Advanced Trauma Life Support, 8th Edition, The Evidence for Change

Kortbeek, John B.; Turki, Saud A. Al; Ali, Jameel; Antoine, Jill A.; Bouillon, Bertil; Brasel, Karen J.; Brenneman, Fred; Brink, Peter R.; Brohi, Karim; Burris, David; Burton, Reginald A.; Chapleau, Will; Cioffi, Wiliam; Silva, Francisco De Salles Collet e; Cooper, Arthur; Cortes, Jaime A.; Eskesen, Vagn; Fildes, John; Gautam, Subash; Gruen, Russell L.; Gross, Ron; Hansen, Kari Schrøder; Henny, Walter; Hollands, Michael; Hunt, Richard C.; Navalón, José María Jover; Kaufmann, Christoph; Knudson, Peggy; Koestner, Amy; Košir, Roman; Larsen, Claus Falck; Livaudais, West; Luchette, Fred A.; Mao, Patrizio; McVicker, John H.; Meredith, J. Wayne; Mock, Charles; Mori, Newton Djin; Morrow, Charles T.; Parks, Steven N.; Pereira, Pedro; Pogetti, Renato Sergio; Ravn, Jesper; Rhee, Peter; Salomone, Jeffrey P.; Schipper, Inger B.; Schoettker, Patrick; Schreiber, Martin A.; Smith, R. Stephen; Svendsen, Lars Bo; Taha, Wa’el; Wijngaarden-Stephens, Mary van; Varga, Endre; Voiglio, Eric J.; Di, Williams; Winchell, Robert J.; Winter, Robert

doi:10.1097/ta.0b013e3181744b03

Cited by 342 publications

(211 citation statements)

References 152 publications

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“…In 2008, the eighth edition of Advanced Trauma Life Support recommended CT as the primary imaging modality to assess cervical spine injury in major trauma. 7 The 2009 published guidelines from the Eastern Association for the Surgery of Trauma Practice Management Guidelines Committee strongly support the use of CT to supplant plain radiography for cervical spine imaging after major trauma. 8 One important downside of CT imaging of the cervical spine is the need for expert radiologist interpretation, which can prolong patient time in cervical spine precautions.…”

Section: Ré Sumémentioning

confidence: 99%

Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

Zyl

Bilbey

Vukusic

et al. 2014

CJEM

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Objective: Emergency physicians are expected to rule out clinically important cervical spine injuries using clinical skills and imaging. Our objective was to determine whether emergency physicians could accurately rule out clinically important cervical spine injuries using computed tomographic (CT) imaging of the cervical spine. Method: Fifteen emergency physicians were enrolled to interpret a sample of 50 cervical spine CT scans in a nonclinical setting. The sample contained a 30% incidence of cervical spine injury. After a 2-hour review session, the participants interpreted the CT scans and categorized them into either a suspected cervical spine injury or no cervical spine injury. Participants were asked to specify the location and type of injury. The gold standard interpretation was the combined opinion of two staff radiologists. Results: Emergency physicians correctly identified 182 of the 210 abnormal cases with cervical spine injury. The sensitivity of emergency physicians was 87% (95% confidence interval [CI] 82-91), and the specificity was 76% (95% CI 74-77). The negative likelihood ratio was 0.18 (95% CI 0.12-0.25). Conclusion: Experienced emergency physicians successfully identified a large proportion of cervical spine injuries on CT; however, they were not sufficiently sensitive to accurately exclude clinically important injuries. Emergency physicians should rely on a radiologist review of cervical spine CT scans prior to discontinuing cervical spine precautions. RÉ SUMÉObjectif: Les urgentologues devraient ê tre en mesure d'é carter l'existence de lé sions, importantes sur le plan clinique, de la colonne cervicale en s'appuyant sur leurs compé tences cliniques et l'imagerie. L'é tude visait à dé terminer si les urgentologues pouvaient é carter correctement l'existence de lé sions, importantes sur le plan clinique, de la colonne cervicale sur le plan clinique à l'aide de l'imagerie par tomodensitomé trie de la colonne cervicale. Mé thode: Quinze urgentologues ont accepté d'interpré ter un é chantillon de 50 tomodensitogrammes (TDM) de la colonne cervicale en milieu non clinique; l'é chantillon comptait 30% de cas de lé sion de la colonne cervicale. Aprè s une sé ance de formation de 2 heures, les participants ont interpré té les TDM et les ont classé s en deux caté gories: lé sion possible et absence de lé sion. Les participants devaient pré ciser le siè ge des lé sions et leur type. L'interpré tation de ré fé rence reposait sur l'avis de deux radiologistes, membres du personnel. Ré sultats: Les urgentologues ont bien identifié 182 cas de lé sion de la colonne cervicale sur 210. La sensibilité des urgentologues é tait de 87% (intervalle de confiance [IC] à 95% 82-91) et la spé cificité de 76% (IC à 95% 74-77). Le quotient de vraisemblance né gatif s'est é tabli à 0.18 (IC à 95% 0.12-0.25). Conclusions: Les urgentologues expé rimenté s ont ré ussi à identifier, dans une grande proportion, les lé sions de la colonne cervicale sur les TDM; toutefois, la sensibilité n'é tait pas suffisamment é lev...

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Section: Ré Sumémentioning

confidence: 99%

Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

Zyl

Bilbey

Vukusic

et al. 2014

CJEM

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“…These two new dressings are compact fabric-like dressings, a quality that is similar to the current standard gauze, and, based on our experience with previous hemorrhage control experimentation, this supports easy application and removal from the wound. This type of dressing is well suited for rapid deployment in the battlefield [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models

Arnaud

Teranishi

Okada

et al. 2011

Journal of Surgical Research

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Background. Fabric-like hemostatic dressings offer promise for hemorrhage control in noncompressible areas, especially given their similarity in form to standard gauze currently in use. Recently, two such products, Combat Gauze (CBG) and TraumaStat (TMS), were introduced. Their performance is evaluated in two vascular injury models.Materials and Methods. The dressings were evaluated in anesthetized Yorkshire pigs, hemorrhaged by full transection of the femoral vasculature with 2 min free bleeding period (CBG [ 6, TMS [ 6) or by 4 mm femoral arterial puncture with 45 s free bleeding period (CBG [ 8, TMS [ 8). After injury, dressings were applied, followed by 5 min of manual compression and then 500 mL resuscitation fluid infused over 30 min. Vital signs, blood pressure, and blood loss were recorded throughout the 3-h experiment. Bleeding control was the primary outcome.Results. All animals had similar pretreatment mean arterial pressure (MAP) (w36.5 mmHg); pretreatment blood loss following injury was similar for both dressing groups in the two models [24% ± 8% estimated blood volume (EBV) 2 min after transection and 17% ± 4% EBV 45 s after puncture. Incidence of post-treatment bleeding, primarily occurring after release of manual compression or restoration of blood pressure, was more frequent in the puncture model (17% with both CBG and TMS) than the transection model (57% with CBG versus 75% with TMS). Post-treatment blood loss not controlled by the dressing was 19% ± 22% and 31% ± 17% EBV, for CBG and TMS, respectively. Survival rate was 100% for both dressings in the transection model, and was 88% for CBG and 50% for TMS in the puncture model.Conclusions. These findings indicated that CBG and TMS were similarly effective in improving hemostasis. These two fabric-like dressings showed easy application and removal, leaving a clean wound for surgical repair. Ó 2011 Elsevier Inc. All rights reserved.

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“…Exact mode of injury, patients position while incident, weather and intoxicated status were documented. On arrival all patient were manages as per advanced trauma life support guidelines [8] . Severity of injury (ISS) [9] , extent of soft tissue damage, fracture pattern, whether close or open, and associated injuries were documented by surgical and orthopaedic team.…”

Section: Methodsmentioning

confidence: 99%

Side swipe injury elbow with fixed object collision in mountain region: Presentation and management

Sharma¹,

Parmar²,

Verma³

et al. 2017

Int. J. Orthop. Sci.

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Introduction: Side swipe injury is a subgroup of complex elbow trauma. Management of such injury is a formidable challenge to the orthopaedic surgeon. There is no fixed management protocol that is followed due to different presentation which results in poor functional outcome. We have presented a series of rarely reported side swipe injury elbow with fixed object collision in mountain region. Material and method: A prospective study of elbow trauma of eight patient sustaining sideswipe injuries to the upper limb. Seven patients were male and one was female. Mean age was with a range of 24 to 45 years. Five were left sided non dominant and three were right dominant limb. In six patient's injury were confined to limb and among rest two who were sustained associated injuries. One patients required immediate vascular repair followed by debridement, external fixation than definitive fixation. One patient was unusually presented with open fracture humerus with brachial plexus injury and 3 patients required external fixation, open reduction and internal fixation for open fractures of the humerus, ulna and radius. Internal fixation was used in 3 patients as primary stabilization. Complications and outcome were recorded in follow-up at outpatient department up to 1 year. Results were evaluated using the Mayo elbow performance score. Results: The injury severity scores ranged from 9 to 22. The average Mayo elbow performance score was 47.5. Good results (score 75-89) was seen in 12.5% patient. Fair (60-74) and poor results (Less than 60) were seen in 25% and 62.5% patients respectively. Conclusions: Initial assessment and staged protocol management may be needed to achieve functional result in side swipe elbow injury with fixed object in mountain region which can be presented from mild to complete loss of limb function.

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Advanced Trauma Life Support, 8th Edition, The Evidence for Change

Cited by 342 publications

References 152 publications

Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models

Side swipe injury elbow with fixed object collision in mountain region: Presentation and management

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