Articles: trauma.
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Scand J Trauma Resus · Jan 2013
Comparative StudySuperimposed traumatic brain injury modulates vasomotor responses in third-order vessels after hemorrhagic shock.
Traumatic brain injury (TBI) and hemorrhagic shock (HS) are the leading causes of death in trauma. Recent studies suggest that TBI may influence physiological responses to acute blood loss. This study was designed to assess to what extent superimposed TBI may modulate physiologic vasomotor responses in third-order blood vessels in the context of HS. ⋯ Superimposed TBI modulated arteriolar and venular responses to HS in third-order vessels in a spinotrapezius muscle preparation. Further research is necessary to precisely define the role of TBI on the microcirculation in tissues vulnerable to HS.
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Scand J Trauma Resus · Jan 2013
Standard operating procedure changed pre-hospital critical care anaesthesiologists' behaviour: a quality control study.
The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists' behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation. ⋯ We have shown that the implementation of a standard operating procedure for pre-hospital controlled ventilation can significantly change pre-hospital critical care anaesthesiologists' behaviour.
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Traumatic Spinal Cord Injury (TSCI) is a condition where the neural elements suffer acute trauma, resulting in short-term or permanent sensory and motor problems. An understanding the underlying structural and functional biological repairs of the TSCI mechanisms has intensely increased over the last two decades. However, compared with the other fields in medicine, the present degree of treatment and care for TSCI are quite unsatisfactory. ⋯ However, research on TSCI has been very limited. Therefore, studies on the long-term incidence of TSCI in Saudi Arabia are vital and most essential to identify the high-risk groups, create awareness, establish trends, predict the needs, and thus contribute to effective health care planning of this condition. In this review, we discuss various aspects of TSCI in Saudi Arabia from the available literature.
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ABSTRACTObjective:Despite evidence that patients suffering major traumatic injuries have improved outcomes when cared for within an organized system, the extent of trauma system development in Canada is limited. We sought to compile a detailed inventory of trauma systems in Canada as a first step toward identifying opportunities for improving access to trauma care. Methods:We distributed a nationwide online and mail survey to stakeholders intended to evaluate the extent of implementation of specific trauma system components. ⋯ Conclusion:There is significant variability in the extent of trauma system development in Canada. Although all provinces have designated trauma centres, opportunities exist in many systems to implement additional components to improve the inclusiveness of care. In future work, we intend to quantify the strength of the relationship between different trauma system components and access to definitive trauma care.
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Editorial Comment
Eubaric hyperoxia: controversies in the management of acute traumatic brain injury.
Controversy exists on the role of hyperoxia in major trauma with brain injury. Hyperoxia on arterial blood gas has been associated with acute lung injury and pulmonary complications, impacting clinical outcome. The hyperoxia could be reflective of the physiological interventions following major systemic trauma. ⋯ The risk of low brain oxygen is most acute in the first 24 to 48 hours after injury. The administration of a high fraction of inspired oxygen (0.6 to 1.0) in the emergency room may be justifiable until ICU admission for the placement of invasive neurocritical care monitoring systems. Thereafter, fraction of inspired oxygen levels need to be careful titrated to prevent low brain oxygen levels.