Evaluation of the Effectiveness of Systematized Training of Advanced Trauma Life Support Protocol in the Interpretation of Cervical Spine and Chest Radiographs in Three Different Emergency Services

2011 ◽  
Vol 70 (6) ◽  
pp. E122-E124 ◽  
Author(s):  
Priscila M. Job ◽  
Luiz Carlos Von Bahten ◽  
Nelson de Oliveira-Junior
Keyword(s):  
Cervical Spine ◽  
Emergency Services ◽  
Life Support ◽  
Chest Radiographs ◽  
Advanced Trauma Life Support

CERVICAL GUNSHOT INJURY

2018 ◽  
Vol 1 (3) ◽  
Author(s):  
Gede Andry Nicolas ◽  
Heru Sutanto Koerniawan ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Life Support ◽  
Surgical Decompression ◽  
Spine Injury ◽  
Advanced Trauma Life Support ◽  
Entire Body ◽  
Cord Injury

The incident of cervical spine injury and cervical spinal cord injury is between 2.0% to 5.0%. The advanced trauma life support (ATLS) stated that a patient with multiple traumas should be assumed tohave cervical spine injury especially if the patient loses consciousness when present in the ER. It is stressed that cervical spine injury requires continuous immobilization of the patient’s entire body using a semirigid collar as well as a backboard with tape and straps before and during transfer to a defnitive care facility. The understanding of the mechanism of injury is the most important as the forces transferred are signifcantly different causing different injuries. A serial case reported by Walter and Adkins found that there was no signifcant difference between the patients that have a bullet removed from the neck and patients that have a bullet left in the cervical cord. In both cases, there was no improvement to the neurologic outcome. Kupcha recommends doing selective wound management and observation of retained intracanal bullet fragments in a patient with complete lesion. Surgical decompression after the injury is not recommended. We report a case of 14 year old boy who was treated at Sanglah Hospital referred froman out-of-island Type C Hospital with a spinal cord injury - American Spinal Injury Association A (SCI ASIA A) caused by a gunshot wound in the cervical. Surgical decompression and bullet removal was performedas well as fusion stabilization. He is then treated in the intensive care unit for 48 hours with a slight improvement in motoric of upper and lower extremities.

Advanced Trauma Life Support Radiographic Trauma Series: Part 1 - the Cervical Spine Radiograph

2010 ◽  
Vol 20 (9) ◽  
pp. 322-328
Author(s):  
Mukai Chimutengwende-Gordon ◽  
Jasmeet Sidhu ◽  
Wasim S Khan ◽  
N Maruthainar
Keyword(s):  
Cervical Spine ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Spine Radiograph ◽  
Cervical Spine Radiograph

Pediatric Trauma

2017 ◽  
Author(s):  
Kathleen Bryant ◽  
Jeremiah Smith ◽  
Michael Gibbs
Keyword(s):  
Cervical Spine ◽  
Head Trauma ◽  
Abdominal Trauma ◽  
Life Support ◽  
Pediatric Trauma ◽  
Research Network ◽  
Advanced Trauma Life Support ◽  
Primary Survey ◽  
Persistent Symptoms ◽  
National Emergency

Children have unique anatomy and physiologic responses to trauma that create different challenges for their management. It is important to follow the Advanced Trauma Life Support (ATLS) algorithm for assessing and treating a pediatric trauma patient, paying close attention to the primary survey. Once the primary survey is accomplished with adequate stabilization, the secondary survey proceeds with a focus on specific injuries. Head trauma is the leading cause of morbidity and mortality (M+M) in children. Early identification and prevention of secondary injury are important to optimize outcomes. The head and neck anatomic differences in a child cause a higher fulcrum of their cervical spine, leading to higher cervical spine injuries (CSIs). CSI is rare but carries a higher M+M due to higher spinal cord injuries. The National Emergency X-radiography Utilization Study (NEXUS) and Canadian C-spine Rule (CCR) are useful decision rules to clear cervical spines in adults but have limited strength in young children. PECARN has derived a pediatric cervical spine clearance rule, but this has yet to be prospectively validated. Similar to CSIs, thoracic injuries in children are rare but carry a higher M+M due to anatomic differences in children. A child’s chest anatomy and increased compliance cause more difficulty in injury identification. Abdominal trauma is common in children and can also be difficult to identify. Unlike adults, children can compensate for blood loss much longer while maintaining their blood pressure. Serial abdominal examinations are useful when imaging is negative and a patient has persistent symptoms. This review contains 5 highly rendered figures, 18 tables, and 92 references. Key words: abdominal trauma, Advanced Trauma Life Support (ATLS), cervical spine injury, head trauma, National Emergency X-radiography Utilization Study (NEXUS),  Pediatric Emergency Care Applied Research Network (PECARN), thoracic trauma, traumatic brain injury

Case Report: FAST Ultrasound Interpretation in Trauma Resuscitation

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 13-14
Author(s):  
Stuart Douglas, PGY4 ◽  
Joseph Newbigging, MD ◽  
David Robertson, MD
Keyword(s):  
Case Report ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Ultrasound Probe ◽  
Trauma Resuscitation ◽  
Highly Sensitive ◽  
Pouch Of Douglas

FAST Background: Focused Assessment with Sonography for Trauma (FAST) is an integral adjunct to primary survey in trauma patients (1-4) and is incorporated into Advanced Trauma Life Support (ATLS) algorithms (4). A collection of four discrete ultrasound probe examinations (pericardial sac, hepatorenal fossa (Morison’s pouch), splenorenal fossa, and pelvis/pouch of Douglas), it has been shown to be highly sensitive for detection of as little as 100cm3 of intraabdominal fluid (4,5), with a sensitivity quoted between 60-98%, specificity of 84-98%, and negative predictive value of 97-99% (3).

Sechs Jahre Advanced Trauma Life Support (ATLS) in Deutschland

2010 ◽  
Vol 113 (7) ◽  
pp. 561-567 ◽  
Author(s):  
M. Münzberg ◽  
L. Mahlke ◽  
B. Bouillon ◽  
T. Paffrath ◽  
G. Matthes ◽  
...  
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support

Pediatric Emergency Medicine: A Developing Subspecialty

PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 336-342
Author(s):  
Marilyn Li ◽  
M. Douglas Baker ◽  
Leland J. Ropp
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Emergency Departments ◽  
Life Support ◽  
Pediatric Emergency ◽  
Advanced Trauma Life Support ◽  
Full Time ◽  
Pediatric Emergency Medicine ◽  
Pediatric Hospitals ◽  
Pediatric Emergency Care

Questionnaires were sent to 245 North American institutions with pediatric residency programs. There was a 69% response rate. Pediatric emergency care is provided in three types of facilities: emergency departments in pediatric hospitals, separate pediatric emergency departments or combined pediatric and adult emergency departments, in multidisciplinary hospitals. There are at least 262 pediatricians practicing full-time pediatric emergency medicine. The majority work in pediatric emergency departments, an average of 30.7 clinical hours per week. There are 27 pediatric emergency medicine programs with 46 fellows in training and 117 full-time positions available for emergency pediatricians throughout North America. Varying qualifications for these positions include board eligibility in pediatrics, certification in Basic Life Support or Advanced Trauma Life Support, and a fellowship in pediatric emergency medicine. The demonstrated need for pediatricians, preferably trained in emergency care, clearly indicates that pediatric emergency medicine is a rapidly developing subspecialty of Pediatrics that will be an attractive career choice for future pediatricians.

Injuries to the Neck

2015 ◽  
Author(s):  
David H. Wisner ◽  
Joseph M. Galante
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Life Support ◽  
Jugular Vein ◽  
Penetrating Trauma ◽  
Operative Management ◽  
Advanced Trauma Life Support ◽  
Neck Trauma ◽  
Anatomical Structures ◽  
Initial Management

Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated rates of morbidity and mortality. Airway management in trauma does not differ based on the mechanism of injury, and so the initial priority is to ensure an adequate airway through cricothyrotomy or tracheotomy. For penetrating neck trauma, initial management is evaluated in accordance with Advanced Trauma Life Support (ATLS) guidelines. Thereafter, the management of penetrating trauma of the stable patients is provided and includes carotid artery exploration and repair, vertebral artery exploration and repair, endovascular repair, jugular vein injuries, treatment of the pharynx and esophagus, and treatment of the larynx and trachea. Blunt trauma is described and includes injuries to the aerodigestive tract and cerebrovascular and vertebral injuries. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular vein, pharynx, and esophagus; the three separate zones of the neck; common incisions made along the sternocleidomastoid muscle; important anatomical structures of the neck; and an algorithm outlining management of known injuries to the vertebral artery. This chapter contains 31 references.

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results

1989 ◽  
Vol 4 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Miroslav Klain ◽  
Edmund Ricci ◽  
Peter Safar ◽  
Victor Semenov ◽  
Ernesto Pretto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Life Support ◽  
Medical Personnel ◽  
The United States ◽  
Structured Interview ◽  
Advanced Trauma Life Support ◽  
Mass Casualties ◽  
Medical Systems ◽  
Preliminary Results ◽  
Medical Teams

AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

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