Articles: trauma.
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This study investigates the impact of extraperitoneal pelvic packing (EPP) on the definitive surgical treatment of pelvic fractures (PF) in trauma patients. While EPP is recognized as an effective life-saving technique for controlling non-compressible retroperitoneal bleeding, concerns persist about its potential to complicate subsequent surgical interventions. A total of 220 trauma patients treated in a single First Level Trauma Centre from October 2016 to December 2021 were analysed. ⋯ Despite these delays, EPP did not significantly limit the possibility of achieving definitive surgery or the choice of fixation technique. Patients who underwent both EPP and open reduction internal fixation did not show a higher rate of severe complications compared to those managed without EPP. The study concludes that while EPP should be considered a practical emergency intervention for critically unstable PF patients, and even though it may affect the timing of definitive PF treatment, it does not prevent further surgical management.
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In recent conflicts, injuries to urogenital organs ranged from 5 to 7.2% of all combat-related injuries. Open surgery remains the main approach in combat settings, and in the French military, urgent surgical procedures are mostly performed by general surgeons with no specialization in urological care. To explore the specific needs in advanced surgery courses, we aimed to describe the epidemiology and management of genito-urinary traumas in recent conflicts in French Medical Treatment Facilities (MTFs). ⋯ This study is the first to examine genito-urinary traumas in overseas operations during French army deployments. The results highlight the relatively low incidence of urological trauma, with most injuries involving the bladder and testis. Our findings highlight the importance of equipping military surgeons with the skills necessary to manage complex cases.
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Scand J Trauma Resus · Feb 2025
ReviewPoint-of-care tests in the emergency medical services: a scoping review.
This scoping review aimed to summarize existing research on point-of-care tests (POCTs) within emergency medical services (EMS). There is a lack of comprehensive reviews covering the breadth and scope of application of POCTs in EMS despite growing interest and potential benefits in this setting. A review of the research will inform how we target future research efforts to support effective implementation and avoid duplication. ⋯ We identified a thriving base of research on POCT in the EMS, however most studies established the diagnostic accuracy of the tests with few RCTs, economic analyses or qualitative research on acceptability. The time-lag from diagnostic accuracy to developing an RCT is considerable. Investment in funding and infrastructure is needed to support the research pathway for potential POCTs beyond diagnostic accuracy to designs able to assess clinical effectiveness, acceptability and economic effectiveness.
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Cervical stenosis (CS) is the pathologic narrowing of the central canal of the cervical spine. It is often incidentally discovered. It is unclear whether pre-existing CS can lead to worse outcomes and higher incidences of post-traumatic spinal cord injury (SCI). ⋯ Though patients with pre-existing CS do not have higher odds of SCI in studies with internal controls, we find that patients with CS do have higher incidences of SCI and are over-represented in the population of SCI patients. In select CS patients with active lifestyles, close follow-up and consideration of various treatment options may be indicated.