European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Current guidelines state that trauma patients at risk of spine injury should undergo prehospital spine immobilization to reduce the risk of neurological deterioration. Although this approach has been accepted and implemented as a standard for decades, there is little scientific evidence to support it. Furthermore, the potential dangers and sequelae of spine immobilization have been extensively reported. The role of the paramedic in this process has not yet been examined. The aim of this study was to evaluate the accuracy of prehospital evaluations for the presence of spine fractures made by paramedics. ⋯ The results of this study suggest that paramedics cannot accurately predict spinal fractures.
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Eur J Trauma Emerg Surg · Aug 2018
Searching for mortality predictors in trauma patients: a challenging task.
We aimed to study the value of new physiological variables compared with ISS and GCS as predictors for trauma mortality in a high-income developing country having a young population. ⋯ The physiological variables including GCS and shock index age were better predictors for trauma mortality comparted with ISS in our young population. A large global multi-centric study could possibly define an accurate global formula that uses both anatomical and physiological variables for predicting trauma mortality.
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Eur J Trauma Emerg Surg · Aug 2018
Using emergency trauma team activations to measure trauma activity and injury severity: 10 years of experience using an Australian major trauma centre registry.
To describe the outcomes of Emergency Department trauma team activations over a 10-year period with respect to injury severity and hospital length of stay. ⋯ Analysis of data from trauma team activations in ED has allowed a description of trauma activity and hospital bed day utilisation as a function of injury severity. The results confirm that those with minor trauma accounted for the vast majority of cases and around half of all hospital in-patient bed-days.
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Eur J Trauma Emerg Surg · Aug 2018
Review Meta AnalysisA systematic review and meta-analysis of the use of resuscitative endovascular balloon occlusion of the aorta in the management of major exsanguination.
Circulatory collapse is a leading cause of mortality among traumatic major exsanguination and in ruptured aortic aneurysm patients. Approximately 40% of patients die before hemorrhage control is achieved. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct designed to sustain the circulation until definitive surgical or endovascular repair. A systematic review was conducted for the current clinical use of REBOA in patients with hemodynamic instability and to discuss its potential role in improving prehospital and in-hospital outcome. ⋯ REBOA has been used in trauma patients and ruptured aortic aneurysm patients with improvement of hemodynamic parameters and outcomes for several decades. Formal, prospective study is warranted to clarify the role of this adjunct in all hemodynamic unstable patients.