Articles: trauma.
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Contemporary war-related studies focus primarily on adults with few reporting the injuries sustained in local pediatric populations. The objective of this study is to characterize pediatric vascular trauma at US military hospitals in wartime Iraq and Afghanistan. ⋯ This study is the first to report vascular trauma in a pediatric population at wartime. Vascular injuries involve a high percentage of extremity and torso wounding. Torso vascular injury in children is four times lethal relative to other injury patterns, and therefore should be considered in operational planning both in the military and civilian setting regarding pediatric vascular injuries.
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Massive posttraumatic bleeding is the leading cause of potentially preventable death among patients with severe trauma. Immediate diagnosis and treatment of traumatic coagulopathy and its differentiation from surgical bleeding after major trauma are critical in the management of such patients. ⋯ Therapy based on massive transfusion protocol and on laboratory coagulation tests would be insufficient to stop bleeding. We conclude that rotational thromboelastometry/thromboelastography analysis plays a critical role in the management of traumatic bleeding and helps us provide more aggressive and targeted therapy for coagulopathy both in the acute and later phases of treatment of severe bleeding.
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Cardiovascular CasesSESSION TYPE: Case ReportsPRESENTED ON: Saturday, March 22, 2014 at 04:15 PM - 05:15 PMINTRODUCTION: Central venous catheters (CVC) are placed in large caliber veins, and though relatively safe, complications can occur. When chest radiograph cannot verify proper CVC placement, further assessments are mandated. We present a case of questionable placement of a left-sided CVC. ⋯ The following authors have nothing to disclose: Andrew Oh, Timothy QuastNo Product/Research Disclosure Information.
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Pleural Case Report PostersSESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Thoracic splenosis should be suspected in a patient with pulmonary nodules and history of splenic trauma. ⋯ In conclusion, thoracic splenosis is considered a benign process, and should be suspected in a patient with any CT or MRI demonstrating left pulmonary nodules with history of splenic trauma. Though new non invasive studies are available and are preferred to the invasive studies, the CT guided biopsy was done to rule out malignancy found on the initial chest CT.Reference #1: Malik U (2010). Parenchymal Thoracic Splenosis: history and nuclear imaging without invasive procedures may provide diagnosis. J Clin Med Res. 2(4),180-184.Reference #2: Mancano A (2012). Thoracic splenosis after thoracoabdominal trauma presenting as pleural nodules. Lung. 190(6), 699-701.Reference #3: Sahin E. (2009). Thoracic splenosis accompanied by diaphragmatic hernia. Can J Surg. 52, E293-294DISCLOSURE: The following authors have nothing to disclose: Ashraf Elsawaf, Jonathan Banibensu, Heather BoakyeNo Product/Research Disclosure Information.
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Determining the appropriate disposition of emergency department (ED) syncope patients is challenging. Previously developed decision tools have poor diagnostic test characteristics and methodological flaws in their derivation that preclude their use. We sought to develop a scale to risk-stratify adult ED syncope patients at risk for serious adverse events (SAEs) within 30 days. ⋯ We derived a risk scale that accurately predicts SAEs within 30 days in ED syncope patients. If validated, this will be a potentially useful clinical decision tool for emergency physicians, may allow judicious use of health care resources, and may improve patient care and safety.