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At least 469 records · Page 26Linked to original sources
PubMed1992

Perforating injury of the neck and vertebral artery trauma.

A 10-year-old schoolboy presented with a penetrating wound to the neck after a children's slide accident. A CT scan and endoscopy showed a traumatic oesophageal-cutaneous fistula. Neurologically the child deteriorated over a period of 34 hours and finally succumbed to a respiratory arrest. Post-mortem findings showed a hypoplastic right vertebral artery. In the left suboccipital triangle a venous clot had blocked the dominant artery thus leading to cerebellar and brainstem infarction. This extraluminal compression leading to obstruction of an otherwise non traumatized vertebral artery is unique in the literature.

Child↗
PubMed1986

Penetrating injuries of the neck. Emergency evaluation and management.

The physician who is called upon to attend to a penetrating wound to the neck must set priorities in management. (1) Establish a safe airway. (2) Maintain adequate cardiocerebral perfusion. (3) Assess and identify the type and severity of the wound so that proper decisions can be made about further evaluation and/or transfer for immediate surgical intervention. All this can be accomplished in an orderly fashion by applying the principles for selective surgical exploration of neck wounds outlined in this article. A well-reasoned approach can help avoid unnecessary surgery and yields a high likelihood of recovery.

Emergencies↗
PubMed2004

Trauma in the pregnant patient.

PURPOSE OF REVIEW: Trauma is the leading overall cause of death in the age group under 40 years of age in the United States. Women of reproductive age are considered the population at greatest risk of trauma. A Medline search for recent articles highlighting anesthetic, obstetric and surgical considerations for pregnant trauma victims was performed, and current guidelines (recommendations) are discussed in this review article. RECENT FINDINGS: Trauma in pregnancy is currently a leading cause of non-pregnancy-related maternal death, and maternal death remains the most common cause of fetal demise. The most common etiologies of trauma in pregnancy include transportation accidents, falls, violent assaults, and burn injuries. Head and neck injuries and hemorrhagic shock account for most maternal deaths secondary to trauma. SUMMARY: Pregnancy must always be suspected in any female trauma patient of childbearing age. The pregnant trauma victim presents a unique spectrum of challenges to the healthcare team. Expeditious maternal resuscitation is the most effective method of fetal resuscitation. Adequate management of pregnant trauma victims requires the anesthesiologist to consider and understand the unique changes in anatomy and physiology that take place during pregnancy.

Journal Article↗
PubMed1996

Significance of chest trauma in children.

Chest trauma in children is a marker of injury severity and is associated with a high mortality rate. This retrospective study of 1,356 trauma patients from a private pediatric hospital over a 2.5-year period identified 82 patients with chest injuries and a mortality rate of 22%. Results of Injury Severity Score, Glasgow Coma Scale, and Revised Trauma Score all indicated that children with chest injuries sustained more severe injuries. The presence of any extrathoracic injury was associated with a higher mortality (29%) than chest injury alone (4.3%). The type of extrathoracic injury was important, with head and neck injuries resulting in the highest mortality. Specific chest injuries, such as rib fractures and pulmonary contusions, were not related to increased mortality unless there was an associated extrathoracic injury. Many reports have shown a high mortality associated with chest trauma. This study suggests that it is the associated extrathoracic injury, rather than the chest injury itself, that is the real cause of the high mortality.

Abdominal Injuries↗
PubMed1995

Posters for accident departments: simple method of sustaining reduction in x ray examinations.

OBJECTIVE: To assess whether a simple strategy would sustain a reduction in the number of unnecessary x ray examinations. DESIGN: Use of posters to display guidelines encouraging the more effective use of radiology in patients with head injuries, twisted ankles, neck injuries, and abdominal pain. SETTING: Accident department of a large metropolitan district general hospital. PATIENTS: 15,875 patients attending the accident department over two years. MAIN OUTCOME MEASURE: Proportion of patients having radiography. RESULTS: Referrals for skull radiography fell from 56% to 20% and those for abdominal radiography fell from 31% to 7%. Referral patterns for adults attending with twisted ankles and cervical spine injuries did not change. Reductions were sustained over two years. CONCLUSION: Carefully designed posters provide a simple method of reducing unnecessary x ray examinations.

Audiovisual Aids↗
PubMed1998

Injuries to children in the United States related to trampolines, 1990-1995: a national epidemic.

STUDY OBJECTIVE: To describe the epidemiology of trampoline-related injuries among children in the United States. DESIGN: A retrospective analysis of data for children 18 years old and younger from the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission for 1990 through 1995. RESULTS: There were an estimated 249 400 trampoline-related injuries [95% confidence interval (CI), 166 300-332 500] to children 18 years old and younger treated in hospital emergency departments in the United States during the 6-year study period. The number of injuries increased by 98% from 29 600 in 1990 to 58 400 in 1995, with an average of 41 600 (95% CI, 27 700-55 500) injuries per year, or 59.4 injuries per 100 000 United States children per year (95% CI, 39.6-79.3). The median age of injured children was 10 years, and 50% were males. Ninety-three percent of injuries occurred at home. Injuries to the extremities predominated among children of all ages and accounted for more than 70% of all injuries. This study identified several age-specific injury patterns. There was an inverse relationship between age versus the relative frequency of upper extremity injuries, and fractures and dislocations; and there was a direct relationship between age versus lower extremity injuries and soft tissue injury. There was also an inverse relationship between age versus facial injuries, head and neck injuries, and lacerations. Annually, an estimated 1400 children (95% CI, 800-2000), or 2.0 per 100 000 United States children (95% CI, 1. 1-2.9), required hospital admission or interhospital transfer because of a trampoline-related injury. This represented 3.3% of all children with a trampoline-associated injury. Fractures or dislocations accounted for 83% of injuries among admitted or transferred children, and children with a fracture or dislocation were more likely to be admitted or transferred to another hospital (8.4%) than children with other types of injury (relative risk, 10.80; 95% CI, 9.40 < relative risk < 12.29). Among children released home from the emergency department, soft tissue injuries (53%), fractures or dislocations (30%), and lacerations (14%) were the most common injuries treated. CONCLUSION: Injuries related to trampolines, especially backyard trampolines, are an important cause of pediatric morbidity. These injuries have also resulted in death. The rapid increase in the number of trampoline-related injuries to children during recent years is evidence that current prevention strategies are inadequate. Children should not use trampolines at home, and the sale of trampolines for private recreational use should be stopped.

Adolescent↗