Articles: trauma.
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Wilderness Environ Med · Dec 2013
Comparative StudyEffect of advanced trauma life support (ATLS) on the time needed for treatment in simulated mountain medicine emergencies.
The number of tourists exploring mountainous areas continues to increase. As a consequence, rescue operations are increasing, especially for trauma and polytrauma victims. The outcome of such patients depends greatly on the duration of the prehospital stabilization. Limited medical training of mountain rescuers may adversely affect the outcome of patients. There is no study investigating high altitude trauma treatment. The aim of this study is to analyze the impact of advanced trauma life support (ATLS) principles in mountain trauma, and to discuss a possible role of ATLS in mountain medicine education programs. ⋯ ATLS principles adapted and implemented for high altitude medicine education may have a positive impact on high altitude trauma treatment and outcomes.
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Review Meta Analysis
Meta-analysis of plasma to red blood cell ratios and mortality in massive blood transfusions for trauma.
The current military paradigm for blood transfusion in major trauma favours high plasma:RBC ratios. This study aimed determine whether high plasma:red blood cell (RBC) ratios during massive transfusion for trauma decrease mortality, using meta-analysis of contemporaneous groups matched for injury severity score. ⋯ In groups matched for ISS, there was a survival benefit with high plasma:RBC resuscitation ratios. No additional benefits of 1:1 over 1:2 ratios were identified.
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Haemorrhage from major trauma is a significant cause of death worldwide. The UK Defence Medical Service (UK-DMS) has had significant experience in managing severely injured and shocked trauma casualties over the last decade. This has led to the integration of rotational thromboelastometry (ROTEM) into damage control resuscitation delivered at Camp Bastion Field Hospital in Afghanistan. This review aims to describe the rationale for its use and how its use has evolved by UK-DMS. ⋯ ROTEM provides a means to rapidly assess coagulation in trauma casualties, allowing targeted use of blood products. It provides information on clot initiation strength and breakdown. However, its use in trauma has still to be fully evaluated.
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This article reviews the latest operative trauma surgery techniques and strategies, which have been published in the last 10 years. Many of the articles we reviewed come directly from combat surgery experience and may be also applied to the severely injured civilian trauma patient and in the context of terrorist attacks on civilian populations. ⋯ The last 10 years of conflict has produced a wealth of experience and novel techniques in operative trauma surgery. The articles we review here are essential for the contemporary care of the severely injured trauma patient, whether they are card for in a level 1 trauma center or in a field hospital at the edge of a battlefield.