J Trauma
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Randomized Controlled Trial Clinical Trial
The effects of inflation of antishock trousers on hemodynamics in normovolemic subjects.
Antishock trousers may maintain mean arterial pressure in trauma patients by increasing central blood volume and cardiac output. Hemodynamics, end-diastolic volume, stroke volume, cardiac output, and blood pressure were recorded in eight supine, healthy men in antishock trousers using two-dimensional echocardiography. Two inflation protocols were used. ⋯ The study shows that the antishock trousers alter several hemodynamic parameters. With lower inflation pressures, antishock trousers cause an increase in arterial pressure by increasing peripheral resistance. At higher inflation pressures, the antishock trousers increase cardiac output and as the cardiovascular system adjusts, maintain the pressure by increasing peripheral resistance.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of methods of cervical immobilization used in patient extrication and transport.
We radiographically studied the efficacy of seven methods of cervical immobilization used in the prehospital setting. The methods were: Philadelphia collar, Hare extrication collar, rigid plastic collar, Philadelphia collar + short board, Hare extrication collar + short board, rigid plastic collar + short board, and the short board used alone. Ninety-seven normal volunteers were randomized to one of these seven methods and each volunteer served as his or her own control. ⋯ The short-board technique appeared to be superior to all the three collars studied. The collars provided no augmentation of immobilization over that provided by the short board alone. We believe that the short-board technique described herein, which is commonly used in the prehospital setting, can be used as the standard of comparison against which newer prehospital devices can be objectively compared.
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Randomized Controlled Trial Clinical Trial
Prophylactic antibiotics and no antibiotics compared in penetrating chest trauma.
Conflicting data exist concerning the value of antimicrobial prophylaxis in chest trauma. In a prospective and randomized study, we assessed the value of antibiotic prophylaxis in 80 consecutive relatively young, predominantly male patients admitted for gunshot or knife injuries of the chest. Forty patients received intravenous doxycycline and 40 received no antibiotic. Between the two groups we found no difference in the incidence of postoperative infections: we conclude that routine antibiotic prophylaxis is not recommended in penetrating chest trauma in patients such as ours.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prolonged tracheal intubation in the trauma patient.
Over a 15-month period, 74 trauma patients who were expected to require extended intubation were studied prospectively to evaluate the appropriateness of tracheostomy. Patients were randomized to receive either early (34) or late (40) tracheostomies. ⋯ Significantly more complications occurred in rigid-posture, head-injured patients than in any other trauma grouping, but there was no significant difference in the complication incidence between the two tracheostomy groups within that classification. We conclude that patients can undergo translaryngeal intubation for up to 2 weeks without significantly increasing complications relative to transtracheal intubation.
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Randomized Controlled Trial Clinical Trial
Colles' fractures treated by plaster and polyurethane braces: a controlled clinical study.
In a prospective randomized controlled trial polyurethane casts and traditional plaster-of-Paris braces were compared in 46 cases of Colles' fractures of the forearm. Secondary fracture dislocation, subjective inconveniences, and the need for secondary adjustment of the cast were recorded. ⋯ In comparison with plaster the synthetic bandage is lighter, water repellent, and hardens faster, and as far as circular bandages are concerned, they have zippers. It is concluded that polyurethane braces are a good supplement to plaster-of-Paris bandage in such fractures and recommended in selected cases.