1201 DOES THE MECHANISM OF INJURY IN PEDIATRIC BLUNT TRAUMA PATIENTS CORRELATE WITH THE SEVERITY OF GENITOURINARY ORGAN INJURY?

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Bayo Tojuola ◽  
Xiao Gu ◽  
Nathan Littlejohn ◽  
Mark Williams ◽  
Dana Giel
Keyword(s):  
Blunt Trauma ◽  
Organ Injury ◽  
Trauma Patients ◽  
Mechanism Of Injury

Focused Assessment with Sonography for Trauma

2018 ◽  
Author(s):  
David Barounis ◽  
Elise Hart
Keyword(s):  
Blunt Trauma ◽  
Low Cost ◽  
Operative Management ◽  
Organ Injury ◽  
Free Fluid ◽  
Trauma Patients ◽  
Solid Organ ◽  
Primary Role ◽  
Ongoing Research ◽  
Screening Ultrasound

The focused assessment with sonography for trauma (FAST) is a screening ultrasound examination used to identify traumatic free fluid in the pericardium and peritoneum through four key windows: the subxiphoid, the hepatorenal recess, the splenorenal recess, and the suprapubic views. The primary role for the FAST examination is in the bedside evaluation of hemodynamically unstable blunt trauma patients to help direct operative management. The extended FAST (E-FAST) examination involves additional evaluation of the thorax and can reliably identify hemothorax and pneumothorax. The advantages of these modalities include rapid speed, low cost, and a lack of ionizing radiation. The limitations include operator dependence, although validated assessments hold promise in mitigating this issue, and poor sensitivity in identifying retroperitoneal hemorrhages, diaphragmatic injuries, and solid-organ injuries that do not produce significant intraperitoneal hemorrhage. In the future, contrast-enhanced ultrasonography may improve ultrasonographic evaluation of solid-organ injury. Nevertheless, significant concerns remain regarding the wide ranges of sensitivity reported for the FAST examination overall, and ongoing research may better identify its optimal role in evaluating trauma patients. Key words: Blunt trauma; focused assessment with sonography for trauma (FAST); extended FAST (E-FAST); hemothorax; pneumothorax; ultrasonography

Focused Assessment with Sonography for Trauma

2016 ◽  
Author(s):  
David Barounis ◽  
Elise Hart
Keyword(s):  
Blunt Trauma ◽  
Low Cost ◽  
Operative Management ◽  
Organ Injury ◽  
Free Fluid ◽  
Trauma Patients ◽  
Solid Organ ◽  
Primary Role ◽  
Ongoing Research ◽  
Screening Ultrasound

The focused assessment with sonography for trauma (FAST) is a screening ultrasound examination used to identify traumatic free fluid in the pericardium and peritoneum through four key windows: the subxiphoid, the hepatorenal recess, the splenorenal recess, and the suprapubic views. The primary role for the FAST examination is in the bedside evaluation of hemodynamically unstable blunt trauma patients to help direct operative management. The extended FAST (E-FAST) examination involves additional evaluation of the thorax and can reliably identify hemothorax and pneumothorax. The advantages of these modalities include rapid speed, low cost, and a lack of ionizing radiation. The limitations include operator dependence, although validated assessments hold promise in mitigating this issue, and poor sensitivity in identifying retroperitoneal hemorrhages, diaphragmatic injuries, and solid-organ injuries that do not produce significant intraperitoneal hemorrhage. In the future, contrast-enhanced ultrasonography may improve ultrasonographic evaluation of solid-organ injury. Nevertheless, significant concerns remain regarding the wide ranges of sensitivity reported for the FAST examination overall, and ongoing research may better identify its optimal role in evaluating trauma patients. Key words: Blunt trauma; focused assessment with sonography for trauma (FAST); extended FAST (E-FAST); hemothorax; pneumothorax; ultrasonography

Isolated Blunt Duodenal Trauma: Simple Repair, Low Mortality

2015 ◽  
Vol 81 (10) ◽  
pp. 961-964 ◽  
Author(s):  
Stefano Siboni ◽  
Elizabeth Benjamin ◽  
Tobias Haltmeier ◽  
Kenji Inaba ◽  
Demetrios Demetriades
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Primary Repair ◽  
Data Bank ◽  
Hospital Length Of Stay ◽  
Organ Injury ◽  
Low Grade ◽  
Trauma Patients ◽  
National Trauma ◽  
National Trauma Data Bank

Optimal surgical management of traumatic duodenal injury (DI) remains controversial. The National Trauma Data Bank was queried for all blunt trauma patients with DI. Patients with isolated injury were identified by excluding chest and head Abbreviated Injury Score > 3 and non-duodenal intra-abdominal Organ Injury Scale ≥ 3. Demographics, OIS, and operative intervention were collected. Outcomes included mortality and hospital length of stay (HLOS). During the study period, 3,456,098 blunt trauma patients were entered into the National Trauma Data Bank, 388,137 of which had abdominal trauma. Overall, 1.0 per cent patients with abdominal trauma had DI with isolated DI in only 0.6 per cent (n = 2220). The majority of isolated DI was low grade with only 158 patients sustaining severe injury and overall mortality was 5.2 per cent. Overall 743 patients were operated, of which 353 (47.5%) patients underwent duodenal operation, 280 (37.7%) had primary repair (PR), and 68 (9.2%) had gastroenterostomy (GE). Patients with PR had similar mortality to those with GE (6.6% vs 4.5%, P = 0.777); however, HLOS was shorter (median 11 days, vs 18 days, P < 0.001). In only OIS 4 and 5 injuries, PR was also associated with shorter HLOS ( P = 0.004) and similar mortality ( P = 1.000) when compared with GE. Isolated DI after blunt abdominal trauma is rare. In severe injuries, PR is associated with a shorter HLOS without effecting mortality when compared with GE.

In the Modern Era of CT, Do Blunt Trauma Patients with Markers for Blunt Bowel or Mesenteric Injury Still Require Exploratory Laparotomy?

2017 ◽  
Vol 83 (7) ◽  
pp. 722-727 ◽  
Author(s):  
Katelyn Young ◽  
Melina Benson ◽  
Andrew Higgins ◽  
James Dove ◽  
Marie Hunsinger ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Bowel Perforation ◽  
Organ Injury ◽  
Acute Injury ◽  
Common Finding ◽  
Wall Thickening ◽  
Trauma Patients ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Mesenteric Injury

After blunt trauma, certain CT markers, such as free intraperitoneal air, strongly suggest bowel perforation, whereas other markers, including free intraperitoneal fluid without solid organ injury, may be merely suspicious for acute injury. The present study aims to delineate the safety of non-operative management for markers of blunt bowel or mesenteric injury (BBMI) that are suspicious for significant bowel injury after blunt trauma. This was a retrospective review of adult blunt trauma patients with abdominopelvic CT scans on admission to a Level I trauma center between 2012 and 2014. Patients with CT evidence of acute BBMI without solid organ injury were included. The CT markers for BBMI included free intraperitoneal fluid, bowel hematoma, bowel wall thickening, mesenteric edema, hematoma and stranding. Two thousand blunt trauma cases were reviewed, and 94 patients (4.7%) met inclusion criteria. The average Injury Severity Score was 13.6 ± 10.1 and the median hospital stay was four days. The most common finding was free fluid (74 patients, 78.7%). The majority of patients (92, 97.9%) remained asymptomatic or clinically improved without abdominal surgery. After a change in abdominal examination, two patients (2.1%) underwent laparotomy with bowel perforation found in only one patient. Thus, 93 patients did not have a surgically significant injury, indicating that these markers demonstrate 1.1 per cent positive predictive value for bowel perforation. The presence of these markers after blunt trauma does not mandate laparotomy, though it should prompt thorough and continued vigilance toward the abdomen.

Focused Assessment with Sonography for Trauma

2018 ◽  
Author(s):  
David Barounis ◽  
Elise Hart
Keyword(s):  
Blunt Trauma ◽  
Low Cost ◽  
Operative Management ◽  
Organ Injury ◽  
Free Fluid ◽  
Trauma Patients ◽  
Solid Organ ◽  
Primary Role ◽  
Ongoing Research ◽  
Screening Ultrasound

The focused assessment with sonography for trauma (FAST) is a screening ultrasound examination used to identify traumatic free fluid in the pericardium and peritoneum through four key windows: the subxiphoid, the hepatorenal recess, the splenorenal recess, and the suprapubic views. The primary role for the FAST examination is in the bedside evaluation of hemodynamically unstable blunt trauma patients to help direct operative management. The extended FAST (E-FAST) examination involves additional evaluation of the thorax and can reliably identify hemothorax and pneumothorax. The advantages of these modalities include rapid speed, low cost, and a lack of ionizing radiation. The limitations include operator dependence, although validated assessments hold promise in mitigating this issue, and poor sensitivity in identifying retroperitoneal hemorrhages, diaphragmatic injuries, and solid-organ injuries that do not produce significant intraperitoneal hemorrhage. In the future, contrast-enhanced ultrasonography may improve ultrasonographic evaluation of solid-organ injury. Nevertheless, significant concerns remain regarding the wide ranges of sensitivity reported for the FAST examination overall, and ongoing research may better identify its optimal role in evaluating trauma patients. Key words: Blunt trauma; focused assessment with sonography for trauma (FAST); extended FAST (E-FAST); hemothorax; pneumothorax; ultrasonography

Focused Assessment with Sonography for Trauma

2018 ◽  
Author(s):  
David Barounis ◽  
Elise Hart
Keyword(s):  
Blunt Trauma ◽  
Low Cost ◽  
Operative Management ◽  
Organ Injury ◽  
Free Fluid ◽  
Trauma Patients ◽  
Solid Organ ◽  
Primary Role ◽  
Ongoing Research ◽  
Screening Ultrasound

The focused assessment with sonography for trauma (FAST) is a screening ultrasound examination used to identify traumatic free fluid in the pericardium and peritoneum through four key windows: the subxiphoid, the hepatorenal recess, the splenorenal recess, and the suprapubic views. The primary role for the FAST examination is in the bedside evaluation of hemodynamically unstable blunt trauma patients to help direct operative management. The extended FAST (E-FAST) examination involves additional evaluation of the thorax and can reliably identify hemothorax and pneumothorax. The advantages of these modalities include rapid speed, low cost, and a lack of ionizing radiation. The limitations include operator dependence, although validated assessments hold promise in mitigating this issue, and poor sensitivity in identifying retroperitoneal hemorrhages, diaphragmatic injuries, and solid-organ injuries that do not produce significant intraperitoneal hemorrhage. In the future, contrast-enhanced ultrasonography may improve ultrasonographic evaluation of solid-organ injury. Nevertheless, significant concerns remain regarding the wide ranges of sensitivity reported for the FAST examination overall, and ongoing research may better identify its optimal role in evaluating trauma patients. Key words: Blunt trauma; focused assessment with sonography for trauma (FAST); extended FAST (E-FAST); hemothorax; pneumothorax; ultrasonography

188. Mechanism of Injury Independently Predicts Mortality and Functional Outcomes in Blunt Trauma Patients

2008 ◽  
Vol 144 (2) ◽  
pp. 260 ◽  
Author(s):  
Adil H. Haider ◽  
David C. Chang ◽  
Elliott R. Haut ◽  
David T. Efron ◽  
Edward E. Cornwell
Keyword(s):  
Blunt Trauma ◽  
Functional Outcomes ◽  
Trauma Patients ◽  
Mechanism Of Injury
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