the outcomes for patients suffering significant trauma in urban and rural environments in Scotland. ⋯ Long prehospital times in the rural environment were not associated with differences in mortality or length of stay in moderately and severely injured patients in the west of Scotland. This may lend support to a policy of rationalization of trauma services in Scotland.
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Randomized Controlled Trial
The role of acute blood transfusion in the development of acute respiratory distress syndrome in patients with severe trauma.
Patients with major trauma necessitating the transfusion of packed red blood cells (PRBCs) are at increased risk for the acute respiratory distress syndrome (ARDS). However, it is presently unknown whether the amount of transfused blood is independently associated with development of ARDS in patients with severe trauma. ⋯ In severely injured trauma patients who require administration of packed red blood cells, the amount of transfused blood is independently associated with both the development of ARDS and hospital mortality.
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Multicenter Study Clinical Trial
Emergent stabilization of pelvic ring injuries by controlled circumferential compression: a clinical trial.
Pelvic ring injuries are associated with a high incidence of mortality mainly due to retroperitoneal hemorrhage. Early stabilization is an integral part of hemorrhage control. Temporary stabilization can be provided by a pelvic sheet, sling, or an inflatable garment. However, these devices lack control of the applied circumferential compression. We evaluated a pelvic circumferential compression device (PCCD), which allows for force-controlled circumferential compression. In a prospective clinical trial, we documented how this device can provide effective reduction of open-book type pelvic injuries without causing overcompression of lateral compression type injuries. ⋯ A PCCD can effectively reduce pelvic ring injuries. It poses a minimal risk for overcompression and complications as compared with reduction alternatives that do not provide a feedback on the applied reduction force.
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Comparative Study Clinical Trial
Diagnosis of occult scaphoid fracture with high-spatial-resolution sonography: a prospective blind study.
Evaluation of diagnostic accuracy of high-spatial-resolution sonography (HSR-S) in occult scaphoid fractures. ⋯ HSR-S is a reliable, available, and cost-effective method in early diagnosis of occult fractures of the scaphoid. The presence of three defined criteria is required to assess the diagnosis.
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A novel, visual display of selected evidence regarding emergency resuscitative thoracotomy is presented as a brief review.