Articles: trauma.
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Ulus Travma Acil Cer · May 2014
Psychiatric disorders and their association with burn-related factors in children with burn injury.
The aim of this study was to assess psychiatric disorders and their association with burn-related factors in a population of Turkish children with burns. ⋯ Pediatric burn patients are at risk of developing psychopathology. The children with a greater percentage of burned area to TBSA and more burned body regions have the greatest risk of psychopathology. Surgeons have an important role in patient referral for psychiatric interventions, so that psychiatric disorders can be prevented as early as possible.
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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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Although the relationship between psychoactive substance use and injury is known, evidence remains conflicting on the impact of substance use on clinical outcomes after injury. We hypothesized that preinjury substance use would negatively impact clinical outcomes. ⋯ Females and those aged >45 y are less likely to receive BASs and UDSs. Differential screening that is biased may place patients at risk for receiving inadequate care.
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Pediatric emergency care · May 2014
Analysis of Infant Lumbar Puncture Success Rates: Sitting Flexed Versus Lateral Flexed Positions.
The primary objective was to determine whether the sitting flexed position yields higher success rates of obtaining cerebrospinal fluid (CSF) for culture. The secondary objectives were to determine whether the sitting flexed position yields higher success rates of obtaining the following: CSF for cell count, non-traumatic CSF, and CSF on the first attempt. ⋯ The sitting flexed position was as successful as the lateral flexed position in the primary objective of obtaining CSF for culture and the secondary objectives of obtaining CSF for cell count and non-traumatic CSF. For the secondary objective of obtaining CSF on the first attempt, the sitting flexed position was associated with a higher rate of obtaining CSF on the first attempt in infants younger than 12 months.
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Injury-related coagulopathy is a complex process. We analyzed coagulation in a swine model of shock using rotational thromboelastometry (ROTEM). ⋯ ROTEM demonstrated the development of an acute coagulopathy. The most significant impacts on coagulopathy were seen with clot initiation and fibrin polymerization. Clot strength decreased over time, although there was little impact on clot breakdown because of fibrinolysis.