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Blunt Neck Trauma

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81. Neck Trauma (Follow-up)

. Ventilation of the patient with a positive-pressure bag-valve-mask device can exacerbate underlying subcutaneous emphysema, conceivably distorting the airway anatomy and impairing breathing and circulation. Impregnated gauze should be used to cover sucking neck wounds or lacerations exuding bubbling air. Patients sustaining significant blunt trauma require cervical spine precautions, including cervical spine immobilization and supine placement of the patient on a backboard. However, based on the latest (...) , for zone I injuries, slide in a Foley catheter toward the pleural cavity, and then inflate the balloon with sterile saline and retract it, striving to compress the injured subclavian vessel against the first rib or clavicle. On rare occasions, such as with wounds in the pharynx, applying direct pressure to wounds may be impractical. These wounds may necessitate a cricothyroidotomy with subsequent packing of the pharynx as a temporary strategy. Disability Blunt neck trauma causes a wide spectrum

2014 eMedicine Emergency Medicine

82. Penetrating Neck Trauma (Overview)

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 (Overview) 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

83. Penetrating Neck Trauma (Follow-up)

. 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 (Follow-up) 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

84. Neck Trauma (Treatment)

. Ventilation of the patient with a positive-pressure bag-valve-mask device can exacerbate underlying subcutaneous emphysema, conceivably distorting the airway anatomy and impairing breathing and circulation. Impregnated gauze should be used to cover sucking neck wounds or lacerations exuding bubbling air. Patients sustaining significant blunt trauma require cervical spine precautions, including cervical spine immobilization and supine placement of the patient on a backboard. However, based on the latest (...) , for zone I injuries, slide in a Foley catheter toward the pleural cavity, and then inflate the balloon with sterile saline and retract it, striving to compress the injured subclavian vessel against the first rib or clavicle. On rare occasions, such as with wounds in the pharynx, applying direct pressure to wounds may be impractical. These wounds may necessitate a cricothyroidotomy with subsequent packing of the pharynx as a temporary strategy. Disability Blunt neck trauma causes a wide spectrum

2014 eMedicine Emergency Medicine

85. Neck Trauma (Overview)

%) 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

86. Paediatric trauma protocols

underpin investigations ? Plain radiographs of the injured region will generally be the primary investigation. 14 www.rcr.ac.uk ? Targeted CT of an area may be required for further assessment. ? CT of the lumbar spine is included in CT of the abdomen and pelvis. ? Where there are definitive neurological signs, the primary imaging modality should be MR where possible. Imaging the chest ? The primary investigation for blunt chest trauma is the chest X-ray. This will detect pneumothorax, haemothorax, rib (...) fractures, gross mediastinal abnormalities, diaphragmatic injuries and rib fracture. 19–22 ? Penetrating trauma is an indication for contrast-enhanced chest CT due to the incidence of occult vascular injury. ? Further imaging in blunt chest trauma should be dictated by the nature of the trauma, the clinical condition of the child and the initial radiographic findings. ? In the following patients CT can be obviated as it is unlikely to lead to a change in management: 23 - The chest film is normal

2014 Royal College of Radiologists

87. Urological Trauma

of changes 6 2. METHODS 6 2.1 Evidence sources 6 2.2 Peer review 6 3. EPIDEMIOLOGY & CLASSIFICATION 6 3.1 Definition and Epidemiology 6 3.1.1 Genito-Urinary Trauma 7 3.2 Classification of trauma 7 3.3 Initial evaluation and treatment 7 4. UROGENITAL TRAUMA GUIDELINES 8 4.1 Renal Trauma 8 4.1.1 Epidemiology, aetiology and pathophysiology 8 4.1.1.1 Definition and impact of the disease 8 4.1.1.2 Mode of injury 8 4.1.1.2.1 Blunt renal injuries 8 4.1.1.2.2 Penetrating renal injuries 8 4.1.1.3 Classification (...) Diagnostic evaluation 24 4.3.3.1 General evaluation 24 4.3.3.2 Supplemental evaluation 25 4.3.3.2.1 Cystography 25 4.3.3.2.2 Cystoscopy 25 4.3.3.2.3 Excretory phase of CT or IVP 25 4.3.3.2.4 Ultrasound 25 4.3.4 Disease management 25 4.3.4.1 Conservative management 25 4.3.4.2 Surgical management 25 4.3.4.2.1 Blunt non-iatrogenic trauma 25 4.3.4.2.2 Penetrating non-iatrogenic trauma 26 4.3.4.2.3 Non-iatrogenic bladder trauma with avulsion of lower abdominal wall or perineum and/or bladder tissue loss 26

2015 European Association of Urology

88. Head Trauma

Head Trauma Date of origin: 1996 Last review date: 2015 ACR Appropriateness Criteria ® 1 Head Trauma American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Head Trauma Variant 1: Minor or mild acute closed head injury (GCS =13), imaging not indicated by NOC or CCHR or NEXUS-II clinical criteria (see Appendix 1). Initial study. Radiologic Procedure Rating Comments RRL* CT head without IV contrast 2 ??? MRI head without IV contrast 1 O MRA head and neck without IV (...) formation are diagnosed in approximately 0.1% of all patients hospitalized for trauma, though the majority of these patients come to attention because of clinical symptoms related to central nervous system ischemia. Screening for traumatic intracranial arterial injury should be considered in patients with neurologic symptoms unexplained by a diagnosed injury and blunt trauma patients with epistaxis from a suspected arterial source. Other risk factors for intracranial arterial injury include GCS =8

2015 American College of Radiology

89. Blunt Chest Trauma (Diagnosis)

. The thoracic duct arises primarily from the cisterna chyli in the abdomen. It traverses the diaphragm and runs cephalad through the posterior mediastinum in proximity to the spinal column. It enters the neck and veers to the left to empty into the left subclavian vein. Previous Next: Pathophysiology The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. Sepsis due to leakage of alimentary tract contents, as in esophageal (...) Blunt Chest Trauma (Diagnosis) Blunt Chest Trauma: Background, Anatomy, Pathophysiology 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDI4NzIzLW92ZXJ2aWV3 processing > Blunt Chest Trauma Updated: Nov 09, 2018

2014 eMedicine Surgery

90. Blunt Chest Trauma (Overview)

. The thoracic duct arises primarily from the cisterna chyli in the abdomen. It traverses the diaphragm and runs cephalad through the posterior mediastinum in proximity to the spinal column. It enters the neck and veers to the left to empty into the left subclavian vein. Previous Next: Pathophysiology The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. Sepsis due to leakage of alimentary tract contents, as in esophageal (...) Blunt Chest Trauma (Overview) Blunt Chest Trauma: Background, Anatomy, Pathophysiology 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDI4NzIzLW92ZXJ2aWV3 processing > Blunt Chest Trauma Updated: Nov 09, 2018

2014 eMedicine Surgery

91. Blunt Chest Trauma (Treatment)

Blunt Chest Trauma (Treatment) Blunt Chest Trauma Treatment & Management: Approach Considerations, Chest-Wall Fractures, Dislocations, and Barotrauma, Blunt Injuries to Pleurae, Lungs, and Aerodigestive Tract 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 (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDI4NzIzLXRyZWF0bWVudA== processing > Blunt Chest Trauma Treatment & Management Updated: Nov 09, 2018 Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: John Geibel, MD, DSc, MSc, AGAF Share Email Print Feedback Close Sections Sections Blunt Chest Trauma Treatment Approach Considerations Indications for operative intervention Operative intervention is rarely necessary in blunt thoracic injuries. In one report, only 8% of cases with blunt thoracic injuries required an operation. Most such injuries can be treated

2014 eMedicine Surgery

92. Abdominal Trauma, Blunt (Treatment)

length of stay, and ICU use. [ ] Previous Next: Surgical Management Resuscitative thoracotomy Resuscitative thoracotomy in the ED is only occasionally life-saving. It is an aggressive, desperate measure intended to save a patient whose death is thought to be imminent or otherwise inevitable. Survival with good neurologic recovery is more likely for patients with than for patients with blunt trauma. Thoracotomy may have a role in selected patients with penetrating injuries to the neck, chest (...) Abdominal Trauma, Blunt (Treatment) Blunt Abdominal Trauma Treatment & Management: Approach Considerations, Prehospital Care, Emergency Department Care 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

2014 eMedicine Surgery

93. Blunt Chest Trauma (Follow-up)

Blunt Chest Trauma (Follow-up) Blunt Chest Trauma Treatment & Management: Approach Considerations, Chest-Wall Fractures, Dislocations, and Barotrauma, Blunt Injuries to Pleurae, Lungs, and Aerodigestive Tract 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 (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDI4NzIzLXRyZWF0bWVudA== processing > Blunt Chest Trauma Treatment & Management Updated: Nov 09, 2018 Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: John Geibel, MD, DSc, MSc, AGAF Share Email Print Feedback Close Sections Sections Blunt Chest Trauma Treatment Approach Considerations Indications for operative intervention Operative intervention is rarely necessary in blunt thoracic injuries. In one report, only 8% of cases with blunt thoracic injuries required an operation. Most such injuries can be treated

2014 eMedicine Surgery

94. Abdominal Trauma, Blunt (Follow-up)

length of stay, and ICU use. [ ] Previous Next: Surgical Management Resuscitative thoracotomy Resuscitative thoracotomy in the ED is only occasionally life-saving. It is an aggressive, desperate measure intended to save a patient whose death is thought to be imminent or otherwise inevitable. Survival with good neurologic recovery is more likely for patients with than for patients with blunt trauma. Thoracotomy may have a role in selected patients with penetrating injuries to the neck, chest (...) Abdominal Trauma, Blunt (Follow-up) Blunt Abdominal Trauma Treatment & Management: Approach Considerations, Prehospital Care, Emergency Department Care 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

2014 eMedicine Surgery

95. Abdominal Trauma, Blunt (Treatment)

length of stay, and ICU use. [ ] Previous Next: Surgical Management Resuscitative thoracotomy Resuscitative thoracotomy in the ED is only occasionally life-saving. It is an aggressive, desperate measure intended to save a patient whose death is thought to be imminent or otherwise inevitable. Survival with good neurologic recovery is more likely for patients with than for patients with blunt trauma. Thoracotomy may have a role in selected patients with penetrating injuries to the neck, chest (...) Abdominal Trauma, Blunt (Treatment) Blunt Abdominal Trauma Treatment & Management: Approach Considerations, Prehospital Care, Emergency Department Care 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

2014 eMedicine Emergency Medicine

96. Abdominal Trauma, Blunt (Follow-up)

length of stay, and ICU use. [ ] Previous Next: Surgical Management Resuscitative thoracotomy Resuscitative thoracotomy in the ED is only occasionally life-saving. It is an aggressive, desperate measure intended to save a patient whose death is thought to be imminent or otherwise inevitable. Survival with good neurologic recovery is more likely for patients with than for patients with blunt trauma. Thoracotomy may have a role in selected patients with penetrating injuries to the neck, chest (...) Abdominal Trauma, Blunt (Follow-up) Blunt Abdominal Trauma Treatment & Management: Approach Considerations, Prehospital Care, Emergency Department Care 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

2014 eMedicine Emergency Medicine

97. Case Series of Adolescents With Stroke-Like Symptoms Following Head Trauma. (Abstract)

Case Series of Adolescents With Stroke-Like Symptoms Following Head Trauma. Studies cite the incidence of pediatric blunt cerebrovascular injuries (BCVI) ranges from 0.03% to 1.3%. While motor vehicle incidents are a known high-risk mechanism, we are the first to report on football injuries resulting in BCVI.Case 1 is a 14-year-old male football player who presented with slurred speech and facial droop 16 h after injury that had resulted in unilateral stinger on the field. The patient had (...) a negative brain computed tomography (CT) at the onset of symptoms. Given progression of symptoms over the next 24 h, re-evaluation with CT angiography (CTA) of brain and neck showed left internal carotid artery (ICA) dissection, and magnetic resonance imaging of the brain showed left middle cerebral artery infarct. Case 2 is a 16-year-old male football player who presented with headache and right hemiparesis immediately following a tackle injury. CT brain and neck were negative at an outside hospital

2019 Journal of Emergency Medicine

98. Abusive Head Trauma and the Eye in Infancy

trauma in infants and young children. Ophthalmology 1992;99(11):1718-23. (19) Reiber GD. Fatal falls in childhood: How far must children fall to sustain fatal head injury? Report of cases and review of the literature. Am J Forensic Med Pathol 1993;14:201-7. 3.1.2. Impact Clinical question: Is additional impact (in addition to shaking injury) necessary for the production of very severe ocular injury? Evidence from previous review 1999 Direct impact (blunt trauma) is likely be involved in the most (...) Abusive Head Trauma and the Eye in Infancy 1 The Royal College of Paediatrics and Child Health and The Royal College of Ophthalmologists Abusive Head Trauma and the Eye in Infancy June 2013 Scientific Department The Royal College of Ophthalmologists 17 Cornwall Terrace Regent’s Park London NW1 4QW Telephone: 020 7935 0702 Facsimile: 020 7487 4674 www.rcophth.ac.uk © The Royal College of Ophthalmologists 2013 All rights reserved For permission to reproduce any of the content contained herein

2013 Royal College of Ophthalmologists

99. The Use of Spine Boards in the Pre-Hospital Setting for the Stabilization of Patients Following Trauma

immobilization has also been associated with additional morbidity. 5,6 The National Association of EMS Physicians and the American College of Surgeons Committee on Trauma acknowledge that long backboards can lead to various morbidities including pain, the development of pressure ulcers, and compromised respiratory function. 6 In addition, patient agitation has also been observed. 6 These groups have determined that immobilization with backboards, “may be indicated in patients with blunt trauma and altered (...) The Use of Spine Boards in the Pre-Hospital Setting for the Stabilization of Patients Following Trauma TITLE: The Use of Spine Boards in the Pre-Hospital Setting for the Stabilization of Patients Following Trauma: A Review of the Clinical Evidence and Guidelines DATE: 31 May 2013 CONTEXT AND POLICY ISSUES Traumatic spinal cord injuries (SCI) predominantly affect adolescents and young adults 1 and males. 1-3 The annual occurance is estimated to be 1,785 Canadians 1 and 10,000 3 to 12,000 2

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

100. Nexus Chest CT Decision Rule in Blunt Trauma

Nexus Chest CT Decision Rule in Blunt Trauma Nexus Chest CT Decision Rule in Blunt Trauma Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Nexus Chest CT Decision Rule in Blunt Trauma Nexus Chest CT Decision Rule in Blunt Trauma Aka: Nexus Chest CT Decision Rule in Blunt Trauma II. Indications: Blunt Chest Trauma Evaluation for major chest injuries injury including aorta injury or requiring evacuation ( ) , r or requiring surgical intervention Multiple s requiring surgery or epidural block requiring in first 24 hours Mediastinal or pericardial hematoma requiring drainage Esophageal, tracheal or al injury requiring surgical

2016 FP Notebook

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