J Trauma
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To determine if pre-existing conditions significantly improve the ability of current (TRISS and ASCOT) methods for predicting survival of patients with trauma from low falls. ⋯ Pre-existing conditions and male gender are significantly related to survival of patients with trauma from low falls, and should be included along with age and the various physiologic and anatomic measures currently being used to predict survival for those patients.
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To assess the teaching effectiveness of the Advanced Trauma Life Support (ATLS) Program among senior medical students. ⋯ Using highly reliable trauma OSCE stations we have demonstrated trauma management skills acquisition by senior medical students after the ATLS course.
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Typical bilateral cheiro-oral syndrome was encountered in a 74-year-old man who had bilateral subdural hematoma after a minor head injury. The delayed grave neurologic deficits occurred 1 month later without expansion of the hematoma. Removal of the lesions reversed both cheiro-oral syndrome and his late-onset neurological disabilities.
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The purpose of this study was to attempt to identify those blunt trauma patients in whom expensive diagnostic studies such as computed tomography and diagnostic peritoneal lavage are unnecessary to exclude intra-abdominal injury. The medical records of 1096 blunt trauma patients evaluated at an urban level I trauma center were reviewed. Because of the urgent need to exclude intra-abdominal hemorrhage in patients with hypotension (blood pressure < 90 mm Hg), and the difficulty in obtaining reliable information from abdominal examination in patients with Glasgow Coma Scale scores < 11 or spinal cord injury, 140 patients meeting these criteria were reviewed but excluded from statistical analysis. ⋯ All of the 44 significant intra-abdominal injuries occurred in the group of 253 patients that had either an abnormal abdominal examination, one of the statistically significant risk factors, or both, for a sensitivity of 100%. Of the 703 patients with a normal abdominal examination and no risk factors, none had a significant abdominal injury, for a negative predictive value of 100%. This study suggests that patients with either an abnormal abdominal examination or one of the two statistically derived risk factors require adjunctive diagnostic evaluation with diagnostic peritoneal lavage or computed tomography scan to exclude intra-abdominal injury.(ABSTRACT TRUNCATED AT 250 WORDS)
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Analyses were conducted to estimate the effectiveness of airbags in reducing driver fatalities in motor vehicle crashes. ⋯ Various estimates of airbag effectiveness are beginning to yield consistent results. These analyses confirm that driver airbags are reducing fatalities in the frontal crashes for which they are designed.