Articles: trauma.
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Eur J Trauma Emerg S · Dec 2008
Mortality Distribution in a Trauma System: From Data to Health Policy Recommendations.
Trimodal distribution of deaths and the golden hour concepts are in part responsible for the genesis of all modern trauma systems but these concepts have been challenged recently. Our aim was to describe distribution of death in trauma using data from a trauma system and discuss what could be done from the organizational point of view to improve outcome. ⋯ A tetramodal pattern of death distribution could be described. Our data support the need to focus on the treatment of severe head injuries namely in the intensive care environment.
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Eur J Trauma Emerg S · Dec 2008
Aseptic Osteonecrosis of the Humeral Head After Anterior Shoulder Dislocation.
Anterior shoulder dislocation is a very common trauma and the main complications are well documented. We report a case of aseptic osteonecrosis of the humeral head following an isolated episode of anterior glenohumeral dislocation without fracture that, to our knowledge, has never been reported in the literature. A 17-year-old male patient sustained an anterior glenohumeral dislocation following a sport accident. ⋯ A radiologically identified aseptic osteonecrosis appeared 6 months later. The instability had been arthroscopically treated. At a follow-up of 4 years, the osteonecrosis has been stabilized leaving a mild arthrosis with stiffness, but without pain.
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Scand J Trauma Resus · Nov 2008
Pre-notification of arriving trauma patient at trauma centre: a retrospective analysis of the information in 700 consecutive cases.
Pre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient actually arrives. In the present study we retrospectively analyzed the pre-hospital information provided by 700 consecutive pre-notification mobile phone calls in terms to asses the response of trauma team activation regard to pre-notified information such as vital signs and level of consciousness, mechanism of injury (MOI), and estimated elapsed time (EET) from the time of pre-notification phone call to arrival. ⋯ Pre-notification phone call is of a crucial importance in organizing every day activities at a busy trauma centre, but it should not take place in too much advance. In any case, a pre-notification phone call, even on short notice, gives emergency department personnel some time to prepare for the incoming patient.
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Eur J Trauma Emerg S · Oct 2008
Wound Complications from the Tsunami Disaster: A Reminder of Indications for Delayed Closure.
To illustrate the character, clinical course and late complications of wounds caused by high energy with severe contamination during a natural disaster, as a basis for designing principles for primary treatment under these conditions. ⋯ The patterns of injury and clinical courses in these patients illustrate the risk of complications in wounds caused by high energy, with severe contamination and which arrive late for primary treatment by staff who are not fully aware of the risk of secondary complications under these conditions. Recommendations for primary treatment should include extensive cleaning, excision of dead tissue and delayed primary closure, according to the well-established principles of management of war wounds, where the conditions are similar.