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Results for “Multiple Trauma”

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At least 487 records · Page 27Linked to original sources
PubMed1999

[Single stab wounds causing multiple trauma].

The authors presented their two-year experience regarding diagnosis and treatment of 6 patients with single stab wounds causing polytrauma. In 4 cases the thoracoabdominal penetrating wounds were diagnosed. Emergency x-ray of the chest and ultrasonographic examination of abdomen were diagnostic in 1 case (17%). Five patients (83%) were operated in first three hours after trauma with good results. In 1 case (17%) delayed operation was complicated by left pyothorax. The results of this study indicated that patients with stab wounds causing polytrauma should be operated urgently in order to avoid complications and improve prognosis.

Adolescent↗
PubMed1997

[Database for assessment of treatment results in patients with multiple trauma].

Data base for assessment of results of treatment of politrauma patients is presented. It was created on the basis of Abbreviated Injury Scale, Injury Severity Score and Revised Trauma Score. Examination was supplemented with TRISS method inclusive of graphic assessment PRE-CHART and statistic Z and M. The software was created on the basis of Excel 7.0 and Windows 95.

Computer Graphics↗
PubMed2004

[Lung separation after reintubation with airway exchange catheter in multiple trauma patient with massive haemoptysis].

A 24-year-old man fell from the third floor. He developed an unilateral pulmonary parenchymal injury and a significant haemoptysis following blunt thoracic trauma. Because of its abundance, it was not possible to obtain adequat oxygenation. To protect controlateral lung from inhalation and to achieve adequat oxygenation, we used double lumen endotracheal tube, lung separation and one lung ventilation. To solve potential airway management difficulties (haemorrhage, trauma, cervical immobilization), we used airway exchange catheter (Cook) to place the double lumen endotracheal tube. Haemoptysis has been controlled by embolization of the right bronchial artery.

Accidental Falls↗
PubMed1996

[Admission documentation of multiple trauma patients using the Zurich Trauma Protocol--initial experiences].

A new protocol to document multiply injured patients in presented. It consists of 23 pages and is indexed on the right side. The pages are structured according to the Abbreviated Injury Scale (AIS): head/neck, face, thorax, abdomen, extremities/pelvis and integument. Different checklists on the right side of each page help to enter data efficiently; schemes and templates on the left side provide further support to visualize and classify the injuries. Summaries for diagnosis, therapies and for further investigations provide a standardized overview of the patient. The experiences of 22 residents were analyzed after one year of the protocol use. The trauma protocol was shown to be easy to learn, it was well accepted, and it increased the exchange of information between the emergency room and the intensive care unit. However, some residents considered this data entry to more laborious compared with the traditional medical record system. The trauma protocol was designed for prospective data acquisition of intensive care patients; it provides also a uniform structure for retrospective analysis and is therefore a helpful tool to increase quality control and quality assurance.

Abbreviated Injury Scale↗
PubMed1995

[Psychiatric management of multiple trauma].

In resuscitation or surgery departments, the recourse to the psychiatrist regarding a polytraumatized patient occurs according to two main contexts. Firstly, patients with major psychiatric troubles are concerned, sometimes after suicide attempts. Secondly, patients with behaviour disorders or somatic complaints may attract the physician's attention. The authors study the psychiatric intervention in those various cases.

Adult↗
PubMed1989

Neuroleptic malignant syndrome in the multiple trauma patient.

A 25-year-old multiply traumatized patient developed neuroleptic malignant syndrome (NMS) secondary to the use of Haldol. The diagnosis was delayed due to poor recognition of the syndrome, risking a fatal outcome. The signs and symptoms of the syndrome are presented along with the pathophysiology and the available treatments for NMS.

Adult↗
PubMed1992

[Therapy of patients with multiple traumas: interdisciplinary organization at a specialized center].

By utilizing all its specialist facilities, the specialized trauma centre can optimize the chances of survival of the severely injured patient. However, this is possible only when the specialties involved have the ability to cooperate and when a "team leader" applying treatment guidelines worked out and accepted on an interdisciplinary basis is available to coordinate activities.

Humans↗
PubMed1997

[Effects of various feeding regimens in multiple trauma patients on septic complications and immune parameters].

OBJECTIVE: The aim of this study was to investigate the incidence of septic complications, the immunological changes by the course of lymphocyte subsets and metabolic parameters on polytraumatised patients when given nutritional support in form of early enteral and total parenteral nutrition. Furthermore, we looked for differences between a standard enteral diet and a diet supplemented with arginine, omega-3-fatty acids, nucleotide, and selenium. METHODS: 30 polytraumatised patients with an Acute Physiology and Chronic Health Evaluation II (APACHE II)-Score > 10 points, who received nutritional support for a minimum of 7 days, were randomised to a "supplemented enteral group" (group 1), an "enteral standard group" (group 2), or a "parenteral group" (group 3). In the first both groups there were early enteral feeding. The patients of group 3 were fed isonitrogenous and isocaloric to group 2. Leucocytes, lymphocytes, CD3(+)-, CD4(+)-, CD3+HLA-DR(+)-, CD8(+)-, CD19(+)-subsets, natural killer-cells (CD56+) and metabolic parameters were measured on days 1, 3, 5, 7. RESULTS: Septic complications occurred in 2 patients in group 1, in 1 patient in group 2 and in 4 patients in group 3. The total number of lymphocytes had an increase on day 7 in group 1 (1420/microliter) and group 2 (1620/microliter) and were higher compared with group 3 (1044/microliter). On day 7 T-cells (CD3+) were 1107/microliter in group 1, 1014/microliter in group 2 and 770/microliter in group 3, T-helper-cells (CD4+) rose on day 7 higher in the enteral fed groups (group 1:746/microliter, group 2:719/microliter) than in group 3 (570/microliter). No significant differences between the groups were seen by CD3+HLA-DR(+)-cells, T-suppressor-cells (CD8+), B-cells (CD19+) and natural killer-cells (CD56). CONCLUSION: Early enteral nutrition seems to stabilise the immunosuppression of polytraumatised patients in an earlier phase. There is a consolidation of the lymphocyte counts, and of T(CD3+)- and T-helper-cells (CD4+). This could be the immunological correlate for the number of septic complications in the enteral fed groups. Therefore polytraumatised patients should be fed rather early enteral than parenteral when possible. In the initial phase after the trauma the way of nutritional support has more importance on the immune system as nutritional contents. So, in this form of studying, there is no advantage of immunonutrition.

APACHE↗
PubMed1989

[The diagnostic and treatment characteristics of spinal fractures in the victims of multiple trauma].

The authors present their experience in the treatment of 107 patients with spinal injuries associated with polytrauma. The topical diagnosis of the spinal lesions in the severely injured patients was rather difficult both at the preclinical stage and during the clinical examination. For making the diagnosis in combined spinal trauma urgent laparoscopy and aimed roentgenography was employed with the patient in the dorsal position. When the latter technique is employed, a special attachment ("cassette holder") is used which allows to make the roentgenograms with mobile X-ray units. The authors have proposed a new construction of the reclining hammock for the treatment of the patients with the thoracic and lumbar spine traumas associated with severe injuries of the head, the breast and the extremities. It is pointed out that in the patients with complicated spinal injuries the surgical treatment of the locomotor system is most effective.

Accidental Falls↗
PubMedDate not supplied

[Prediction of the nature of the course and outcome of shock in multiple trauma based on a mathematical analysis of heart rhythm].

As the result of research an expanded scale for evaluating the shock-producing property of traumas in marks was created. The cardiac interval measurement values were found to be of high prognostic value. Regressive models of traumatic shock outcome were obtained on the basis of statistic characteristics of heart rhythm. It is shown that the prognosis models may be more effective with the use of alternating switches.

Heart Rate↗
PubMed1987

Traumatic rupture of the pericardium with intermittent cardiac herniation in a multiple-trauma patient.

This is a case report of an 18-year-old multiply injured patient with blunt chest trauma, a total rupture of the right pericardium and an intermittent cardiac dislocation. Intermittent signs suggestive of cardiac tamponade accompanied the cardiac herniations. Acute renal failure followed these acute hemodynamic disorders. Early diagnosis and therapy were responsible for the successful outcome.

Adolescent↗
PubMed2004

[Choice of surgical tactics in patients with multiple trauma and predominant injury of hollow abdominal organs, diaphragm, and pancreas].

The experience of treatment of 67 suffered with predominant injury of hollow abdominal organs, diaphragm and pancreas is present. The choice of surgical tactics was depend of many factors: time from accident to operation, the severity stage of patients, presence of extraabdominal injuries, localization and degree of abdominal organ injuries.

Abdominal Injuries↗
PubMed2002

[Multiple trauma: evaluation of patient's condition and local injuries by trauma classification systems].

Evaluation of polytrauma patient's status by using scoring system is very important for selection of patient's placement and management, prophylaxis and diagnosis of early complications. In the article trauma classification systems are presented and discussed. Clinical evidences of Kaunas Medical University Hospital are presented as well. There are suggestive recommendations on evaluation of polytrauma patient's status and proper separation of severely injured.

Adolescent↗
PubMedDate not supplied

[Efficacy of intensive manual therapy in severe multiple trauma].

How intensive rehabilitation influences external respiration function, central and peripheral hemodynamics in the injured with a severe multitrauma was investigated in 71 injured. Intensive rehabilitation in combined treatment is shown to improve external respiration function, central hemodynamics, tissue blood flow, sleep, appetite, healing of bedsores, to enhance cough reflex.

Adult↗
PubMed1997

Long-term prevalence of impairments and disabilities after multiple trauma.

The prevalence of impairments and disabilities in activities of daily living (ADL), nonwork activities, and work were registered in a consecutive series (n = 69) of subjects with severe injuries. At follow-up 3 years after trauma, residual impairments prevailed in 80%. Only a few (6%) were ADL-dependent. Seventy-six percent had lost at least one nonwork activity, while vocational disability caused by the trauma occurred in 19%. Cognitive impairment was significantly associated with vocational disability, while physical impairment and pain were significantly associated with nonwork disability. Other parameters that influenced vocational disability negatively were age and blue-collar employment status. Although overall changes in social network quantity and quality were small, significantly more subjects with cognitive impairment or vocational disability experienced a decline in the quality and quantity of their social network after trauma. Furthermore, 25% of the subjects reported an increase in feelings of loneliness after trauma. We recommend the design of individualized, multidisciplinary rehabilitation plans before discharge from departments of surgery.

Abbreviated Injury Scale↗
PubMedDate not supplied

Brain injury without head injury after multiple trauma.

Watershed infarction has previously been described after cerebral trauma, when it is due to raised intracranial pressure or systemic hypotension. A case is reported, so far as is known for the first time, of bilateral watershed infarction following blunt systemic trauma, without injury to the head or neck. The importance of resuscitation in preventing secondary brain injury caused by systemic hypotension is highlighted. The advantages of HMPAO-SPET in detecting cerebral perfusion defects are discussed.

Adult↗
PubMedDate not supplied

[Characteristics of blood circulation in the lungs during the early period after blunt multiple trauma].

The microscopic and histostereometric examinations of specific features of blood circulation in the lungs (in lethal cases) performed during the early period after combined trauma showed pronounced disturbances of blood circulation in body organs which had a certain sequence in the development of vascular reactions and vascular temporal dynamics. The influence of a preceding alcoholic intoxication and intensive hemorrhage on the circulatory dynamics was demonstrated.

Adolescent↗
PubMed2007

[Coagulopathy in multiple trauma: new aspects of therapy].

Coagulopathy after trauma is a major cause for uncontrolled hemorrhage in trauma victims. Approximately 40% of trauma related deaths are attributed to or caused by exsanguination. Therefore the prevention of coagulopathy is regarded as the leading cause of avoidable death in these patients. Massive hemorrhage after trauma is usually caused by a combination of surgical and coagulopathic bleeding. Coagulopathic bleeding is multifactorial, including dilution and consumption of both platelets and coagulation factors, as well as dysfunction of the coagulation system. Because of the high mortality associated with hypothermia, acidosis and progressive coagulopathy, this vicious circle is often referred to as the lethal triad, potentially leading to exsanguination. To overcome this coagulopahty-related bleeding an empiric therapy is often instituted by replacing blood components. However, the use of transfusion of red blood cells has been shown to be associated with post-injury infection and multiple organ failure. In the management of mass bleeding it is therefore crucial to have a clear strategy to prevent coagulopathy and to minimize the need for blood transfusion.

Acidosis↗