European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2019
ReviewDetermination of mis-triage in trauma patients: a systematic review.
Mis-triage including undertriage and overtriage is associated with morbidity and mortality. It is not clear what the extent of mis-triage rates among traumatic patients is. The aim of this study is to determine of mis-triage (undertriage and overtriage) in traumatic patients. ⋯ The standardization of mis-triage definitions is vital to estimate true rate of mis-triage among different studies and clarify the role of triage scales. The trauma triage scales need to be further developed to provide more valid and reliable results.
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Eur J Trauma Emerg Surg · Oct 2019
Comparative StudyComparison of PECARN and CATCH clinical decision rules in children with minor blunt head trauma.
Computerized brain tomography (CBT) imaging plays a key role in the management of patients with head trauma, and there is an indication for CBT in moderate and severe injuries. However, it is difficult to determine an indication for CBT in patients with minor head trauma. The primary aim of this study is to compare the efficiency of the most commonly used clinical decision rules: the guidelines of the Pediatric Emergency Care Applied Research Network (PECARN), and those of the Canadian Assessment of Tomography for Childhood Head Injury (CATCH). ⋯ While both PECARN and CATCH were found to be effective in determining the necessity of CBT for children with minor blunt head trauma, PECARN proved to be more useful for emergency services because of its higher sensitivity. The authors suggest that conducting a CBT scan based on clinical decision rules may be a suitable approach for early detection of the presence of intracranial acute pathologies in young children with minor blunt head trauma, especially if the GCS score is < 15 and non-frontal hematomas are present.
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Eur J Trauma Emerg Surg · Oct 2019
Penetrating femoral artery injuries: an urban trauma centre experience.
This study reviews a single centre experience with penetrating femoral artery injuries. ⋯ This study has a primary and secondary amputation rate of 2.5 and 6.5%, respectively. There was greater than 90% limb salvage rate. The outcome of threatened limbs due to femoral artery injury is good, provided that there is no delay to surgery.
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Eur J Trauma Emerg Surg · Oct 2019
Informing prehospital care planning using pilot trauma registry data in Yaoundé, Cameroon.
About 54% of deaths in low- and middle-income countries (LMICs) are attributable to lack of prehospital care. The single largest contributor to the disability-adjusted life years due to poor prehospital care is injury. Despite having disproportionately high injury burdens, most LMIC trauma systems have little prehospital organization. An understanding of existing prehospital care patterns in LMICs is warranted as a precursor to strengthening prehospital systems. ⋯ Possible areas for prehospital trauma care strengthening include training lay commercial vehicle drivers in trauma care and formalizing triage, referral, and communication protocols for prehospital care to optimize timely transfer and care while minimizing secondary injury to patients.
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Eur J Trauma Emerg Surg · Oct 2019
Blunt splenic injury in children: haemodynamic status key to guiding management, a 5-year review of practice in a UK major trauma centre.
To review the management of children and adolescents (0-18 years), with blunt splenic injury treated at a single UK major trauma centre over a 5-year period, focusing upon efficacy of non-operative management and the use of haemodynamic stability as a guide to planning treatment strategy, rather than radiological injury grading. To produce a treatment pathway for management of blunt splenic injury in children. ⋯ Non-operative management should be first-line treatment in the haemodynamically stable child with a blunt splenic injury and may be carried out with a high degree of efficacy. It may also be successfully implemented in those initially showing signs of haemodynamic instability that respond to fluid resuscitation. Radiological injury grade does not predict definitive management, level of care, or length of stay; however, haemodynamic stability may be utilised to produce a treatment algorithm and is key to guiding management.