Articles: trauma.
-
The objective was to determine if use of ultrasound (US) by emergency physicians (EPs) to localize spinal landmarks improves the performance of lumbar puncture (LP). ⋯ These data do not suggest any advantage to the routine use of US localization for LP insertion, although further study may be warranted to look for benefit in the difficult to palpate or obese patient subgroups.
-
Randomized Controlled Trial
Stay and play eFAST or scoop and run eFAST? That is the question!
The concept that ultrasonography could be interesting in the prehospital setting and during the transfer of traumatized patients is not new. Paradoxically, there is a lack of description of routine use of ultrasonography in emergency ambulances. The aim of this study was to compare the feasibility and efficiency of an extended focused assessment sonography for trauma (eFAST) examination performed on-site, during the patient's transfer, or both. ⋯ The eFAST examination can provide reliable and important information in the initial evaluation of traumatized patients. It can be completed either on-site or during patient transfer. Its feasibility and efficiency are similar to that done in intensive units, especially if the examination is repeated.
-
Scand J Trauma Resus · Jan 2014
Randomized Controlled TrialDose reduction in whole-body computed tomography of multiple injuries (DoReMI): protocol for a prospective cohort study.
Single-pass, contrast-enhanced whole body multidetector computed tomography (MDCT) emerged as the diagnostic standard for evaluating patients with major trauma. Modern iterative image algorithms showed high image quality at a much lower radiation dose in the non-trauma setting. This study aims at investigating whether the radiation dose can safely be reduced in trauma patients without compromising the diagnostic accuracy and image quality. ⋯ Although non-experimental, this study will generate first large-scale data on the utility of imaging-enhancing algorithms in whole-body MDCT for major blunt trauma.
-
Randomized Controlled Trial
Mechanism of action of tranexamic acid in bleeding trauma patients: an exploratory analysis of data from the CRASH-2 trial.
To investigate the mechanism of action of tranexamic acid (TXA) in bleeding trauma patients, we examined the timing of its effect on mortality. We hypothesised that if TXA reduces mortality by decreasing blood loss, its effect should be greatest on the day of the injury when bleeding is most profuse. However, if TXA reduces mortality via an anti-inflammatory mechanism its effect should be greater over the subsequent days. ⋯ Early administration of tranexamic acid appears to reduce mortality primarily by preventing exsanguination on the day of the injury.
-
J. Thromb. Haemost. · Oct 2013
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of fondaparinux with low molecular weight heparin for venous thromboembolism prevention in patients requiring rigid or semi-rigid immobilization for isolated non-surgical below-knee injury.
In several small studies, anticoagulant therapy reduced the incidence of venous thromboembolism (VTE) in patients with isolated lower-limb injuries. ⋯ Fondaparinux 2.5 mg day(-1) may be a valuable therapeutic option over nadroparin 2850 anti-FXa IU day(-1) for preventing VTE after below-knee injury requiring prolonged immobilization in patients with additional risk factors.