Organ Injury Scaling

Ee, Moore; Shackford,; Hl, Pachter; Jw, McAninch; Bd, Browner; Hr, Champion; Lm, Flint; Ta, Gennarelli; Ma, Malangoni; Ml, Ramenofsky

doi:10.1097/00005373-198912000-00013

Cited by 982 publications

(127 citation statements)

References 0 publications

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“…In blunt trauma, the injuries affect the abdominal organs in the following order of frequency: spleen, liver, small intestine and retroperitoneal space (kidneys, hematomas). As to the type of injury, the OIS classification (based on anatomic and topographic criteria established using CT) lists at least 5 traumatic injuries to the abdominal organs: (1) hematoma (subcapsular or intraparenchymal with or without active bleeding), (2) capsular laceration with or without vascular involvement, (3) ruptured hematoma, (4) complete destruction, (5) vascular shutdown [54].…”

Section: Fastmentioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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Objectives The aim of this review article is to present the current views and visions of the role of ultrasound (US) in the management of patients with multiple trauma. The article is divided into two parts. Part 1 (US findings and techniques) will mainly deal with the technical aspects of US imaging in trauma patients and is written also for educational purposes. Part 2 (pathophysiology and US imaging in trauma patients) will deal with integration of US in the clinical and pathophysiological management of multiple trauma patients. Methods A non-systematic review of the literature through PubMed search (restricted to the last 10 years) of original articles and review articles. Results 80 publications were selected for Part 1. Of these 80 articles, the author selected 50 according to personal criteria on the basis of their innovative or original contents (48 original articles and 2 literature review articles); 19 articles were furthermore extracted from the references of the selected publications. The information extracted from these 69 publications was organized into sections dealing with different fields of applications of US imaging in multiple trauma patients. Conclusions US imaging in trauma has evolved from the initial use, i.e., early diagnosis of peritoneal effusion (focused abdominal sonography for trauma), to a wider use known as resuscitative ultrasonography, and is today considered as an extension of physical examination to implement a more effective approach to clinical problems and increase the timeliness and safety of interventions. Keywords Trauma Á Ultrasound Á Ultrasound findings Á Ultrasound techniqueRiassunto Obiettivi L'obiettivo di questa ricerca è di presentare la visione e le opinioni correnti sul ruolo dell'ecografia nella gestione del paziente con politrauma. L'articolo è diviso in due parti: nella prima ('Semeiotica ecografica e tecnica di esecuzione dell'esame') verrà data attenzione agli aspetti prevalentemente tecnici dell'ecografia nel trauma, con intento anche didattico; nella seconda (Fisiopatologia e ecografia clinica del trauma) sarà esplorato il tema dell'integrazione dell'ecografia con la clinica e la fisiopatologia nella gestione del politraumatizzato. Metodi Revisione non sistematica della letteratura. Ricerca su PubMed (restrizione agli ultimi 10 anni) di articoli originali e revisioni. Risultati Per la Parte prima sono stati selezionati 80 articoli, tra i quali sono stati scelti con criteri personali quelli ritenuti innovativi o originali nei contenuti (48 articoli originali, 2 revisioni di letteratura). 19 articoli sono stati estratti dalla bibliografia delle pubblicazioni prescelte. I contenuti estratti dai 69 articoli sono stati organizzati in paragrafi intitolati ai singoli ambiti di applicazione dell'ecografia nel politrauma. Conclusioni L'ecografia del trauma è evoluta dalla iniziale applicazione nella diagnosi precoce del versamento peritoneale (Focused Abdominal Sonography for Trauma o FAST) all'accezione più ampia di Resuscitative Ultrasonography (RUS) e v...

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Section: Fastmentioning

confidence: 99%

Bedside US imaging in multiple trauma patients. Part 1: US findings and techniques

Sofia

2013

J Ultrasound

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“…(b) Venous bleeding Grade V liver injury [47] is a well-established model that involves massive venous bleeding. This model has been used to assess the haemostatic potential of rFVIIa and topical agents [48][49][50][51].…”

Section: Potential Models Of Haemorrhage Relevant To Battlefield Casumentioning

confidence: 99%

“…Ideally this model should involve bleeding into a body cavity for face-validity 4 . A grade IV liver injury [47] has been used by others and has been shown to involve significant bleeding that is sensitive to therapy [52]. This is viewed as a mixed model since although it is predominantly venous it does also involve section of significant arteries as well as veins [52].…”

Section: Potential Models Of Haemorrhage Relevant To Battlefield Casumentioning

confidence: 99%

Blast injury research models

Kirkman

Watts

Cooper

2011

Phil. Trans. R. Soc. B

105

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Blast injuries are an increasing problem in both military and civilian practice. Primary blast injury to the lungs (blast lung) is found in a clinically significant proportion of casualties from explosions even in an open environment, and in a high proportion of severely injured casualties following explosions in confined spaces. Blast casualties also commonly suffer secondary and tertiary blast injuries resulting in significant blood loss. The presence of hypoxaemia owing to blast lung complicates the process of fluid resuscitation. Consequently, prolonged hypotensive resuscitation was found to be incompatible with survival after combined blast lung and haemorrhage. This article describes studies addressing new forward resuscitation strategies involving a hybrid blood pressure profile (initially hypotensive followed later by normotensive resuscitation) and the use of supplemental oxygen to increase survival and reduce physiological deterioration during prolonged resuscitation. Surprisingly, hypertonic saline dextran was found to be inferior to normal saline after combined blast injury and haemorrhage. New strategies have therefore been developed to address the needs of blast-injured casualties and are likely to be particularly useful under circumstances of enforced delayed evacuation to surgical care.

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“…The pre-requisites for adopting a non-operative protocol are haemodynamically stable and con› scious child, facility for repeated physical exami› nation, ICU facility, USG and CT scan facility round the clock, availability of operation theater as and when required, and an organ injury score of grade I or 2 [9]. Non-operative management of hepatic injuries mandates admission to TCU and strict bed rest for 5-6 days.…”

Section: Discussionmentioning

confidence: 99%