Indication for resuscitative thoracotomy in thoracic injuries—Adherence to the ATLS guidelines. A forensic autopsy based evaluation

Ohrt-Nissen, Søren; Colville-Ebeling, B.; Kandler, Kristian; Hornbech, Kåre; Steinmetz, Jacob; Ravn, Jesper; Lehnert, Per

doi:10.1016/j.injury.2015.10.034

Cited by 10 publications

(7 citation statements)

References 16 publications

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“…The most frequently used nighttime braces are the Charleston [5][6][7] and the Providence brace. [8][9][10][11] The available literature regarding the nighttime brace is scarce and whether the efficacy, in terms of limiting progression to a surgical level, is similar to the full-time brace has not been sufficiently assessed. Table 1 summarizes some of the main clinical studies on the traditional TLSO full-time brace and the Charleston and Providence nighttime braces.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Ohrt-Nissen

Lastikka

Andersen

et al. 2019

J Orthop Surg (Hong Kong)

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Purpose: To compare treatment efficacy between the Boston full-time brace and the Providence part-time brace in main thoracic adolescent idiopathic scoliosis (AIS). Methods: Patients were treated with either the Boston brace ( n = 37) or the Providence brace ( n = 40). Inclusion criteria were Risser grade ≤2, major curve between 25° and 40° with the apex of the curve between T7 and T11 vertebrae. Two-year follow-up was available in all patients unless brace treatment had reached endpoint. The primary outcome measure was main curve progression to ≥45°. Results: Median age was 12.6 years and median treatment length at follow-up was 25 months (interquartile range (IQR): 18–32)) with no difference between the groups ( p ≥ 0.116). Initial median main Cobb angle was 29° (IQR: 27–33) and 36° (IQR: 33–38) in the Boston and Providence groups, respectively ( p < 0.001). At follow-up, 13 patients (35%) had progressed to ≥45° in the Boston group versus 16 patients (40%) in the Providence group ( p = 0.838). Twenty-three patients (62%) had progressed by more than 5° in the Boston group versus 22 patients (55%) in the Providence group ( p = 0.685). The secondary thoracolumbar/lumbar curve progressed by more than 5° in 14 (38%) and 18 (45%) in the Boston and Providence groups, respectively ( p = 0.548). Conclusions: Despite a larger initial curve size in the Providence group, progression of more than 5° or to surgical indication area was similar in the Boston group. Our results indicate that nighttime bracing is a viable alternative to full-time bracing also in main thoracic AIS.

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Section: Introductionmentioning

confidence: 99%

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Ohrt-Nissen

Lastikka

Andersen

et al. 2019

J Orthop Surg (Hong Kong)

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“…Emergency care thoracotomies are performed on almost-morbid patients in the emergency unit by making a left anterolateral incision between the 4th and 5th intercostal space. Emergency care thoracotomies should not be confused with thoracotomies performed in an operating room or in intensive care during the first hours following the initial injury [35,36]. The reasons for an emergency care thoracotomy include the drainage of the pericardial tamponade, the control of intrathoracic or cardiac bleeding, the control of massive bronchovenous air embolisms, or bronchopleural fistula, open cardiopulmonary resuscitation or temporary occlusion of the descending thoracic aorta (crossclamp placement) ( Table 2) [36].…”

Section: Emergency Care Thoracotomymentioning

confidence: 99%

“…Emergency and Current Approaches to Thoracic Traumas http://dx.doi.org/10.5772/intechopen.74713 4th or 5th intercostal space and a chest retractor is inserted. After the bleeding is controlled and a steady heartbeat has been achieved, the patient must be transferred to the operating room as soon as possible [36].…”

Section: Rescuable Cardiac Arrest After Injurymentioning

confidence: 99%

Emergency and Current Approaches to Thoracic Traumas

Dubus¹

2018

Trauma Surgery

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Trauma is one of the main causes of death in the young population, and trauma-related deaths usually occur in the initial hours following the trauma and are frequently associated with bleeding. In elderly populations, physiological changes and concomitant conditions alleviate the negative consequences of trauma. In injuries to the head or spine, thoracic trauma is the trauma category that is mostly associated with a serious risk of mortality, being generally penetrating or blunt thoracic traumas. Of these, blunt thoracic traumas are more frequent and fatal than penetrating traumas and are caused most often by traffic accidents. The most common causes of death related to blunt thoracic trauma include injuries to the heart and main vessels, and in such cases, emergency resuscitation, early diagnosis, and fast and effective treatment could be life-saving. Penetrating thoracic traumas may result in intrathoracic organ injuries and develop following stab wounds, firearm injuries, and explosions and are likely to require very urgent interventions. Emergency medical interventions could be life-saving in the presence of penetrating thoracic trauma, while mortality in these cases is mostly due to respiratory problems and heart or lung pathologies.

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“…Theoretical teaching method A class about thoracic trauma and drainage thoracic was ministered to both groups, "A" and "B"; exposing the subject fundamental, and highlighting the step by step of the drainage thoracic procedure as described in the ATLS manual 6 .…”

Section: Phase 2: Learning and Training Processmentioning

confidence: 99%

Chest drainage teaching and training for medical students. Use of a surgical ex vivo pig model

et al. 2016

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PURPOSE: Implement a constructivist approach in thoracic drainage training in surgical ex vivo pig models, to compare the acquisition of homogeneous surgical skills between medical students. METHODS:Experimental study, prospective, transversal, analytical, controlled, three steps. Selection, training, evaluation. Inclusion criteria: a) students without training in thoracic drainage; b) without exposure to constructivist methodology. 2) Exclusion criteria: a) students developed surgical skills; b) a history of allergy. (N = 312). Two groups participated in the study: A and B. Lecture equal for both groups. Differentiated teaching: group A, descriptive and informative method; group B, learning method based on problems. A surgical ex vivo pig model for training the chest drain was created. Were applied pre and post-test, test goal-discursive and OSATS scale. RESULTS:Theoretical averages: Group A = 9.5 ± 0.5; Group B = 8.8 ± 1.1 (p = 0.006). Medium Practices: Group A = 22.8 ± 1.8; Group B = 23.0 ± 2.8 (p <0.001). CONCLUSION:Through the constructivist methodology implemented in the thoracic drainage training in surgical ex vivo pig models, has proven the acquisition of surgical skills homogeneous compared among medical students.

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Indication for resuscitative thoracotomy in thoracic injuries—Adherence to the ATLS guidelines. A forensic autopsy based evaluation

Cited by 10 publications

References 16 publications

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Conservative treatment of main thoracic adolescent idiopathic scoliosis: Full-time or nighttime bracing?

Emergency and Current Approaches to Thoracic Traumas

Chest drainage teaching and training for medical students. Use of a surgical ex vivo pig model

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