Ulus Travma Acil Cer
-
We aimed to compare different fluids indicated in volume replacement in multiple trauma patients, enlightening the indications, mechanisms of action and side effects. An extensive review of references (indexed journals) between 1997 and 2008 was performed. There is not yet a consensus about which fluids should be used in trauma patients. ⋯ Gelatins are no longer used in developed countries due to their insignificant ability regarding volume expansion when compared to crystalloids and the potential risks of anaphylactic reactions. The crystalloids are used more in trauma, even if some authors prefer the use of colloids, which can produce a quicker restoration of the intravascular volume. No convincing evidence shows a clear superiority of colloids over crystalloids for restoration of the volume depletion.
-
Ulus Travma Acil Cer · May 2009
Review Case ReportsManagement algorithm for intestinal obstruction due to ascariasis: a case report and review of the literature.
Ascaris lumbricoides is the largest and most prevalent of the human helminths. Ascariasis causes a unique type of intestinal obstruction with specific problems, having high morbidity and mortality. There is no management algorithm available in the literature to treat such cases. ⋯ The management of intestinal obstruction due to ascariasis was challenging and required difficult decisions. We think that this algorithm will be of great assistance in facilitating a rapid and successful treatment. This algorithm may prove to be of a great value for physicians treating such cases.
-
Ulus Travma Acil Cer · Oct 2008
Review[War surgery in the 21st century: current approach to trauma cases].
Death caused by trauma is a major social problem in both the military and the civilian world. The goal is to reduce injuries and deaths to acceptable limits. ⋯ Significant changes have occurred recently in the treatment of trauma cases. In our study, we aimed to search the literature in order to describe the principles of proper medical approach, to review the operational strategies recommended in the field and to develop a consensus to the extent possible.
-
Hemorrhage is the leading cause of trauma-related deaths. The early identification and surgical control of this hemorrhage is the crucial first step in the management of the injured patient; however, this objective remains challenging in the most critically ill trauma patients. As an adjunct to traditional methods of surgical hemorrhage control, several advanced hemostatic agents are currently available. ⋯ Materials such as Zeolite and Chitosan comprise the newest generation of local hemostatics and the efficacy and safety of these agents are currently under investigation. Recombinant factor VIIa has emerged recently as a promising systemic hemostatic adjunct for the treatment of intractable surgical bleeding; however, until completion of the ongoing multinational randomized control trial, the indications for its use in trauma patients and its safety profile are unclear. This article reviews the role of commercially available local and systemic hemostatic products in the trauma patient population; it also addresses the unique set of characteristics, indications, limitations and rationale for their use.
-
Trauma is tissue damage caused by an extrinsic force. The stress response comprises an activation of neurohumoral and physiologic process that would lead to improved survivability of an untreated organism following a traumatic injury. The sequelae of inadequate pain control following an injury are more than physiological. ⋯ Early or even preemptive treatment of pain have been shown to reduce analgesic requirements over time. Individual patients will have widely variant requirements for pain medications, so induction of analgesia must be carefully adjusted, ideally in a closely monitored environment. Pharmacotherapy and interventional methods can be used in a wide variety for the management of pain in trauma and burns.