J Trauma
-
Multicenter Study Comparative Study
Blunt traumatic occult pneumothorax: is observation safe?--results of a prospective, AAST multicenter study.
An occult pneumothorax (OPTX) is found incidentally in 2% to 10% of all blunt trauma patients. Indications for intervention remain controversial. We sought to determine which factors predicted failed observation in blunt trauma patients. ⋯ Most blunt trauma patients with OPTX can be carefully monitored without tube thoracostomy; however, OPTX progression and respiratory distress are independently associated with observation failure.
-
Randomized Controlled Trial Comparative Study
Removing a patient from the spine board: is the lift and slide safer than the log roll?
After spine board immobilization of the trauma victim and transport to the hospital, the patient is removed from the spine board as soon as practical. Current Advanced Trauma Life Support's recommendations are to log roll the patient 90 degrees, remove the spine board, inspect and palpate the back, and then log roll back to supine position. There are several publications showing unacceptable motion in an unstable spine when log rolling. ⋯ Spine boards can be removed using a lift-and-slide maneuver with less motion and potentially less risk to the patient's long-term neurologic function than expected using the log roll.
-
Comparative Study
The relationship between INR and development of hemorrhage with placement of ventriculostomy.
This study seeks to evaluate the relationship between the risk of symptomatic hemorrhage from ventriculostomy placement and International Normalized Ratio (INR) in patients who received a ventriculostomy after traumatic brain injury. ⋯ In this retrospective study, INRs between 1.2 and 1.6 appeared to be acceptable for a neurosurgeon to place an emergent ventriculostomy in a patient with traumatic brain injury.