Invasive techniques in emergency medicine

Aul, A.; Klose, R.

doi:10.1007/s00101-004-0766-1

Cited by 17 publications

(2 citation statements)

References 16 publications

(2 reference statements)

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“…Several authors recommend that patients with a suspected diagnosis of tension pneumothorax should be managed not only by primary decompression but also by prehospital chest drain insertion. Skin emphysema and serial rib fractures have been suggested as further indications for the prehospital placement of a chest drain in ventilated patients [ 27 ]. The current S3 Guideline too does not generally recommend prehospital chest insertion in patients with severe thoracic trauma.…”

Section: Discussionmentioning

confidence: 99%

Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®

Bieler

Kollig

Hackenberg

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background The management of penetrating wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. In Germany, penetrating injuries are reported to occur in 4–5 % of the severely injured patients who are enrolled in the TraumaRegister DGU® (trauma registry of the German Trauma Society). They include gunshot injuries, knife stab injuries, which are far more common, and penetrating injuries of other origin, for example trauma caused by accidents. The objective of this study was to assess the epidemiology and outcome of penetrating injuries in Germany, with a particular focus on the level of care provided by the treating trauma centre to gain more understanding of this trauma mechanism and to anticipate the necessary steps in the initial treatment. Materials and methods Since 2009, the TraumaRegister DGU® has been used to assess not only whether a trauma was penetrating but also whether it was caused by gunshot or stabbing. Data were taken from the standard documentation forms that participating German hospitals completed between 2009 and 2018. Excluded were patients with a maximum abbreviated injury scale (MAIS) score of 1 with a view to obtaining a realistic idea of this injury entity, which is rare in Germany. Results From 2009 to 2018, there were 1123 patients with gunshot wounds, corresponding to a prevalence rate of 0.5 %, and 4333 patients with stab wounds (1.8 %), which were frequently caused by violent crime. The high proportion of intentionally self-inflicted gunshot wounds to the head resulted in a cumulative mortality rate of 41 % for gunshot injuries. Stab wounds were associated with a lower mortality rate (6.8 %). Every fourth to fifth patient with a gunshot or stab wound presented with haemorrhagic shock, which is a problem that is seen during both the prehospital and the inhospital phase of patient management. Of the patients with penetrating injuries, 18.3 % required transfusions. This percentage was more than two times higher than that of the basic group of patients of the TraumaRegister DGU®, which consists of patients with a MAIS ≥ 3 and patients with a MAIS of 2 who died or were treated on the intensive care unit. Conclusions In Germany, gunshot and stab wounds have a low incidence and are mostly caused by violent crime or attempted suicides. Depending on the site of injury, they have a high mortality and are often associated with major haemorrhage. As a result of the low incidence of these types of trauma, further data and analyses are required in order to provide the basis for evaluating the long-term quality of the management of patients with stab or gunshot wounds.

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Section: Discussionmentioning

confidence: 99%

Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®

Bieler

Kollig

Hackenberg

et al. 2021

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…Skin emphysema and serial rib fractures have been suggested as further indications for the prehospital placement of a chest drain in ventilated patients. 27 The current S3 Guideline too does not generally recommend prehospital chest insertion in patients with severe thoracic trauma. According to grade B recommendations, tension pneumothorax should be managed by surgical decompression with or without the placement of a chest drain and pneumothorax should be treated with a chest drain, if indicated.…”

Section: Discussionmentioning

confidence: 99%

Penetrating injuries in Germany – Epidemiology, management and outcome - An analysis based on the TraumaRegister DGU®

Bieler

Kollig²,

Hackenberg³

et al. 2021

Preprint

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Background The management of penetrating wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. In Germany, penetrating injuries are reported to occur in 4–5% of the severely injured patients who are enrolled in the TraumaRegister DGU® (trauma registry of the German Trauma Society). They include gunshot injuries, knife stab injuries, which are far more common, and penetrating injuries of other origin, for example trauma caused by accidents. The objective of this study was to assess the epidemiology and outcome of penetrating injuries in Germany, with a particular focus on the level of care provided by the treating trauma centre to gain more understanding of this trauma mechanism and to anticipate the necessary steps in the initial treatment. Materials and methods Since 2009, the TraumaRegister DGU® has been used to assess not only whether a trauma was penetrating but also whether it was caused by gunshot or stabbing. Data were taken from the standard documentation forms that participating German hospitals completed between 2009 and 2018. Excluded were patients with a maximum abbreviated injury scale (MAIS) score of 1 with a view to obtaining a realistic idea of this injury entity, which is rare in Germany. Results From 2009 to 2018, there were 1123 patients with gunshot wounds, corresponding to a prevalence rate of 0.5%, and 4333 patients with stab wounds (1.8%), which were frequently caused by violent crime. The high proportion of intentionally self-inflicted gunshot wounds to the head resulted in a cumulative mortality rate of 41% for gunshot injuries. Stab wounds were associated with a lower mortality rate (6.8%). Every fourth to fifth patient with a gunshot or stab wound presented with haemorrhagic shock, which is a problem that is seen during both the prehospital and the inhospital phase of patient management. Of the patients with penetrating injuries, 18.3% required transfusions. This percentage was more than two times higher than that of the basic group of patients of the TraumaRegister DGU®, which consists of patients with a MAIS ≥ 3 and patients with a MAIS of 2 who died or were treated on the intensive care unit. Conclusions In Germany, gunshot and stab wounds have a low incidence and are mostly caused by violent crime or attempted suicides. Depending on the site of injury, they have a high mortality and are often associated with major haemorrhage. As a result of the low incidence of these types of trauma, further data and analyses are required in order to provide the basis for evaluating the long-term quality of the management of patients with stab or gunshot wounds.

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Invasive Techniken

Sikinger¹,

Gries²

Die Notfallmedizin

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Invasive techniques in emergency medicine

Cited by 17 publications

References 16 publications

Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®

Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®

Penetrating injuries in Germany – Epidemiology, management and outcome - An analysis based on the TraumaRegister DGU®

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