Articles: trauma.
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Diagn Interv Imaging · Mar 2014
Review Comparative StudyUltrasonography of the brachial plexus, normal appearance and practical applications.
Ultrasound examination of the brachial plexus, although at first sight difficult, is perfectly feasible with fairly rapid practical and theoretical training. The roots are accurately identified due to the shape (a single tubercle) of the transverse process of C7 in the paravertebral space, and the superficial position of C5 in the interscalene groove. ⋯ In trained hands, it also provides information in thoracic outlet syndromes, traumatic conditions (particularly for postganglionic lesions) and tumoral diseases. Even if MRI remains the standard examination in these indications, ultrasound, with its higher definition and dynamic character, is an excellent additional method which is still under-exploited.
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Clinical Trial Observational Study
Plasma Colloid Osmotic Pressure is an Early Indicator of Injury and Hemorrhagic Shock.
Hemorrhagic shock is the leading cause of traumatic deaths; many could be potentially prevented with appropriate resuscitation. However, to initiate resuscitation, one must identify patients with hemorrhagic shock early. In this article, we determined the associations between plasma colloid osmotic pressure (COP) and clinical outcomes in severely injured trauma patients. ⋯ Reduced plasma COP and serum protein in trauma patients are indicative of injury severity. In the absence of significant alterations in vital signs, plasma COP levels were associated with increased requirements for blood products and increased syndecan 1 shedding. We believe that plasma COP provides new insight in guiding resuscitation.
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Can J Public Health · Mar 2014
Traumatic and other non-natural childhood deaths in Manitoba, Canada: a retrospective autopsy analysis (1989-2010).
The goals of analyzing all non-natural childhood deaths in Manitoba for the 22-year period (1989-2010) are to highlight preventable causes of death and to document temporal trends that might be influenced by changes in society. ⋯ Most non-natural childhood deaths in Manitoba might be avoidable through education about prevention strategies and by correction of social inequities. Improved transportation to hospital from remote locations would likely have little impact on survival.
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Admission hypocoagulability has been associated with negative outcomes after trauma. The purpose of this study was to determine the impact of hypercoagulability after trauma on the need for blood product transfusion and mortality. ⋯ Approximately a quarter of trauma patients presented in a hypercoagulable state. Hypercoagulable patients required less blood products, in particular plasma. They also had a lower 24-h and 7-day mortality and lower rates of bleeding-related deaths. Further evaluation of the mechanism responsible for the hypercoagulable state and its implications on outcome is warranted.
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Multicenter Study
Tourniquet use for peripheral vascular injuries in the civilian setting.
Haemorrhage in peripheral vascular injuries may cause life-threatening exsanguination. Tourniquets are used extensively by the military, with increased interest in the civilian setting to prevent deaths. This is a retrospective study of trauma patients at two large Canadian trauma centres with arterial injury after isolated extremity trauma. We hypothesized that tourniquet use may decrease mortality rate and transfusion requirements if applied early. ⋯ Tourniquets may prevent exsanguination in the civilian setting for patients suffering either blunt or penetrating trauma to the extremity. Future studies will help determine the utility of deploying tourniquets in the civilian setting, given the rarity of exsanguinating haemorrhage from isolated extremity trauma in this setting.