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Results for “Multiple Trauma”

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At least 991 records · Page 55Linked to original sources
PubMed2003

The role of temporary inferior vena cava filters in critically ill surgical patients.

HYPOTHESIS: Prophylactic temporary inferior vena cava (IVC) filters are safe and effective in critically ill patients at high risk for venous thromboembolism. DESIGN: Prospective cohort study. SETTING: Urban level I trauma center. SUBJECTS: Multiple-trauma patients and critically ill surgical patients undergoing prophylactic temporary IVC filter placement. All patients were at high risk for venous thromboembolism but had contraindications to low-dose heparin therapy. INTERVENTIONS: The interventional radiologist used the femoral or internal jugular approach to place a removable IVC filter in all patients. The filter was removed when the patient could safely be treated with heparin. If the filter could not be removed by 14 days, it was relocated to prevent incorporation precluding retrieval. MAIN OUTCOME MEASURES: Complications of filter insertion and removal, deep venous thrombosis, and pulmonary embolism. RESULTS: From May 1, 2001, to October 1, 2002, 44 patients underwent placement of temporary IVC filters. Thirty-seven patients (84%) were severely injured. The mean +/- SD age was 37 +/- 3 years, and 55% were men. The mean +/- SD Injury Severity Score of the trauma patients was 33 +/- 2, and all had blunt injury. There were no complications associated with filter insertion or removal. Nine patients required filter relocation prior to retrieval. Three filters could not be removed: 2 secondary to significant clots trapped below the filter and 1 because of angulation resulting in the inability to grasp the filter. There were no documented instances of venous thromboembolism following IVC filter placement and removal. CONCLUSIONS: Temporary IVC filters are safe and effective in critically ill surgical and trauma patients and allow an aggressive approach to prevention of venous thromboembolism in this challenging group of patients.

Adult↗
PubMedDate not supplied

Childhood trauma and multiple personality disorder: the case of a 9-year-old girl.

This paper reports the case of a 9-year-old girl, evaluated and diagnosed with multiple personality disorder over a 6 month period. Included is a detailed description of the child's presentation with historical and developmental data. A discussion of the dynamic and predisposing features of the case with references to current literature follows, along with treatment perspectives.

Child↗
PubMed2000

Elastic adhesive dressing treatment of bleeding wounds in trauma victims.

Conventional methods for hemorrhage control in the trauma patient fall short of providing a full solution for the life-threatening bleeding injury. The tourniquet is limited specifically to injuries of the distal limbs. Local pressure or tight bandaging with military bandages is cumbersome and often insufficient. Therefore, we sought a superior method to stop bleeding in emergency situations. Our objective is report and description of our experience with this method. Since 1992 our trauma team repeatedly encountered multiple trauma victims presenting with bleeding wounds. We achieved hemorrhage control by means of an adhesive elastic bandage applied directly over a collection of 4 x 4 gauze pads placed on the wound surface. The roll is then wrapped around the body surface, over the bleeding site, until sufficient pressure is reached to terminate ongoing hemorrhage. Three typical cases are described in detail. Adhesive elastic dressing compression was successful in fully controlling bleeding without compromise of distal blood flow. Our method corresponded to the demand for an immediate, effective and lasting form of hemorrhage control without complications. Furthermore, this technique proved successful even over body surfaces normally recognized as difficult to compress. We experienced equal favorable success while working during transit by either ambulance or helicopter transportation. We find our preliminary experience using elastic adhesive dressing for bleeding control encouraging and suggest that this may substitute existing practices as the selected treatment when indicated. This method is presently underrecognized for this purpose. Development of a single unit bandage may further enhance success in the future.

Adhesives↗
PubMed1985

Acute acalculous cholecystitis following multiple skeletal trauma. A report of three cases.

Three cases of acute acalculous cholecystitis are reported in patients with multisystem failure following major long-bone trauma. The diagnosis should be suspected in any such patient who develops septicaemia from an unidentified site. A high index of suspicion should be maintained, especially in patients who are sedated or in receipt of mechanical ventilation of the lungs and in whom physical signs may be minimal or absent.

Acute Disease↗
PubMed2003

Does trauma trigger multiple sclerosis? 2: A medicolegal view.

Set against the scientific debate in multiple sclerosis are a number of medicolegal cases in which the scientific evidence has been examined in the context of specific events. It is instructive to understand something of the legal approach to cause and association, and to consider this in relation to individual cases.

Adult↗
PubMed1995

Cost-effective rehabilitation: Part 1--Basic principles.

Patients may be referred for rehabilitation services with a variety of diagnoses, including stroke, spinal cord injury, brain injury, multiple trauma, orthopedic disorders, arthritis, multiple medical problems, and chronic pain. The goals and endpoints for treatment of these conditions are often unclear. The principles that are described in this article provide a structure for creating efficient and effective rehabilitation treatment plans. These principles can also focus the utilization and peer review processes and can assist in determining medical necessity of rehabilitation services. Part one of this two-part article discusses general principles of cost-effective rehabilitation. Part two, in the December 1995 issue, will focus on individual patient management issues.

Cost-Benefit Analysis↗
PubMedDate not supplied

[Laparoscopy in abdominal trauma. Preliminary report in 37 cases].

The role of diagnostic laparoscopy (DL) and therapeutic laparoscopy (TL) in abdominal trauma is not clear. Even after diagnostic punction lavage (DPL), ultrasonography (US), and CT scan (CT), in some cases is difficult to decide between laparotomy and observation. In 37 cases of abdominal trauma, a laparoscopic evaluation was done; 28 abdominal blunt trauma (22 associated with multiple trauma), and 9 abdominal wounds (8 stab wounds). In blunt abdominal trauma, DL was done for haemoperitoneum (26 cases), after DPL, US or CT. In three cases, with equivocal diagnosis, an extra abdominal operation in general anaesthesia was necessary. In abdominal wounds a DL was done for suspicion of penetration. All the patients were haemodynamic stable, TS > or = 12. A laparotomy was necessary in 12 cases (32.43%), a LT was possible in 5 cases (13.51%). In the rest of cases, a DL with or without lavage-drenage enough.

Abdominal Injuries↗