Expedited Treatment of Lower Extremity Gunshot Wounds

Accuracy of Physical Examination, Ankle‐Brachial Index, and Ultrasonography in the Diagnosis of Arterial Injury in Patients With Penetrating Extremity Trauma: A Systematic Review and Meta‐analysis

“…were excluded due to insufficient available data. Finally, we omitted Frykberg et al., Knudson et al., Dennis et al., Sadjadi et al.,and Fry et al . due to an inadequate inpatient observation period for patients who did not undergo the reference standard.…”

“…Finally, although CTA is relatively low in cost, its non–evidence‐based use may deplete the limited resources of hospitals in urban areas or high‐conflict regions where patients with penetrating injuries are frequently encountered. Ultrasonography may be an acceptable, even lower‐cost alternative in certain low‐risk patients, and a selective approach to CTA has shown to greatly reduce the expense per patient …”

Gender Differences Among Recidivist Trauma Patients

“…Nevertheless, as a county hospital that serves a large surrounding patient population, our analysis found that the majority of trauma patients, both single visit and recidivist patients, are uninsured and less likely to seek care at another hospital. A previous study by our group found that our institution is the sole provider for approximately 90% of our trauma patients [12]. Second, our study population included only patients who were treated through the trauma response system; therefore, patients with less severe injuries, including injuries secondary to domestic violence, who were seen and treated by the emergency department, are not included in the trauma registry that was used for this analysis.…”

Vascular Injury in Orthopedic Trauma

“…67,68 A patient with diminished peripheral pulses or an API less than 0.9 should undergo an imaging study, typically an arteriography, DUS, or CT angiography (CTA) to document the presence and location of a possible vascular injury. 67,69 Beyond the obvious hard or soft signs of vascular injury, physical examination of the injured extremity should include observation of the position in which the extremity is held, presence of an obvious deformity of a long bone or joint, presence or absence of an open wound or bony crepitus, skin color of the distal extremity compared with that of the opposite side (in light-skinned individuals), time required for skin capillary refill in the distal digits, and a complete motor and sensory examination. In the lower extremity, the stability of the knee joint should be assessed carefully; increased laxity may suggest spontaneous reduction of a knee dislocation.…”