SMJ articles in the category "trauma"

Original Article

CME Article: Enhanced Notification of Radiographic Incidental Findings in Trauma Does Not Guarantee Follow-Up Compliance

Objectives: Follow-up care for incidental findings (IFs) on trauma computed tomography scans is a component of comprehensive healthcare. Our objective was to assess the effectiveness of our IF predischarge disclosure practice guideline and identify factors contributing to follow-up failure. Methods: This was a secondary analysis of a prospective observational database:…

Posted in: radiology 3 trauma 24

Original Article

Evaluating Adequacy of VTE Prophylaxis Dosing with Enoxaparin for Overweight and Obese Patients on an Orthopedic-Medical Trauma Comanagement Service

Objectives: Venous thromboembolism (VTE) is a common nosocomial condition, developing frequently in overweight and obese patients. VTE prophylaxis with weight-based enoxaparin dosing may be more effective than the standard dosing regimen for overweight and obese patients; however, weight-based dosing is not practiced routinely. In this pilot study we sought to…

Posted in: enoxaparin 3 Obesity 70 prophylaxis 4 trauma 24 venous thromboembolism 5

Original Article

OPEN: Incidence of Pediatric Cervical Spine Injuries in Iraq and Afghanistan

Objective: Military providers frequently treat civilians, including pediatric patients. Cervical spine injuries in pediatric trauma patients occur infrequently, with limited data on the incidence. The aim of this study was to describe the incidence of cervical spine injuries in pediatric patients in Iraq and Afghanistan.Methods: We queried the Department of…

Posted in: cervical 3 fracture 7 Pediatric 11 spine 2 trauma 24

Original Article

Trauma Providers’ Perceptions of Frailty Assessment: A Mixed-Methods Analysis of Knowledge, Attitudes, and Beliefs

Objectives: Quality improvement in geriatric trauma depends on timely identification of frailty, yet little is known about providers’ knowledge and beliefs about frailty assessment. This study sought to understand trauma providers’ understanding, beliefs, and practices for frailty assessment. Methods: We developed a 20-question survey using the Health Belief Model of…

Posted in: frailty 8 geriatric 3 trauma 24

Original Article

CME Article: Clinical Utility of Routine Chest X-Rays During the Initial Stabilization of Trauma Patients

Objectives: The Advanced Trauma Life Support (ATLS) course encourages the use of chest x-ray (CXR) to identify injuries that may change clinical management during the initial stage of trauma resuscitations. Several studies have failed to show benefit for the routine use of CXR without a clinical indication, however. We sought…

Posted in: imaging 5 resource utilization 2 trauma 24

Original Article

Characteristics of Dog Bites in Arkansas

Objective: Dog bite injuries are encountered frequently in emergency departments and can cause significant morbidity. The objective of this study was to explore the associations between the multiple variables at play during these occurrences (eg, the patient’s age, the bite location, the bite severity, the dog’s relationship with the patient,…

Posted in: trauma 24

Original Article

THAM Administration to Pediatric Trauma Patients in a Combat Zone

Objectives: Pediatric casualties made up a significant proportion of patients during the recent military conflicts in Iraq and Afghanistan. Damage control resuscitation strategies used by military physicians included rapid reversal of metabolic acidosis to mitigate its pathophysiologic consequences, primarily through hemorrhage control and volume restoration. Alkalizing agents, including tris(hydroxymethyl)aminomethane (THAM),…

Posted in: pediatrics 33 resuscitation 5 trauma 24

Original Article

Nontraumatic Emergency Laparotomy: Surgical Principles Similar to Trauma Need to Be Adopted?

Objectives: In 2011, the Royal College of Surgeons published Emergency Surgery: Standards for Unscheduled Care in response to variable clinical outcomes for emergency surgery. The purpose of this study was to examine whether different treatment modalities would alter survival. Methods: All patients who underwent emergency laparotomy between April 2011 and…

Posted in: trauma 24

Review Article

Transfusion Practice in Trauma Resuscitation

Recognition of the acute coagulopathy of trauma and the limits of reconstituting whole blood with conventional blood components has led to a radical change in the way trauma patients with severe injuries are resuscitated. Massive transfusion protocols (MTP) have evolved toward the administration of conventional blood components in fixed ratios….

Posted in: trauma 24

Original Article

Evaluation of a New Elderly Trauma Triage Algorithm

Objectives: Undertriage is common in patients 55 years and older and is even worse for those 65 and older. In 1999, the Florida legislature implemented a statewide trauma system, including a new Florida trauma triage algorithm (FTTA). This study examines how the new system affected prehospital triage in younger versus…

Posted in: elderly adults 3 trauma 24 triage 4

Case Report

Septicemia Secondary to Ileus in Trauma Patients: A Human Model for Bacterial Translocation

Paralytic ileus is a common problem in trauma patients. We present two cases of ileus leading to septicemia. Both patients developed sudden septicemia on hospital day six and underwent urgent exploratory laparotomies, and both were found to only have paralytic ileus without evidence of bowel injury or obstruction. We attribute…

Posted in: bacterial 2 trauma 24

CME Topic

Evaluation of Blunt Cervical Spine Injury

Abstract:Injuries resulting from blunt cervical spine trauma are common problems seen in emergency departments and treated by trauma care specialists. Timely and appropriate imaging studies are essential to the cervical spine evaluation in the trauma patient. Despite advances in imaging techniques, cervical injuries may still be missed. Several specialty bodies…

Posted in: blunt 2 cervical 3 Diagnosis 17 management 10 spine 2 trauma 24

Case Report

Clavicular Tuberculosis Following Trivial Trauma

Abstract:Tuberculosis of the clavicular bone is a very rare clinical entity, with limited cases reported in the United States. Furthermore, sparing of the sternoclavicular joint is exceedingly unusual. A literature review of the prevalence of clavicular tuberculosis identified fewer than 80 cases reported since the discovery of the tubercular bacillus,…

Posted in: trauma 24 tuberculosis 13

Case Report

Prone Ventilation in a United States Marine with Acute Respiratory Distress Syndrome and an Open Abdominal Injury

Abstract:A United States Marine with an open abdominal injury from a single gunshot wound to the chest and abdomen was placed in the prone position after suffering from acute respiratory distress syndrome (ARDS). Prone ventilation in traumatic injuries involving an open abdomen has been rarely reported or attempted because of…

Posted in: ARDS 3 critical care 12 trauma 24

Review Article

Acute Acalculous Cholecystitis Complicating Major Trauma: A Report of Five Cases

The purpose of this study was to identify the clinical characteristics of the patients in our institution who developed acute acalculous cholecystitis (AAC) after major trauma. Data of all trauma patients who developed AAC from January 2001 through June 2006 were analyzed. Five out of 1386 (0.3%) major trauma patients…

Posted in: trauma 24

Case Report

Stenting as an Alternative to Open Repair in Traumatic Superficial Femoral Artery Injuries

Lower limb ischemia may occur when a superficial femoral artery (SFA) is injured in blunt or penetrating trauma. Surgical repair of the injured artery can be challenging and time-consuming when there is an associated fracture. Two cases of traumatic SFA injury treated with endovascular stent grafting are described. Key Points…

Posted in: endovascular 2 stent 5 trauma 24

Original Article

Urologic Injuries Sustained After Free Falls From Hunting Tree Stands

Objectives: Hunting is a popular recreational pastime in the United States. Injuries sustained from falls out of tree stands remain a significant cause of morbidity among hunters, often resulting in significant urological injury. The purpose of this study is to identify the type and pattern of urologic injuries sustained after…

Posted in: trauma 24

Case Report

Disseminated Fusarium Infection in a Multiple Trauma Patient

The hyalohyphomycetes (especially Fusarium sp.) have emerged as significant pathogens in severely immunocompromised patients. Human infections by Fusarium sp. can be superficial or limited to single organs in otherwise healthy patients. Such infections are rare and tend to respond well to therapy. By contrast, disseminated fusarial hylohyphomycosis affects the immunocompromised…

Posted in: trauma 24 voriconazole 5

Case Report

Embryonal Rhabdomyosarcoma Secondary to an Open Fracture of the Tibia: A Case Report and Review of Literature

Embryonal rhabdomyosarcoma (ERMS) is a highly malignant tumor in children and adolescents. It rarely occurs in adults. A 47-year-old patient presented with ERMS of the muscle flap transplant 20 years after an open type III-comminuted fracture of the lower leg. The affected leg was amputated. The patient refused adjuvant chemotherapy…

Posted in: risk factors 23 trauma 24

Expired CME Article

Minorities, the Poor, and Survivors of Abuse: HIV-Infected Patients in the US Deep South

Background: The HIV/AIDS epidemic in the U.S. South is undergoing a marked shift toward a greater proportion of new HIV/AIDS cases in women, African-Americans, and through heterosexual transmission. Methods: Using consecutive sampling, 611 participants were interviewed from eight Infectious Diseases clinics in five southeastern states in 2001 to 2002. Results:…

Posted in: Depression 22 epidemiology 36 HIV/AIDS 3 substance use 6 trauma 24 US South 3
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