European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2017
Observational StudyThe characteristics and pre-hospital management of blunt trauma patients with suspected spinal column injuries: a retrospective observational study.
Pre-hospital spinal immobilisation by emergency medical services (EMS) staff is currently the standard of care in cases of suspected spinal column injuries. There is, however, a lack of data on the characteristics of patients who received spinal immobilisation during the pre-hospital phase and on the adverse effects of immobilisation. The objectives of this study were threefold. First, we determined the pre-hospital characteristics of blunt trauma patients with suspected spinal column injuries who were immobilised by EMS staff. Second, we assessed the choices made by EMS staff regarding spinal immobilisation techniques and reasons for immobilisation. Third, we researched the possible adverse effects of immobilisation. ⋯ Spinal immobilisation was applied in 96.3 % of all included patients based on pre-hospital criteria. We found that consensus among EMS staff on how to interpret the criterion 'distracting injury' was lacking. Furthermore, the adverse effects of spinal immobilisation were incompletely documented in pre-hospital care reports. To provide validated information on potential symptoms of SCI, a uniform EMS scoring system for motoric assessment should be developed.
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Eur J Trauma Emerg Surg · Aug 2017
Low failure rate by means of DLBP fixation of undisplaced femoral neck fractures.
This study evaluated the clinical results of a new implant in the internal fixation of undisplaced femoral neck fractures. ⋯ The fixation of undisplaced femoral neck fractures by the DLBP resulted in a low failure rate of 4 %.
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Eur J Trauma Emerg Surg · Aug 2017
ReviewVolume replacement during trauma resuscitation: a brief synopsis of current guidelines and recommendations.
Intravascular volume and fluid replacement are still cornerstones to correct fluid deficits during early trauma resuscitation, but optimum strategies remain under debate. ⋯ Volume replacement at a reduced level in severely injured and bleeding trauma patients is advocated (permissive hypotension) until the bleeding is controlled. ATLS principles with Hb, BE, and/or lactate can assess perfusion, estimate/monitor the extent of bleeding/shock, and guide therapy. Isotonic crystalloid solutions are first-line and specific recommendations apply for patients with TBI.
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Eur J Trauma Emerg Surg · Aug 2017
Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study.
The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. ⋯ The tested model was evaluated as an accurate tool to determine SC. The results illustrate that SC cannot be determined by testing one single function in the hospital, since all functions interact with each other and different functions can be identified as limiting factors at different times during the response.
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Eur J Trauma Emerg Surg · Aug 2017
Comparative StudyA novel nail providing more biomechanical rotational and axial stability than conventional interlocking nail in femur complex fracture model.
Inter-fragmentary rotational and axial instabilities are major challenges in nailing of complex or comminuted fractures. We aimed to compare the inter-fragmentary rotational and axial stability of novel anti-rotation interlocking nail and the conventional interlocking nail in complex or comminuted femur shaft fractures. ⋯ An anti-rotational novel nail is superior to the conventional interlocking nail in terms of maximum inter-fragmentary rotational and axial stabilities in complex and comminuted femur shaft fractures.