scholarly journals Emergency Treatment of Patients of Thoraco Abdominal Trauma in Surgical Ward According to Advanced Trauma and Life Support (ATLS)

2021 ◽  
pp. 24-29
Author(s):  
Ahsan Ali Laghari ◽  
Shiraz Shaikh ◽  
Shahnawaz Abro ◽  
Muhammad Ali Suhail ◽  
Gulshan Ali Memon ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Emergency Treatment ◽  
Prospective Observational Study ◽  
Chest Trauma ◽  
Life Support ◽  
Vital Role ◽  
Penetrating Injury ◽  
Surgical Ward ◽  
Trauma Intervention

Objective: To determine the emergency treatment of Patients of Thoraco abdominal trauma in surgical ward according to Advance trauma and life support (ATLS). Methodology: Prospective observational study was conducted for two years from April 2018 to March 2020 at Liaquat university of Medical and Health Sciences Jamshoro/Hyderabad Hospital. The study comprises 50 patients. All were admitted from Emergency department. The patients were evaluated fully after history & clinical examinations. Results were analyzed by using statistical package for social sciences (SPSS) version 23. Results: In this study of 50 patients of Thoraco abdominal trauma, the maximum numbers of patients were in age group 15-70 years. Out of 50 patients 25 patients were presented with Trauma in Thorax, in which 5 patients were presented with penetrating injury & 20 patients were presented with Blunt trauma, 10 patients were presented with combine Thoraco abdominal trauma in which 2 patient were presented with penetrating injury & 8 patients were presented with Blunt trauma. Related to chest trauma 10 patients were treated needle thoracotomy with chest intubation, 5 patients were treated endotracheal intubation, 3 patients were treated thoracotomy and 2 patients were treated cardiosentesis, 5 patients were treated cricothyroidotomy. Better out were seen in 45 patients and mortality were seen in 5 patients. Conclusion: Advance trauma and life support (ATLS) has a vital role in thoraco abdominal trauma intervention. 90% of successful interventions were obtained using advance trauma and life support.

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

Trauma ◽  
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.

Trauma to the Abdomen and Pelvis

2018 ◽  
Author(s):  
Zahir Basrai ◽  
Timothy Jang ◽  
Manuel Celedon
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Peritoneal Lavage ◽  
Penetrating Trauma ◽  
Balloon Occlusion ◽  
Organ Injury ◽  
Abdominal Organs ◽  
Fast Exam ◽  
Definitive Management ◽  
Endovascular Balloon Occlusion

Abdominal trauma accounts for approximately 12% of all trauma. The evaluation of abdominal trauma is difficult as the patient may have concomitant distracting injuries or alteration of mental status. As a result, a systematic approach to abdominal trauma is needed to ensure that life threatening injuries are not missed. The evaluation and management of abdominal trauma is directed by the Western and Eastern Trauma Association guidelines. Trauma to the abdomen is divided into two main categories, penetrating and blunt. The initial steps in management of both types are determined by the hemodynamic stability of the patient. Unstable patients with either pattern of injury are emergently taken to the operating room (OR) for exploration. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is being used at select trauma centers in unstable patients with abdominal trauma that are unresponsive to standard trauma resuscitation. For hemodynamically stable patient with penetrating trauma, recent data on selective non-operative management has shown promising outcomes. Patients with tenuous hemodynamics and blunt abdominal trauma are resuscitated with blood transfusions while being worked up by a Focused Assessment with Sonography for Trauma (FAST) exam or deep peritoneal lavage (DPL). If the patient stabilizes further work up with labs and imaging is performed. Patients that remain tenuous should be taken to the OR. Hemodynamically stable patients with blunt trauma and evidence of peritonitis on exam can be evaluated with labs and imaging to assess for organ injury. Non- tender patients can be evaluated with labs and serial abdominal exams. The American Association for the Surgery of Trauma (AAST) organ injury scales are used to guide the definitive management of patients with intraabdominal injury. The Young-Burgess Classification System can be used to characterize pelvic fractures and to guide stabilization and definitive management. Tables demonstrate the AAST Injury Scales for the different abdominal organs. Images demonstrate the FAST exam and CT findings for different abdominal organs.   This review contains 14 figures, 6 tables and 48 references Key Words: Abdominal Trauma, Penetrating Trauma, Blunt Trauma, FAST exam, Liver Trauma, Splenic Trauma, Intestinal Trauma, Pancreatic Trauma, Diaphragmatic Trauma, Aortic Trauma, Pelvic Fracture, Deep peritoneal lavage, DPL, Focused Assessment with Sonography for Trauma, REBOA, Resuscitative Endovascular Balloon Occlusion of the Aorta

scholarly journals Utilization of a Voice-Based Virtual Reality Advanced Cardiac Life Support Team Leader Refresher: Prospective Observational Study

10.2196/17425 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17425
Author(s):  
Daniel Katz ◽  
Ronak Shah ◽  
Elizabeth Kim ◽  
Chang Park ◽  
Anjan Shah ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Life Support ◽  
Survival Rates ◽  
Cost Effective ◽  
Advanced Cardiac Life Support ◽  
The United States ◽  
Team Leader ◽  
Cost Comparison

Background The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison. Objective This study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS. Methods This prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed. Results A total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; P<.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); P<.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model. Conclusions Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.

scholarly journals Derivation and Validation of Two Decision Instruments for Selective Chest CT in Blunt Trauma: A Multicenter Prospective Observational Study (NEXUS Chest CT)

PLoS Medicine ◽  
2015 ◽  
Vol 12 (10) ◽  
pp. e1001883 ◽  
Author(s):  
Robert M. Rodriguez ◽  
Mark I. Langdorf ◽  
Daniel Nishijima ◽  
Brigitte M. Baumann ◽  
Gregory W. Hendey ◽  
...  
Keyword(s):  
Observational Study ◽  
Blunt Trauma ◽  
Prospective Observational Study ◽  
Chest Ct ◽  
Multicenter Prospective Observational Study

scholarly journals Outcomes with advanced versus basic life support in blunt trauma

2020 ◽  
Vol 220 (3) ◽  
pp. 783-786
Author(s):  
Michael S. Farrell ◽  
Benjamin Emery ◽  
Richard Caplan ◽  
John Getchell ◽  
Mark Cipolle ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Basic Life Support ◽  
Life Support

scholarly journals Duodenal Perforation following Blunt Abdominal Trauma Presenting as Normal in Abdominal Computed Tomography

2014 ◽  
Vol 21 (6) ◽  
pp. 396-399 ◽  
Author(s):  
Pk Tsai ◽  
Yt Yeh ◽  
Cb Yeh
Keyword(s):  
Computed Tomography ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Life Support ◽  
Optimal Time ◽  
Advanced Trauma Life Support ◽  
Duodenal Perforation ◽  
Abdominal Ct ◽  
Abdominal Computed Tomography ◽  
Repeat Examination

Most emergency department (ED) physicians implement the Advanced Trauma Life Support (ATLS) approach, including primary and secondary survey, for the assessment of blunt abdominal trauma (BAT) patients. This report emphasizes the need for repeat Focused Assessment with Sonography for Trauma (FAST) and abdominal computed tomography (CT) if a BAT patient's condition persists or worsens. After initial negative FAST and abdominal CT findings, it is recommended that BAT patients with suspected intraabdominal injury should receive repeat examination in an optimal time. We report a patient who sustained duodenal perforation following BAT diagnosed by repeat ultrasound examination and abdominal CT scan. (Hong Kong j.emerg.med. 2014;21:396-399)

scholarly journals The Value of Modified Early Warning Score (MEWS) in Surgical In-Patients: A Prospective Observational Study

2006 ◽  
Vol 88 (6) ◽  
pp. 571-575 ◽  
Author(s):  
J Gardner-Thorpe ◽  
N Love ◽  
J Wrightson ◽  
S Walsh ◽  
N Keeling
Keyword(s):  
Risk Management ◽  
Observational Study ◽  
Critically Ill ◽  
Early Warning ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Early Warning Score ◽  
Management Tool ◽  
Quality And Safety ◽  
Surgical Ward

INTRODUCTION The Modified Early Warning Score (MEWS) is a simple, physiological score that may allow improvement in the quality and safety of management provided to surgical ward patients. The primary purpose is to prevent delay in intervention or transfer of critically ill patients. PATIENTS AND METHODS A total of 334 consecutive ward patients were prospectively studied. MEWS were recorded on all patients and the primary end-point was transfer to ITU or HDU. RESULTS Fifty-seven (17%) ward patients triggered the call-out algorithm by scoring four or more on MEWS. Emergency patients were more likely to trigger the system than elective patients. Sixteen (5% of the total) patients were admitted to the ITU or HDU. MEWS with a threshold of four or more was 75% sensitive and 83% specific for patients who required transfer to ITU or HDU. CONCLUSIONS The MEWS in association with a call-out algorithm is a useful and appropriate risk-management tool that should be implemented for all surgical in-patients.

scholarly journals Severe Spasm of the Renal Artery after Blunt Abdominal Trauma Simulating End-Organ Infarction

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Adem Ucar ◽  
Aghakishi Yahyayev ◽  
Ayaz Agayev ◽  
Fatih Yanar ◽  
Selim Bakan ◽  
...  
Keyword(s):  
Renal Artery ◽  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Arterial Occlusion ◽  
Endovascular Intervention ◽  
Surgical Revascularization ◽  
Injury Management ◽  
Main Renal Artery ◽  
Serious Injury

Traumatic occlusion of the renal artery is a serious injury. Management differs according to the grade of injury. In most circumstances, emergency surgical revascularization or endovascular intervention is required. We describe the case of a child with multiorgan injuries and spasm of the main renal artery after blunt trauma simulating arterial occlusion or end-organ infarction.

scholarly journals Impact of Room Location on UV-C Irradiance and UV-C Dosage and Antimicrobial Effect Delivered by a Mobile UV-C Light Device

2016 ◽  
Vol 37 (6) ◽  
pp. 667-672 ◽  
Author(s):  
John M. Boyce ◽  
Patricia A. Farrel ◽  
Dana Towle ◽  
Renee Fekieta ◽  
Michael Aniskiewicz
Keyword(s):  
Staphylococcus Aureus ◽  
Stainless Steel ◽  
Prospective Observational Study ◽  
Uv Light ◽  
Antimicrobial Effect ◽  
M 10 ◽  
Surgical Ward ◽  
Ultraviolet C ◽  
Vancomycin Resistant ◽  
Uv C

OBJECTIVETo evaluate ultraviolet C (UV-C) irradiance, UV-C dosage, and antimicrobial effect achieved by a mobile continuous UV-C device.DESIGNProspective observational study.METHODSWe used 6 UV light sensors to determine UV-C irradiance (W/cm2) and UV-C dosage (µWsec/cm2) at various distances from and orientations relative to the UV-C device during 5-minute and 15-minute cycles in an ICU room and a surgical ward room. In both rooms, stainless-steel disks inoculated with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile spores were placed next to sensors, and UV-C dosages and log10 reductions of target organisms achieved during 5-minute and 15-minute cycles were determined. Mean irradiance and dosage readings were compared using ANOVA.RESULTSMean UV-C irradiance was nearly 1.0E-03 W/cm2 in direct sight at a distance of 1.3 m (4 ft) from the device but was 1.12E-05 W/cm2 on a horizontal surface in a shaded area 3.3 m (10 ft) from the device (P<.001). Mean UV-C dosages received by UV-C sensors located at different distances and orientation relative to the device varied significantly during 5-minute cycles and during 15-minute cycles (P<.001). Log10 reductions ranged from >4 to 1–3 for MRSA, >4 to 1–2 for VRE and >4 to 0 log10 for C. difficile spores, depending on the distance from, and orientation relative to, the device with 5-minute and 15-minute cycles.CONCLUSIONUV-C irradiance, dosage, and antimicrobial effect received from a mobile UV-C device varied substantially based on location in a room relative to the UV-C device.Infect Control Hosp Epidemiol 2016;37:667–672

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