Articles: trauma.
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Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.
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Observational Study
Requirement for a structured algorithm in cardiac arrest following major trauma:Epidemiology, management errors, and preventability of traumatic deaths in Berlin.
Despite continuous innovation in trauma care, fatal trauma remains a significant medical and socioeconomic problem. Traumatic cardiac arrest (tCA) is still considered a hopeless situation, whereas management errors and preventability of death are neglected. We analyzed clinical and autopsy data from tCA patients in an emergency-physician-based rescue system in order to reveal epidemiologic data and current problems in the successful treatment of tCA. ⋯ Trauma CPR is beyond routine with the need for a tCPR-algorithm, including chest/pericardial decompression, external pelvic stabilization and external bleeding control. The prehospital trauma management has the highest potential to improve tCPR and survival. Therefore, we suggested a pilot prehospital tCPR-algorithm.
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DVT/PE PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Chest computed tomography (CT) has replaced angiography and ventilation/perfusion scanning as the diagnostic method of choice for pulmonary embolism. This study reviews the indications and outcomes of chest CT scanning in the setting of a non-trauma based community hospital Emergency Department (ED) in an effort to develop a "best practice" guideline that optimizes patient care while minimizing radiation exposure and cost. ⋯ The following authors have nothing to disclose: Thomas Willson, Benjamin Larsen, Matthew Blecha, Mark Connolly, Francis PodbielskiNo Product/Research Disclosure Information.
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Ulus Travma Acil Cer · Mar 2014
Randomized Controlled TrialComparison of diagnostic peritoneal lavage and focused assessment by sonography in trauma as an adjunct to primary survey in torso trauma: a prospective randomized clinical trial.
Lately, Focused Assessment with Sonography in Trauma (FAST) is preferred over diagnostic peritoneal lavage (DPL) as adjunct to primary survey. However, this is not evidence-based as there has been no randomized trial. ⋯ This study shows that DPL is better than FAST.
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Pleural Disease/Pneumothorax PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Management of secondary spontaneous pneumothorax (SSP) is more complex than the primary spontaneous pneumothorax (PSP), often requiring multiple interventions. There is paucity of data comparing the efficacy of various treatment strategies in SSP. Current British Thoracic Society guidelines recommend considering needle aspiration (NA) in symptomatic patients with small SSP. We looked at the efficacy of NA versus Intercostal Tube (ICT) drainage as the first intervention; outcomes included immediate successful re-inflation, length of stay (LOS) and recurrence at 1 year. ⋯ The following authors have nothing to disclose: Muhammad Ganaie, Shiva Bikmalla, Masood Khalil, Muhammad Afridi, Mohammed Haris, Imran HussainNo Product/Research Disclosure Information.