J Trauma
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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.
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Randomized Controlled Trial Comparative Study
A survey of American Association for the Surgery of Trauma member practices in the management of blunt splenic injury.
Conflicting data exist regarding pseudoaneurysm screening (PSA-S), initial angioembolization (IE), deep venous thrombosis prophylaxis (DVT-P), and activity limitation after hemodynamically stable blunt splenic injury (BSI). To determine whether there was consensus regarding BSI management, the multi-institutional trial committee of the American Association for the Surgery of Trauma (AAST) approved a survey of member practice patterns regarding BSI management. ⋯ There is considerable variation in the opinions of AAST members regarding BSI management, particularly for high-grade injuries. These results will aid in the design of prospective observational and random trials to determine optimal BSI management.
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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.