Multiple Trauma

Gross, Eric; Martel, Marc O.

doi:10.1016/b978-0-323-05472-0.00033-5

Cited by 5 publications

(3 citation statements)

References 98 publications

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“…Patients of any age or sex admitted to the emergency department (ED) of hospital for blunt abdominal trauma, high energy trauma ( Box 1 ) ( 11 ), and multiple trauma were deemed eligible for participation in the study.…”

Section: Methodsmentioning

confidence: 99%

RETRACTED ARTICLE: A Comparative Analysis of Diagnostic Accuracy of Focused Assessment With Sonography for Trauma Performed by Emergency Medicine and Radiology Residents

Zamani

Masoumi

Esmailian

et al. 2015

Iran Red Crescent Med J

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Background:Focused assessment with sonography in trauma (FAST) is a method for prompt detection of the abdominal free fluid in patients with abdominal trauma.Objectives:This study was conducted to compare the diagnostic accuracy of FAST performed by emergency medicine residents (EMR) and radiology residents (RRs) in detecting peritoneal free fluids.Patients and Methods:Patients triaged in the emergency department with blunt abdominal trauma, high energy trauma, and multiple traumas underwent a FAST examination by EMRs and RRs with the same techniques to obtain the standard views. Ultrasound findings for free fluid in peritoneal cavity for each patient (positive/negative) were compared with the results of computed tomography, operative exploration, or observation as the final outcome.Results:A total of 138 patients were included in the final analysis. Good diagnostic agreement was noted between the results of FAST scans performed by EMRs and RRs (κ = 0.701, P < 0.001), also between the results of EMRs-performed FAST and the final outcome (κ = 0.830, P < 0.0010), and finally between the results of RRs-performed FAST and final outcome (κ = 0.795, P < 0.001). No significant differences were noted between EMRs- and RRs-performed FASTs regarding sensitivity (84.6% vs 84.6%), specificity (98.4% vs 97.6%), positive predictive value (84.6% vs 84.6%), and negative predictive value (98.4% vs 98.4%).Conclusions:Trained EMRs like their fellow RRs have the ability to perform FAST scan with high diagnostic value in patients with blunt abdominal trauma.

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Section: Methodsmentioning

confidence: 99%

RETRACTED ARTICLE: A Comparative Analysis of Diagnostic Accuracy of Focused Assessment With Sonography for Trauma Performed by Emergency Medicine and Radiology Residents

Zamani

Masoumi

Esmailian

et al. 2015

Iran Red Crescent Med J

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“…Those inappreciable minutes can be used to identify the victim's clinical condition and institute specific treatments. Trauma victims with certain criteria should be transferred to developed institutions also called as trauma centers in some countries: penetrating injuries to head, neck, torso, and extremities proximal to elbow and knee, flail chest, two or more proximal long bone fractures, crushed, degloved, or mangled extremity, amputation proximal to wrist and ankle, pelvic fractures, open or depressed skull fracture, and paralysis [3].…”

Section: Approach To Multiple Traumamentioning

confidence: 99%

Introductory chapter: How to contemplate the hidden threat in the management of multiple trauma patients?

Karcioglu,

Akman

2024

Contemporary Approach to Trauma and Emergency Surgery

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Time 05.30: after the motor-vehicle accident (MVA), a 28 year-old man has been transported to the emergency department (ED) by a taxi. The patient had been driving the vehicle himself, his seat belt was not fastened, and he smelt alcohol. He was on the ground next to the vehicle that had tumbled off the road at the time of the accident. Time 05.52: the patient is taken to the ED. Conscious, trying to cooperate, agitated. BP: 100/70 mmHg, pulse: 128 bpm, respiratory rate (RR): 30 bpm, arterial O 2 saturation (SaO 2 , pulse oximetry): 96%.Head -neck: there is skin abrasion in the right maxillary region. There is no cervical tenderness.Resp: breath sounds are equal. No rales, no rhonchus. Crepitus and tenderness are detected on the right at the 10th rib level.CVS: rhythmic, tachycardic. Abdomen: cannot be reliably evaluated due to the patient's agitation. Voluntary guarding and tenderness in the right upper quadrant are noted. Bedside abdominal ultrasonography was difficult to interpret because of overlying bowel gas and obesity.Extremity: open, comminuted fracture 20 cm proximal to the ankle on the right tibia and fibula. There is no pulse in the dorsalis pedis. There is external bleeding from the wound.At 06.00: a vascular access is opened to the patient from the left antecubital region with an 18 G, and 500 mL of normal saline is infused.Tetanus vaccine 0.5 mL IM and antibiotic prophylaxis are administered. Complete blood count, blood group, and blood alcohol level are ordered, and blood transfusion is prepared. His chest radiography and right tibia and fibula radiographies are ordered.The right leg is irrigated with normal saline, bandaged, and splinted, and the patient was sent to radiology suit. His tachycardia is thought to be due to pain and agitation.07.00: the patient returns from radiology. PA chest radiograph shows a right 10th rib fracture and a communited, displaced fracture in the right tibia and fibula.

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“…Caring for injured patients remains a mainstay of emergency medical practice, and emergency physicians play a vital role in the stabilization and diagnostic phases of trauma care. 1 Trauma patients accounted for 23.1% of the patients who were transported to emergency departments by ambulance in Japan in 2015. 2 Death due to trauma is classified as "accidental death" in Japan.…”

Section: Introductionmentioning

confidence: 99%

The significance of the levels of fibrin/fibrinogen degradation products for predicting trauma severity

Murata

Hagiwara

Aoki

et al. 2018

Hong Kong Journal of Emergency Medicine

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Background: On initial treatment in the emergency room, trauma patients should be assessed using simple clinical indicators that can be measured quickly. Objectives: The purpose of this study is to investigate the relationship between the injury severity score and blood test parameters measured on emergency room arrival in trauma patients. Methods: Trauma patients transferred to Gunma University Hospital between May 2013 and April 2014 were evaluated in this prospective, observational study. Blood samples were collected immediately on their arrival at our emergency room and their hematocrit, platelet, international normalized ratio of prothrombin time, activated partial thromboplastin time, fibrin/fibrinogen degradation products, and D-dimer were measured. We evaluated the correlations between the injury severity score and those biomarkers, and examined whether the correlation varied according to the injury severity score value. We also evaluated the correlations between the biomarkers and the abbreviated injury scale values of six regions. Results: We analyzed 371 patients. Fibrin/fibrinogen degradation products and D-dimer showed the greatest coefficients of correlation with injury severity score (0.556 and 0.543, respectively). The area under the curve of the receiver operating characteristic was larger in patients with injury severity score ⩾ 9 than in those with injury severity score ⩾ 4; however, patients with injury severity score ⩾ 9 or ⩾16 showed no significant differences. The area under the curve of fibrin/fibrinogen degradation products was larger than that of D-dimer at all injury severity score values. The chest abbreviated injury scale had the strongest relationship with fibrin/fibrinogen degradation products. Conclusion: Fibrin/fibrinogen degradation products and D-dimer were positively correlated with injury severity score, and the relationships varied according to trauma severity. Chest trauma contributed most strongly to fibrin/fibrinogen degradation product elevation.

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Multiple Trauma

Cited by 5 publications

References 98 publications

RETRACTED ARTICLE: A Comparative Analysis of Diagnostic Accuracy of Focused Assessment With Sonography for Trauma Performed by Emergency Medicine and Radiology Residents

RETRACTED ARTICLE: A Comparative Analysis of Diagnostic Accuracy of Focused Assessment With Sonography for Trauma Performed by Emergency Medicine and Radiology Residents

Introductory chapter: How to contemplate the hidden threat in the management of multiple trauma patients?

The significance of the levels of fibrin/fibrinogen degradation products for predicting trauma severity

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