J Trauma
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To determine the value of calculating an ocular trauma score (OTS) for patients with open-globe injuries. OTS evaluating system can provide valuable prognostic information, and its use may be an asset in counseling patients with open-globe injuries. ⋯ In open-globe injuries, a commonly accepted system for calculating ocular trauma score (OTS) can provide reliable prognostic information.
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Accurate data regarding intimate partner violence is difficult to obtain, particularly when examining only homicides or trauma registries. This study characterizes firearm violence against women by examining data from both the county coroner and an urban level I trauma center. ⋯ IP firearm assaults against women may be underrepresented in current databases. These assaults are highly lethal, frequently occur at home, and often involve head injury. These observations may lend to strategies for trauma prevention.
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Personnel sustaining combat-related injuries in current overseas conflicts continue to have their care complicated by infections caused by multidrug-resistant organisms, including Acinetobacter, Klebsiella, and Pseudomonas. Although presumed to be due to multiple factors both within and outside of the combat theater, concern has been raised about the difficulties in establishing and maintaining standard infection control (IC) practices in deployed medical treatment facilities and in the evacuation of the injured back to the United States. ⋯ Effective IC practices are often difficult to maintain in modern US hospitals. In the deployed setting, with ever-changing personnel in a less than optimal practice environment, IC is even more challenging. Standardization of practice with emphasis on the basics of IC practice (e.g., hand hygiene and isolation procedures) needs to be emplaced and maintained in the deployed setting.
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Computed tomography (CT) is routinely performed in traumatic brain injury (TBI). Magnetic resonance imaging (MRI) is considered more sensitive than CT for subtle abnormalities. Because CT does not always explain the posttraumatic neurologic examination, MRI is being performed with increasing frequency. Although MRI at a later stage may be of significant prognostic value, the role of early MRI is questionable. Our objective was to evaluate the role of early MRI in the initial management of patients with TBI. ⋯ Early MRI may be superior to CT in describing subtle TBI findings, but this information does not affect management. Head CT is the only imaging test necessary in the first 48 hours after TBI.
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Early recognition of coagulopathy may improve the care of patients with multiple injuries. Rapid thrombelastography (RapidTEG) is a new variant of thrombelastography (TEG), in which coagulation is initiated by the addition of protein tissue factor. The kinetics of coagulation and the times of measurement were compared for two variants of TEG--RapidTEG and conventional TEG, in which coagulation was initiated with kaolin. ⋯ There were significant correlations between the RapidTEG results and those from kaolin TEG and conventional coagulation tests. RapidTEG is the most rapid available test for providing reliable information on coagulopathy in patients with multiple injuries. This has implications for improving patient care.