J Trauma
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Comparative Study
Tracheostomy in thermally injured patients: does diagnosis-related group 483 adequately estimate resource use and hospital costs?
This study compares burn and nonburn patients undergoing tracheostomy, all of whom were assigned to diagnosis-related group 483 to determine hospital reimbursement. ⋯ Burn patients requiring tracheostomies during their acute hospitalization consume significantly more resources than patients without burn injuries. More appropriate resource-based reimbursement for the care of these patients appears warranted.
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To examine the effect of change in velocity (MV) and energy dissipation (IE) on impact, above and below the test levels for federal motor vehicle crash (MVC) safety standards, on the incidence of aortic injury (AI) and its mortality and associated injury patterns in frontal (F) and lateral (L) MVCs. Comparison of 80 AI and 796 non-AI patients of AIS=3. ⋯ The implications for AI of the focused IE at the upper chest suggest a probable mechanism for MVC AI with the pressurized aortic arch acting as the long arm of a lever system with the fulcrum at the subclavian artery, producing maximum torsional strain at the short arm of the isthmus where 75% of the AIs occurred. AI mortality is also influenced by the associated injuries. To develop more effective safety systems to prevent AI, MVC safety testing with airbags and seatbelts should be carried out at DeltaVs of 1 SD above means for FMVC and LMVC.
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Comparative Study
The sternal fracture: radiographic analysis of 200 fractures with special reference to concomitant injuries.
The assessment of the sternal fracture and concomitant injuries is discussed. ⋯ The observation of fracture morphology and topography, with reference to displacement, gives important information about the existence of serious concomitant injuries and can determine further diagnostic and therapeutic options in sternal fractures.
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As HBOC-201 improves outcome in animals with hemorrhagic shock (HS), we compared HBOC-201 and HEX (used by U.S. military special operations forces) in a swine model of delayed evacuation and uncontrolled HS. ⋯ Despite evidence of vasoactivity, HBOC-201 more effectively stabilized tissue oxygenation, reversed anaerobic metabolism, decreased bleeding, and increased survival in comparison with HEX. If confirmed in clinical trials, these data suggest that for the resuscitation of combat casualties with delayed evacuation and uncontrolled HS due to solid organ injury, HBOC-201 is a superior low-volume resuscitative fluid.
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Comparative Study
Pediatric trauma in southwestern Ontario: linking data with injury prevention initiatives.
Our objective was to provide an epidemiologic description of pediatric trauma in SW Ontario using multiple data sets. Injury prevention (IP) initiatives were linked with predominant injury mechanisms to determine whether IP programs were supported by data. ⋯ Injury is a serious problem for children in SW Ontario. Data can be used to identify modifiable risk factors to develop and implement new IP initiatives with the goal of reducing childhood injury and death. There is a need to integrate and link IP programs in SW Ontario for full coverage of all injury mechanisms.