Sternal fractures in blunt trauma patients

Introduction Bedside lung sonography is recognized as a reliable diagnostic modality in trauma settings due to its ability to detect alterations both in lung parenchyma and in pleural cavities. In severe blunt chest trauma, lung ultrasound can identify promptly life-threatening conditions which may need direct intervention, whereas in minor trauma, lung ultrasound contributes to detection of acute pathologies which are often initially radio-occult and helps in the selection of those patients that might need further investigation. Topic Description We did a literature search on databases EMBASE, PubMed, SCOPUS and Google Scholar using the terms ‘trauma’, ‘lung contusion’, ‘pneumothorax’, ‘hemothorax’ and ‘lung ultrasound’. The latest articles were reviewed and this article was written using the most current and validated information. Discussion Lung ultrasound is quite accurate in diagnosing pneumothorax by using a combination of four sonographic signs; absence of lung sliding, B-lines, lung pulse and presence of lung point. It provides a rapid diagnosis in hemodynamically unstable patients. Lung contusions and hemothorax can be diagnosed and assessed with lung ultrasound. Ultrasound is also very useful for evaluating rib and sternal fractures and for imaging the pericardium for effusion and tamponade. Conclusion Bedside lung ultrasound can lead to rapid and accurate diagnosis of major life-threatening pathologies in blunt chest trauma patients.

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Repairing the injured bronchus in blunt chest trauma – A case series

Trauma ◽

10.1177/1460408620988116 ◽

2021 ◽

pp. 146040862098811

Author(s):

Anith Nadzira Riduan ◽

Narasimman Sathiamurthy ◽

Benedict Dharmaraj ◽

Diong Nguk Chai ◽

Narendran Balasubbiah

Keyword(s):

Blunt Trauma ◽

Chest Trauma ◽

Surgical Intervention ◽

Case Series ◽

Trauma Patients ◽

Lung Collapse ◽

Comprehensive Management ◽

Lung Capacity ◽

Management Algorithm ◽

Operative Outcomes

Introduction Traumatic bronchial injury (TBI) is uncommon, difficult to diagnose and often missed. The incidence of TBI among blunt trauma patients is estimated to be around 0.5–2%. Bronchoplastic surgery is indicated in most cases to repair the tracheobronchial airway and preserve lung capacity. There is limited existing literature addressing the management of this condition in view of its rarity. The comprehensive management and outcomes of these patients are discussed. Methods The case notes of all patients who presented with persistent lung collapse due to trauma since July 2017 were reviewed retrospectively. Those patients requiring surgical intervention were included in the review. The mode of injury, clinical, radiological and bronchoscopy findings, concurrent injuries, type of surgery, length of stay (LOS) and operative outcomes were reviewed. Results Out of 11 patients who presented with persistent lung collapse post-blunt trauma, four (36%) were found to have structural bronchial disruption. All of them underwent successful repair of the injured bronchus, without the need of a pneumonectomy. The other seven patients were successfully treated conservatively. Conclusion The repair of the injured bronchus is essential in improving respiratory function and to prevent a pneumonectomy. Routine bronchoscopic evaluation should be performed for all suspected airway injuries as recommended in our management algorithm. Delayed presentations should not hinder urgent referral to thoracic centers for tracheobronchial reconstruction.

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Association between Mode of Transportation and Survival in Adult Trauma Patients with Blunt Injuries: Matched Cohort Study between Police and Ground Ambulance Transport

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000510 ◽

2021 ◽

pp. 1-9

Author(s):

Fouad A. Sakr ◽

Rana H. Bachir ◽

Mazen J. El Sayed

Keyword(s):

Cohort Study ◽

Survival Rate ◽

Blunt Trauma ◽

Survival Rates ◽

Trauma Patients ◽

Matched Cohort ◽

Matched Cohort Study ◽

Blunt Injuries ◽

Ground Ambulance ◽

Mode Of Transportation

Abstract Introduction: Early police transport (PT) of penetrating trauma patients has the potential to improve survival rates for trauma patients. There are no well-established guidelines for the transport of blunt trauma patients by PT currently. Study Objective: This study examines the association between the survival rate of blunt trauma patients and the transport modality (police versus ground ambulance). Methods: A retrospective, matched cohort study was conducted using the National Trauma Data Bank (NTDB). All blunt trauma patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by ground Emergency Medical Services (EMS) for analysis. Descriptive analysis was carried out. This was followed by comparing all patients’ characteristics and their survival rates in terms of the mode of transportation. Results: Out of the 2,469 patients with blunt injuries, EMS transported 1,846 patients and police transported 623 patients. Most patients were 16-64 years of age (86.2%) with a male predominance (82.5%). Fall (38.4%) was the most common mechanism of injury with majority of injuries involving the head and neck body part (64.8%). Fractures were the most common nature of injury (62.1%). The overall survival rate of adult blunt trauma patients was similar for both methods of transportation (99.2%; P = 1.000). Conclusion: In this study, adult blunt trauma patients transported by police had similar outcomes to those transported by EMS. As such, PT in trauma should be encouraged and protocolized to improve resource utilization and outcomes further.

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Neutrophil Priming for Elastase Release in Adult Blunt Trauma Patients

Journal of Trauma and Acute Care Surgery ◽

10.1097/01.ta.0000205614.51885.ff ◽

2006 ◽

Vol 60 (3) ◽

pp. 590-596 ◽

Cited By ~ 24

Author(s):

Raj Bhatia ◽

Colin Dent ◽

Nicholas Topley ◽

Ian Pallister

Keyword(s):

Blunt Trauma ◽

Trauma Patients ◽

Neutrophil Priming

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Comparison of the Trauma and Injury Severity Score (TRISS) and Modified Early Warning Score with Rapid Lactate Level (the ViEWS-L Score) in Blunt Trauma Patients

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2012.09.108 ◽

2012 ◽

Vol 43 (5) ◽

pp. 936

Author(s):

S. Jo ◽

J.B. Lee ◽

Y.H. Jin ◽

T. Jeong ◽

J. Yoon

Keyword(s):

Injury Severity Score ◽

Blunt Trauma ◽

Early Warning ◽

Severity Score ◽

Lactate Level ◽

Injury Severity ◽

Early Warning Score ◽

Trauma Patients ◽

Trauma And Injury

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Body Mass Index and Outcomes in Critically Injured Blunt Trauma Patients: Weighing the Impact

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2006.12.042 ◽

2007 ◽

Vol 204 (5) ◽

pp. 1056-1061 ◽

Cited By ~ 99

Author(s):

Mark A. Newell ◽

Michael R. Bard ◽

Claudia E. Goettler ◽

Eric A. Toschlog ◽

Paul J. Schenarts ◽

...

Keyword(s):

Body Mass Index ◽

Blunt Trauma ◽

Body Mass ◽

Trauma Patients ◽

The Impact

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Corrigendum to “Routine pelvic X-rays in asymptomatic hemodynamically stable blunt trauma patients: A meta-analysis” [Injury 49 (11) (2018) 2024–2031]

Injury ◽

10.1016/j.injury.2018.11.033 ◽

2019 ◽

Vol 50 (2) ◽

pp. 621

Author(s):

Jessica van Trigt ◽

Niels Schep ◽

Rolf Peters ◽

Carel Goslings ◽

Tim Schepers ◽

...

Keyword(s):

Blunt Trauma ◽

Meta Analysis ◽

Trauma Patients ◽

X Rays

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Ruling out intra-abdominal injuries in blunt trauma patients using clinical criteria and abdominal ultrasound

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912017006015 ◽

2017 ◽

Vol 44 (6) ◽

pp. 626-632 ◽

Cited By ~ 2

Author(s):

Flávia Helena Barbosa Moura ◽

José Gustavo Parreira ◽

Thiara Mattos ◽

Giovanna Zucchini Rondini ◽

Cristiano Below ◽

...

Keyword(s):

Blunt Trauma ◽

Abdominal Ultrasound ◽

Physical Exam ◽

Trauma Patients ◽

Abdominal Injuries ◽

Hemodynamic Stability ◽

Abdominal Ultrasonography ◽

Clinical Criteria ◽

Clinical Variables ◽

Abdominal Lesions

ABSTRACT Objective: to identify victims of blunt abdominal trauma in which intra-abdominal injuries can be excluded by clinical criteria and by complete abdominal ultrasonography. Methods: retrospective analysis of victims of blunt trauma in which the following clinical variables were analyzed: hemodynamic stability, normal neurologic exam at admission, normal physical exam of the chest at admission, normal abdomen and pelvis physical exam at admission and absence of distracting lesions (Abbreviated Injury Scale >2 at skull, thorax and/or extremities). The ultrasound results were then studied in the group of patients with all clinical variables evaluated. Results: we studied 5536 victims of blunt trauma. Intra-abdominal lesions with AIS>1 were identified in 144 (2.6%); in patients with hemodynamic stability they were present in 86 (2%); in those with hemodynamic stability and normal neurological exam at admission in 50 (1.8%); in patients with hemodynamic stability and normal neurological and chest physical exam at admission, in 39 (1.5%); in those with hemodynamic stability, normal neurological, chest, abdominal and pelvic physical exam at admission, in 12 (0.5%); in patients with hemodynamic stability, normal neurological, chest, abdominal and pelvic physical exam at admission, and absence of distracting lesions, only two (0.1%) had intra-abdominal lesions. Among those with all clinical variables, 693 had normal total abdominal ultrasound, and, within this group, there were no identified intra-abdominal lesions. Conclusion: when all clinical criteria and total abdominal ultrasound are associated, it is possible to identify a group of victims of blunt trauma with low chance of significant intra-abdominal lesions.

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