J Trauma
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Historically, the carrying of concealed firearms has been either substantially restricted or prohibited outright. Over the past two decades, laws making it easier for civilians to obtain permits allowing them to carry concealed weapons legally have proliferated throughout the United States. This study investigates the effect of such changes in state laws on state homicide rates. ⋯ The current findings are consistent with those of other published studies indicating that nondiscretionary concealed weapon laws are not associated with significant increases or decreases in homicide.
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Comparative Study
Management of blunt thoracic aortic injuries: endovascular stents versus open repair.
Endovascular stent graft (EV) technology has been successfully adapted to the repair of blunt traumatic aortic injuries. The purpose of this study was to compare the outcomes of patients treated with EV repair and open repair after blunt thoracic aortic trauma. ⋯ We observed a clear trend toward improved outcomes after EV repair of thoracic aortic injuries compared with standard open repair. EV repair is emerging as the preferred method of repairing blunt thoracic aortic injuries in trauma patients with multiple injuries.
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Comparative Study
Helical computed tomographic angiography for the diagnosis of traumatic arterial injuries of the extremities.
The radiologic study of choice for evaluation of traumatic arterial injuries is conventional arteriography, but it poses the risks of an invasive procedure. Computed tomographic arteriography (CTA) is emerging as a new way to study arterial anatomy, with the additional advantages of being noninvasive and a technique that allows evaluation of different body areas simultaneously. Our experience using CTA for evaluation of traumatic arterial injuries is provided in this study. ⋯ CTA is a reliable technique for the detection and characterization of traumatic extremity arterial injuries. These results suggest CTA may be an alternative to conventional arteriography for the diagnosis of traumatic arterial injuries.
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Surgeon-performed ultrasound has become ubiquitous in the trauma suite. Initial reports suggest that sonography may be used for the detection of pneumothorax. The purpose of this study was to evaluate the efficacy of sonography to rule out the presence of a pneumothorax in the trauma population. ⋯ Ultrasound is a reliable modality for the diagnosis of pneumothorax in the injured patient. This modality may serve as an adjunct or precursor to routine chest radiography in the evaluation of injured patients.
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The purpose of this study was to determine the relationship of cerebral hypoxia with admission Glasgow Coma Scale (GCS) score, brain computed tomographic (CT) severity, cerebral perfusion pressure (CPP), and survival in patients with severe brain injury. ⋯ Cerebral hypoxia is common, even with CPP > or = 70, and is associated with GCS score, CT scan severity, and mortality. Cerebral hypoxia is related to cerebral hypoperfusion. Additional studies may prove that Stco2 monitoring will enhance the treatment of severe brain injury.