J Trauma
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Multicenter Study Comparative Study
Variable application and misapplication of cricoid pressure.
In 1961, Sellick described a three-finger technique of cricoid pressure used to prevent gastric regurgitation during induction of anesthesia. The "Sellick maneuver" is now used worldwide. The authors have observed great variability in the application of cricoid pressure by health care providers and have suspected that misapplication occurs. The objectives of this observational study were to determine how many different techniques of cricoid pressure were being used and to identify the reasons for such variability of technique. ⋯ This observational study demonstrates that there is great variability in the application of cricoid pressure, identifying 10 different techniques in 32 observations. Misapplication does occur with possible patient harm. We suggest four possible reasons for this variability of technique. The authors use the three-finger cricoid pressure technique as originally described by Sellick and thought that this technique is effective, easy to teach, and safely keeps the fingers in the midline of the cricoid cartilage.
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Comparative Study
New intramedullary locking nail for olecranon fracture fixation--an in vitro biomechanical comparison with tension band wiring.
The aim of this study was to determine the difference in displacement of a newly designed intramedullary olecranon fracture fixation device compared with multifilament tension band wiring after 4 cycles and 300 cycles of dynamic continuous loading. ⋯ The newly designed interlocking nailing system showed higher stability in comparison with multifilament tension band wiring after continuous dynamic loading.
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Reported iatrogenic injury to the proximal femoral vascular structures is rare after retrograde femoral nailing. Previous cadaveric dissections have recommended placement of proximal interlocking screws above the level of the lesser trochanter. ⋯ No true safe zone corridor exists anteriorly for placement of AP interlocking screws in this region. Surgical technique modifications are suggested to minimize the potential risks of iatrogenic arterial injury during retrograde femoral nail AP proximal interlocking.
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Comparative Study
Bicyclists injured by automobiles: relationship of age to injury type and severity--a national trauma databank analysis.
Bicycle riding is a popular recreational activity and a common mode of transportation. Impact with a motor vehicle, however, has the potential to result in significant injury to the rider. The magnitude of this problem, the incidence and types of injuries, and the effect of age on these variables are poorly defined in the literature. ⋯ Bicycle-related injuries involving motor vehicles are associated with a high incidence of head injuries and extremity fractures. Age plays a critical role in the severity and anatomic distribution of injuries sustained, with a stepwise increase in mortality with increasing age. Further evaluation of specific preventative measures, especially for elderly bicyclists is warranted.
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Comparative Study
Use of force by law enforcement: an evaluation of safetyand injury.
Little is known about the frequency and types of injuries sustained from law enforcement use of force (UOF). The purpose of this study was to examine injury patterns and subject conditions after law enforcement UOF under real-life conditions. ⋯ Significant injuries related to law enforcement UOF in one city were rare and the only deaths were related to firearm use. A large percentage of those subjected to UOF had diagnoses of substance abuse and/or psychiatric conditions, and most hospital admissions were for problems unrelated to the UOF.