Articles: trauma.
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Eur J Trauma Emerg S · Apr 2009
Is the Grading of Liver Injuries a Useful Clinical Tool in the Initial Management of Blunt Trauma Patients?
Computed tomography (CT) has become the preferred method for evaluation of the abdomen for victims of blunt trauma. Grading of liver injuries, primarily by CT, has been advocated as a measure of severity and, by implication, the likelihood for intervention or complications. We have sought to determine if grading of liver injuries, as a clinical tool, affects immediate or extended management of patients. ⋯ In conclusion, grading of liver injuries does not seem to influence immediate management. Physiologic behavior dictated management and need for operative intervention, as well as prognosis. However, both major hepatic injuries and need for early operation reflected overall severity and the possibility of associated injuries.
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Eur J Trauma Emerg S · Feb 2009
Hemorrhage is More Prevalent than Brain Injury in Early Trauma Deaths: The Golden Six Hours.
Under the trimodal distribution, most trauma deaths occur within the first hour. Determination of cause of death without autopsy review is inaccurate. The goal of this study is to determine cause of death, in hourly intervals, in trauma patients who died in the first 24 h, as determined by autopsy. ⋯ The temporal distribution of the cause of death varies in the first 24 h after admission. Hemorrhage should not be overlooked as the cause of death, even after survival beyond 1 h. Understanding the temporal relationship of causes of early death can aid in the targeting of management and surgical training to optimize patient outcome.
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Eur J Trauma Emerg S · Feb 2009
The Value of the Trauma Mechanism in the Triage of Severely Injured Elderly.
The triage of trauma patients is currently based on the trauma mechanism. However, it is known that elderly patients can sustain severe injuries due to insignificant trauma mechanisms. As such, triage methods might be questionable. ⋯ In elderly people a low energy trauma may lead to severe consequences. Not only the trauma mechanism, but also age, co-morbidity, and the likelihood of a brain injury should be leading in the triage and subsequent management of severely injured elderly.
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Eur J Trauma Emerg S · Feb 2009
Evaluation of Quality of Trauma Care in a Local Hospital Using a Customization of ASCOT.
Evaluating processes of care and outcomes of injured patients are important if improvements in the quality of care delivered to injured patients are to be accomplished. We applied a customized ASCOT model developed from our database as a tool to criticize the quality of care in a local hospital. ⋯ We believe that a customization of ASCOT model when used for evaluation of quality of care in a local hospital can be useful for detection of defects and improvement of the process of care delivered to the patients.
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Obstetric brachial plexus palsy is rare, but the limb impairments are manifold and often long-lasting. Physiotherapy, microsurgical nerve reconstruction, secondary joint corrections, and muscle transpositions are employed with success. The role of conservative and operative treatment options should be regularly reviewed. ⋯ The potential for scientific analysis is limited, due to the rarity and interindividual variability of the lesions and the varying effects on function and growth. Expectations and compliance are different in every patient. Surgical techniques are not yet standardized. Knowledge of the consequences for joint growth and congruence is inadequate. Today, functional improvement can be achieved by surgery in most clinical manifestations of obstetric brachial plexus palsy, within the framework of an interdisciplinary treatment concept.