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Blunt Neck Trauma

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61. Clinical considerations for blunt laryngotracheal trauma in children. (Abstract)

Clinical considerations for blunt laryngotracheal trauma in children. Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy.Systematic review and proposed clinical consideration algorithm.PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials.A medical librarian was utilized.329 titles and abstracts were identified, and 50 reports were included. A total of 66 children were identified (...) , with a majority of males (76.1%). Average age was 9.5±4.4years [range 2-17]. CT was employed in 66.7% of cases. False negative CT occurred in 29.5% of cases. Treatment consisted of observation (9.1%), endoscopy alone (31.8%), endoscopic repair (7.6%), and open neck exploration with repair/open reduction internal fixation (ORIF) (51.5%). Tracheotomy was utilized in 33.3% of the cases. Mortality was rare, with only one (1.5%) reported and occurred within one hour after presentation.Significant deviation

2016 Journal of Pediatric Surgery

62. Towards an inclusive system for major trauma

Towards an inclusive system for major trauma 2017 www.kce.fgov.be KCE REPORT 281 TOWARDS AN INCLUSIVE SYSTEM FOR MAJOR TRAUMA 2017 www.kce.fgov.be KCE REPORT 281 HEALTH SERVICES RESEARCH TOWARDS AN INCLUSIVE SYSTEM FOR MAJOR TRAUMA MARIA-ISABEL FARFAN-PORTET, CECILE DUBOIS, PATRIEK MISTIAEN, AUDREY CORDON, SABINE STORDEUR, KOEN VAN DEN HEEDE COLOPHON Title: Towards an inclusive system for major trauma Authors of the scientific report: Maria-Isabel Farfan-Portet (KCE), Cécile Dubois (KCE (...) Saint-Luc, Belgian Orthopaedic Trauma Association [BOTA]), Peter De Paepe (UZ Gent, Trauma Task Force [TTF]), Saïd Hachimi-Idrissi (UZ Gent, Belgian Society of Emergency and Disaster Medicine [BeSEDiM]), Stefaan Nijs (UZ Leuven, Belgian Trauma Society [BTS]), François Pitance (CHR La Citadelle, Liège, Trauma Task Force [TTF]), Frank Plasschaert (UZ Gent, Belgische Vereniging voor Orthopedie en Traumatologie [BVOT]), Bart Poffyn (UZ Gent, Belgische Vereniging voor Orthopedie en Traumatologie [BVOT

2017 Belgian Health Care Knowledge Centre

63. Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review

Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review Comparative Effectiveness Review Number 182 Glasgow Coma S for Field Triage of Trauma: A Syste cale matic Review eComparative Effectiveness Review Number 182 Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00009-I Prepared by: Pacific (...) Web site at www.effectivehealthcare.ahrq.gov. Search on the title of the report. Persons using assistive technology may not be able to fully access information in this report. For assistance contact EffectiveHealthCare@ahrq.hhs.gov. Suggested citation: Chou R, Totten AM, Pappas M, Carney N, Dandy S, Grusing S, Fu R, Wasson N, Newgard C. Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review. Comparative Effectiveness Review No.182. (Prepared by the Pacific Northwest Evidence-based

2017 Effective Health Care Program (AHRQ)

64. Accuracy of single-pass whole-body computed tomography for detection of injuries in patients with major blunt trauma Full Text available with Trip Pro

Accuracy of single-pass whole-body computed tomography for detection of injuries in patients with major blunt trauma Contrast-enhanced whole-body computed tomography (also called "pan-scanning") is considered to be a conclusive diagnostic tool for major trauma. We sought to determine the accuracy of this method, focusing on the reliability of negative results.Between July 2006 and December 2008, a total of 982 patients with suspected severe injuries underwent single-pass pan-scanning (...) at a metropolitan trauma centre. The findings of the scan were independently evaluated by two reviewers who analyzed the injuries to five body regions and compared the results to a synopsis of hospital charts, subsequent imaging and interventional procedures. We calculated the sensitivity and specificity of the pan-scan for each body region, and we assessed the residual risk of missed injuries that required surgery or critical care.A total of 1756 injuries were detected in the 982 patients scanned

2012 EvidenceUpdates

65. Timing of intervention may influence outcomes in blunt injury to the carotid artery. (Abstract)

Timing of intervention may influence outcomes in blunt injury to the carotid artery. Blunt carotid artery injury (BCI) is present in approximately 1.0% to 2.7% of all blunt trauma admissions and can result in significant morbidity and mortality. Management ranges from antithrombotic therapy alone to surgery, where potential indications include pseudoaneurysm, failed or contraindication to medical therapy, and progression of neurologic symptoms. Still, optimal management, including approach (...) and timing, continues to be an active area for debate. The goal of this study was to assess the epidemiologic characteristics of BCI, and, after controlling for presenting features intrinsic to the data, compare outcomes based on management, operative approach, and timing of intervention.A retrospective review was conducted of adult BCI patients identified within the National Trauma Data Bank from 2002 to 2016. The National Trauma Data Bank is the largest trauma database in the United States, collating

2019 Journal of Vascular Surgery

66. Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa Full Text available with Trip Pro

to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death.Prospective audit of patients presenting to GSH trauma center following penetrating or blunt chest, abdominal, neck and peripheral vascular trauma who underwent surgery over a 4-month period was performed. Post-operative complications were graded according to Clavien-Dindo classification of surgical complications.One-hundred six patients (...) Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed

2018 World journal of emergency surgery : WJES

67. Risk Factors in Pediatric Blunt Cervical Vascular Injury and Significance of Seatbelt Sign Full Text available with Trip Pro

demographic, clinical and radiographic data from the electronic medical record and a trauma registry for patients less than age 18 years who underwent CTA of the neck in their evaluation at a Level I trauma center from November 2002 to December 2014 (12 years). The primary outcome was BCVI.We identified 11,446 pediatric blunt trauma patients of whom 375 (2.7%) underwent CTA imaging. Fifty-three patients (0.4%) were diagnosed with cerebrovascular injuries. The average age of patients was 12.6 years (...) Risk Factors in Pediatric Blunt Cervical Vascular Injury and Significance of Seatbelt Sign Computed tomography angiography (CTA) is used to screen patients for cerebrovascular injury after blunt trauma, but risk factors are not clearly defined in children. This modality has inherent radiation exposure. We set out to better delineate the risk factors associated with blunt cervical vascular injury (BCVI) in children with attention to the predictive value of seatbelt sign of the neck.We collected

2018 Western Journal of Emergency Medicine

68. AIUM Practice Parameter for the Performance of Ultrasound Examinations of the Head and Neck

an abscess from confluent lymphadenopathy 46,47 ; • Detection of subcutaneous emphysema in blunt neck trauma 48 ; • Identification of fractures of the laryngeal framework 49,50 ; • Identification of tracheal transection 49,50 ; and • Detection of the size and location of hematoma. Ultrasound is particularly useful in infectious states for both initial identification and sequential determination of treatment success. It is also particularly relevant as an intra- operative means of locating abscess (...) imaging is always applied to the lesion. 2013—AIUM PRACTICE PARAMETER—Ultrasound Examinations of the Head and Neck 5 www.aium.org headNeck.qxp_1115 12/1/15 3:14 PM Page 5E. Infection and Trauma 1. Indications for ultrasound assessment of inflammatory and traumatic conditions of the neck include but are not limited to the following: • Identification of multiple enlarged lymph nodes with benign characteristics 16,18,19 ; • Differentiating cellulitis from abscess formation 46,47 ; • Differentiating

2013 American Institute of Ultrasound in Medicine

69. Neck Pain

) neck pain with movement coordination impairments, including cranial cervical flexion and neck flexor muscle endurance tests. Clinicians should include algometric assessment of pressure pain threshold for classifying pain. DIAGNOSIS/CLASSIFICATION C Clinicians should use motion limitations in the cervical and upper thoracic regions, presence of cervicogenic headache, history of trauma, and referred or radiating pain into an upper ex- tremity as useful clinical findings for classifying a patient (...) Practice Guidelines Revision 2017 journal of orthopaedic & sports physical therapy | volume 47 | number 7 | july 2017 | a13 many patients with acute cervical radiculopathy, the clinical course appears favorable, with resolution of symptoms occur- ring over weeks to months. As described below, monitoring for worsening of clinical status is advised during nonsurgical management. CLINICAL PROGNOSIS Evidence Update In the context of neck pain, prognostic factors are most commonly evaluated in acute trauma

2017 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

70. Effect of Family Presence on Advanced Trauma Life Support Task Performance During Pediatric Trauma Team Evaluation. (Abstract)

years of age who met trauma activation criteria and were evaluated by the trauma team in our emergency department.We compared task performance between patients with and without FP.Video recordings of 135 trauma evaluations were reviewed. Family was present for 88 (65%) evaluations. Patients with FP were younger (mean age, 6.4 years [SD = 4.1] vs 9.0 years [SD = 4.9]; P < 0.001) and more likely to have sustained blunt injuries (95% vs 85%, P = 0.03). Noninferiority of frequency and timeliness (...) of completion of all primary survey tasks were confirmed for evaluations with FP. Noninferiority of frequencies of secondary survey task completion was confirmed for most tasks except for examination of the neck, pelvis, and upper extremities. Family members did not directly interfere with patient care in any case.Performance of most advanced trauma life support tasks during pediatric trauma evaluation was not worsened by FP. Our data provide additional evidence supporting FP during the acute management

2017 Pediatric Emergency Care

71. Epidemiological Survey of Head and Neck Injuries and Trauma in the United States Full Text available with Trip Pro

Epidemiological Survey of Head and Neck Injuries and Trauma in the United States Head and neck trauma results in a range of injuries, spanning minor lacerations to life-threatening airway compromise. Few studies provide in-depth analysis of injuries to the head and neck (HN). We aim to (1) describe HN injury prevalence in the US and (2) investigate patient disposition and the outcome of mortality.Case series with chart review.Nationwide emergency department (ED) sample.The 2011 database (...) was queried for encounters with a primary diagnosis of HN injury, as categorized by the Barell Injury Matrix. Weighted estimates for demographics, injury category, and mechanism were extracted. Predictors of mortality and admission were determined by multivariable regression.We identified 131 million ED encounters. A weighted total of 5,418,539 visits were related to primary HN injuries. Average age was 30 (SE = 0.4), and 56.8% were male. Sixty-four percent of injuries were attributed to fall or blunt

2014 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

72. Spontaneous Obliteration of Right Ventricular Pseudoaneurysm after Blunt Chest Trauma: Diagnosis and Follow-Up with Multidetector CT Full Text available with Trip Pro

Spontaneous Obliteration of Right Ventricular Pseudoaneurysm after Blunt Chest Trauma: Diagnosis and Follow-Up with Multidetector CT Right ventricular (RV) pseudoaneurysm caused by trauma is very rare. We report a case of RV pseudoaneurysm which resolved without surgical treatment in a patient who survived a falling accident. Echocardiography failed to identify the pseudoaneurysm. Electrocardiography-gated CT showed a 17-mm-sized saccular pseudoaneurysm arising from the RV outflow tract (...) with a narrow neck. Follow-up CT after two months showed spontaneous obliteration of the lesion.

2014 Korean Journal of Radiology

73. CRACKCast E047 – Genitourinary Trauma

be treated with a foley catheter Vaginal lacerations need transvaginal repair 6) Classify bladder injuries and describe the mechanism of injury. Bladder at highest risk when full ⅔ from blunt trauma, 90% from MVC ejection/seat belt 80% of ruptures are associated with pelvic #s Occasionally injured in penetrating stab or missile trauma Bladder has three layers with blood supply from the internal iliac artery/vein Muscle contracts via parasympathetic stimulation Three injury types: Contusions Intra (...) -peritoneal ruptures Extra-peritoneal rupture Diagnostic clues: Lower abdominal / suprapubic pain Pelvic #s Unable to urinate Gross hematuria – present in 95% of cases! Especially in the presence of pelvic #’s Differentiate between extraperitoneal and Intraperitoneal bladder rupture Not mutually exclusive! Intraperitoneal Blunt lower abdominal trauma with a distended bladder The blunt forces stretch the weaker dome of the bladder Leads to intraperitoneal urinary contamination Extraperitoneal Usually

2016 CandiEM

74. CRACKCast E038 – Pediatric Trauma

diameter and distance between rings Needle cric. for kids <12 yrs: not surgical airway SHORTER tracheal length; large airways more narrow Right mainstem intubation (neck extension) and EASY dislodgement of tube (neck flexion) ; greater airway resistance 3) List potential fluid therapies for hemorrhagic shock and their doses standard trauma/resus protocol : MOVIE Monitor Oxygen Vitals IV ECG 10-20ml/kg of crystalloid IV bolus repeated up to three times then consider: PRBCs: 10 ml/kg FFP: 25 ml/kg (...) to C / distance from A to B 15) List 2 ways to choose the size of chest tube in pediatrics 2 X ETT size 4 X ETT size 16) What are indications for ER resuscitative thoracotomy in chest trauma? RARE same indications as adults (see episode on Major Trauma) penetrating chest trauma with signs of life and less than 15 min of CPR blunt trauma with signs of life and pericardial tamponade with <10 mins of CPR 17) List pediatric specific cardiovascular and abdominal injury patterns Principles of disease

2016 CandiEM

75. TREKK Series | Pediatric Multisystem Trauma

. Remember to displace the soft tissue when doing these in the femur, either laterally or medially! Pediatric Glasgow Coma Score Remember the Pediatric GCS is age based. This chart was adapted from Rosen’s Emergency Medicine textbook, 8th ed. 1 Radiography in Blunt Pediatric Trauma CXR: Recommended C- spine X-rays or CT imaging of neck: Not warranted for all patients. May be done if not able to clinically clear the C-spine or mechanism. Luckily, C-spine injuries are significantly less common in kids (...) compared to adults. A child’s C-spine fulcrum is around C2 (adult fulcrum~ C7). For C-spine X-rays <8 years, use AP and lateral neck views, once >=8 years inclusion of the odontoid view is recommended. Pelvic X-Rays: Can be omitted if low risk for fracture with a normal GCS and hemodynamic status, and NONE of 1) signs of abdominal trauma, 2) abnormalities on pelvic exam, 3) associated femur fracture or hematuria. Should be included if suspicion of pelvic fracture or hemodynamic instability CT imaging

2016 CandiEM

76. CRACKCast E039 – Geriatric Trauma

-existing spinal stenosis painful hyperesthesias usually stable, need immobilization may need surgery [2] Cervical extension-distraction injuries: “hyperextension: face or forehead trauma” Caused by reduced ROM — degenerative spondylolysis/disk space collapse/osteophyte formation pt. may report that they are able to extend their neck more than they used to = “open book” fracture UNstABLE [3] Odontoid fractures: Fall with impact to head <10% cause neuro deficits ****Type II (base of the dens (...) CRACKCast E039 – Geriatric Trauma CRACKCast E039 - Geriatric Trauma - CanadiEM CRACKCast E039 – Geriatric Trauma In , , by Adam Thomas September 5, 2016 This episode of CRACKCast cover’s Rosen’s Chapter 039, Geriatric Trauma. We see more and more elderly patients in our trauma bay as our population ages, and there are important distinctions in the management of this growing population. Shownotes – Rosen’s in Perspective GERIATRIC trauma is on the rise Have increased morbidity and mortality ATLS

2016 CandiEM

77. Open stent graft repair with upper-half Sternotomy for blunt thoracic aortic injury: a case report Full Text available with Trip Pro

the risk of endoleakage and migration. We applied open stent grafting to the treatment of blunt aortic injury in the subacute phase and herein report the patient's clinical course.A 20-year-old man with a developmental disorder collided with a steel tower while skiing. He was transferred to our hospital by helicopter. X-ray examination and computed tomography revealed fractures of left humeral head and femoral neck and aortic isthmus dissection. We did not perform an acute-phase operation because (...) of the presence of multiple trauma and instead performed open stent grafting with an upper-half sternotomy 42 days after the injury. He recovered uneventfully without psychological problems other than his preexisting developmental disorder. No endoleakage or aneurysm was observed during an 18-month follow-up period.Open stent grafting might be an alternative to open surgery and thoracic endovascular aortic repair for blunt chest trauma, although intensive follow-up is needed.

2017 Journal of cardiothoracic surgery

78. Penetrating Neck Trauma (Diagnosis)

study. J Trauma . 2003 Jan. 54(1):61-4; discussion 64-5. . Kendall JL, Anglin D, Demetriades D. Penetrating neck trauma. Emerg Med Clin North Am . 1998 Feb. 16(1):85-105. . Kuehne JP, Weaver FA, Papanicolaou G, et al. Penetrating trauma of the internal carotid artery. Arch Surg . 1996 Sep. 131(9):942-7; discussion 947-8. . Mattox K, Feliciano DV, Moore EE. Penetrating and blunt neck trauma. Trauma . 4th ed. Appleton and Lange; 1999. 437-450. McConnell DB, Trunkey DD. Management of penetrating trauma (...) Penetrating Neck Trauma (Diagnosis) Penetrating Neck Trauma: Practice Essentials, History of the Procedure, Problem Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDMzMzA2LW92ZXJ2aWV3 processing > Penetrating Neck

2014 eMedicine Surgery

79. Neck Trauma (Diagnosis)

%) are the most common sites of vascular injuries. Injury to the pharynx or the esophagus occurs in 5-15% of cases. The larynx or the trachea is injured in 4-12% of cases. Major nerve injury occurs in 3-8% of patients sustaining penetrating neck trauma. Spinal cord injury occurs infrequently and almost always results from direct injury rather than secondary osseous instability. Blunt trauma Blunt trauma to the neck typically results from motor vehicle crashes but also occurs with sports-related injuries (eg (...) , clothesline tackle), strangulation, blows from the fists or feet, and excessive manipulation (ie, any manual operation such as chiropractic treatment or physical realignment or repositioning of the spine). [ , ] In motor vehicle crashes in which the driver is not belted, the driver is in danger of thrusting forward with the head extended, forcing the anterior neck against the steering column. Shoulder harnesses appear to offer some, though incomplete, protection against blunt neck trauma; cerebral vessel

2014 eMedicine Emergency Medicine

80. Penetrating Neck Trauma (Treatment)

. Arch Surg . 1996 Sep. 131(9):942-7; discussion 947-8. . Mattox K, Feliciano DV, Moore EE. Penetrating and blunt neck trauma. Trauma . 4th ed. Appleton and Lange; 1999. 437-450. McConnell DB, Trunkey DD. Management of penetrating trauma to the neck. Adv Surg . 1994. 27:97-127. . Munera F, Cohn S, Rivas LA. Penetrating injuries of the neck: use of helical computed tomographic angiography. J Trauma . 2005 Feb. 58(2):413-8. . Osborn TM, Bell RB, Qaisi W, Long WB. Computed tomographic angiography (...) Penetrating Neck Trauma (Treatment) Penetrating Neck Trauma Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDMzMzA2LXRyZWF0bWVudA

2014 eMedicine Surgery

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