J Trauma
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Randomized Controlled Trial Comparative Study
Airway scope versus macintosh laryngoscope in patients with simulated limitation of neck movements.
Tracheal intubation in patients with suspected neck injuries should achieve two contradicting goals-sufficient laryngeal exposure and the least cervical spine movement. Because the former involves displacements of the cervical vertebrae, intubation under immobilization is widely performed today to prevent exacerbation of spinal code injuries. The unique curving blade of the Airway Scope (AWS) is designed to fit the oropharyngeal anatomy. A camera at the tip of the blade displays the view of the larynx, but unlike the direct laryngoscope, it needs no line-of-sight of the oral, pharyngeal, and tracheal axis. Our purpose is to determine whether AWS could be a suitable airway device for the intubation of patients with potential neck injury. ⋯ In neck-immobilized patients using semi-rigid cervical collars, AWS improves laryngeal exposure and facilitates tracheal intubation. AWS may be a suitable intubation device for trauma patients.
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Federal law prohibits firearm possession by felons and certain others. Little is known about criminal activity resulting in new ineligibility to possess firearms among persons who have previously purchased them. ⋯ Among legal purchasers of handguns, the incidence of new felonious and violent criminal activity resulting in ineligibility to possess firearms is low for those with no prior criminal history but is substantially higher for those with a prior criminal record and is affected by demographic characteristics.
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High-energy tibial plateau fractures may present with an acute or impending compartment syndrome requiring emergent fasciotomy. There is little information regarding the optimal management of the fasciotomy wound with respect to the subsequent definitive internal fixation of the tibial plateau fracture. The purpose of this study was to compare the rate of infection complication after internal fixation of tibial plateau fractures in patients requiring fasciotomy for compartment syndrome with patients in whom a fasciotomy was not required. ⋯ Definitive internal fixation of tibial plateau fractures in the presence of open fasciotomy wounds does not seem to be associated with an increased infection risk.
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Comparative Study
Ventilator-associated pneumonia in trauma patients is associated with lower mortality: results from EU-VAP study.
Differences in trauma patients developing ventilator-associated pneumonia (VAP) are described regarding etiology and risk factors associated. We aim to describe the differences in outcomes in trauma and nontrauma patients with VAP. ⋯ Trauma patients developing VAP had different demographic characteristics and episodes of etiology. After adjustment for potential confounders, VAP episodes in trauma patients are associated with lower mortality when compared with nontrauma patients.