Articles: trauma.
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Review Comparative Study
Preemies to Preschoolers: Tubing Tiny Tots and Trauma FAQs, Part 1.
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Chronic diastasis of the syndesmosis has been recognized as a cause of persistent pain and dysfunction after a rotational ankle injury. Recently, there has been an increased effort to define the use of computed tomography (CT) imaging in making this diagnosis; however, no clear consensus has been reached on the best way to assess the anatomical integrity of the syndesmosis. In this retrospective case series, we have evaluated the diagnostic capability of 2 novel CT-based measurements. ⋯ Level IV, diagnostic.
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Journal of neurotrauma · May 2014
Alcohol Intoxication and its Effects on Traumatic Spinal Cord Injury Outcomes.
There are sparse data regarding the impact of alcohol on in-hospital complications associated with traumatic spinal cord injuries (TSCIs). We set out to quantify the impact of alcohol on TSCI outcomes and its influence on health care cost and utilization. The National Trauma Data Bank (NTDB) Research Data Set version 7.2 (2000-2006) was utilized to gather data between 2007 and 2009. ⋯ Further, there was a statistically significant association with the presence alcohol and increased risk for pulmonary, pneumonia, deep vein thrombosis and pulmonary embolism, urinary tract infection, and ulcer/skin complications. Alcohol intoxication is associated with increased in-hospital morbidity. The significant association with in-hospital complications increases health resource utilization after spinal cord injury.
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The control of torso and junctional zone bleeding in combat casualties is particularly challenging because of its noncompressible nature. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has demonstrated promise in translational large animal and early clinical series as an effective resuscitation and hemorrhage control adjunct. However, it is unknown what proportion of combat casualties has an injury pattern and clinical course that is amenable to REBOA deployment. ⋯ The median (interquartile range) time to death in patients dying en route was 75 (42-109) min, and the median prehospital time for casualties admitted to hospital was 61 (34-89) min. One-in-five severely injured UK combat casualties have a focus of hemorrhage in the abdomen or pelvic junctional region potentially amenable to REBOA deployment. The UK military should explore REBOA as a potential en route hemorrhage control and resuscitation adjunct.
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The aim of this study was to evaluate the safety and efficacy of a new intravenous (IV) regular human insulin infusion (RHI) algorithm for glycemic control in critically ill patients with renal failure. ⋯ The new RHI algorithm improved patient safety by decreasing the prevalence of moderate hypoglycemia and eliminating severe hypoglycemia. The duration of glycemic control within the target BG range was decreased, but acceptable within a higher target BG ceiling.