Articles: trauma.
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Pediatric emergency care · Sep 2014
Case ReportsCentral cord syndrome in a 7-year-old boy secondary to standing high jump.
Acute traumatic central cord syndrome is commonly associated with major trauma such as falling and motor vehicle crash, but minor or nontraumatic causes are very rare in children. As a consequence, most physicians frequently overlook children presenting with complaints of arm weakness when history of any definite major trauma does not exist, especially in the emergency department. We present the case of a 7-year-old boy who was experiencing weakness in both arms after a standing high jump with tilting his head back in school. ⋯ Magnetic resonance imaging of the cervical spine revealed observable swelling with increased signal intensity at C1 to 4 levels. This case showed a spinal cord injury caused by standing high jump with neck extension alone. Therefore, the physicians have to consider the possibility of spinal cord injury even without any history of major trauma.
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Evaluation of: Hampton DA, Lee TH, Diggs BJ, McCully SP, Schreiber MA. A predictive model of early mortality in trauma patients. Am. ⋯ This was incorporated with haemoglobin level, international normalized ratio, Glasgow Coma Score and the presence of penetrating injury to form their five-variable mortality prediction model. Hampton et al. conclude that the correlation between r-TEG measurements and trauma mortality makes it a useful tool in mortality prediction. The report highlights the importance of using this point-of-care coagulation assessment machine in mortality prediction for trauma patients.
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Pediatric emergency care · Sep 2014
Risk Factors for Apnea in Children Presenting With Out-of-Hospital Seizure.
This study aimed to quantify risk factors for apnea in children 0 to 5 years of age with out-of-hospital seizure. ⋯ Field treatment with diazepam and seizing at the time of PED arrival are associated with the occurrence of apnea in children 0 to 5 years of age with out-of-hospital seizure. Larger studies are needed to determine what other factors may contribute to this risk.
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Palliative medicine · Sep 2014
Utilization and determinants of palliative care in the trauma intensive care unit: results of a national survey.
There is a paucity of data evaluating utilization of palliative care in trauma intensive care units. ⋯ Although a plurality of trauma surgeons reported palliative care beneficial, those surveyed indicate that palliative care is underutilized. Barriers identified provide important opportunities to further appropriate utilization of palliative care services.
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Secondary injury following initial spinal cord trauma is uncommon and frequently attributed to mismanagement of an unprotected cord in the acute time period after injury. Subacute posttraumatic ascending myelopathy (SPAM) is a rare occurrence in the days to weeks following an initial spinal cord injury that is unrelated to manipulation of an unprotected cord and involves 4 or more vertebral levels above the original injury. The authors present a case of SPAM occurring in a 15-year-old boy who sustained a T3-4 fracture-dislocation resulting in a complete spinal cord injury, and they highlight the imaging findings and optimum treatment for this rare event.