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Blunt Neck Trauma

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121. Cervical spine assessment following trauma

clearance, the British Trauma Society 15 and the Eastern Association for the Surgery of Trauma 16 suggest the use of the neck movement assessment from the Canadian C-spine rule in addition to the NEXUS criteria. Table 1. NEXUS criteria. Cervical spine injury cannot be excluded if any criterion are present 12 Midline cervical tenderness Present if pain is elicited on palpation of the posterior cervical midline from the nuchal ridge to the prominence of the first thoracic vertebra, or if pain is reported (...) trauma should initially be assessed to exclude cervical spine injury as per acute presentations. Gradual instability and deformity may occur following stable injury due to the fact that soft tissue healing in adults is unpredictable in comparison with osseous healing. This gradual deterioration may also result in disastrous and permanent deficit. 26 However, in many cases, patients report generalised neck pain lateral to the midline, usually attributed to paraspinal muscle oedema or minor muscular

2012 Clinical Practice Guidelines Portal

122. Predictive value of focused assessment with sonography for trauma (FAST) for laparotomy in unstable polytrauma Egyptians patients Full Text available with Trip Pro

of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED. This study aims to evaluate the accuracy of FAST in hemodynamically unstable polytraumatized patients and to determine its role as an indication of laparotomy.This study is a cross-sectional study included 150 polytrauma patients with a blunt mechanism admitted in Suez Canal University Hospital. Firstly primary (...) survey by airway check, cervical spine securing with neck collar, maintenance of breathing/circulation and management of life threading conditions if present were conducted accordingly to ATLS (advanced trauma life support) guidelines. The patients were assessed in the primary survey using the FAST as a tool to determine the presence of intra-abdominal collection.A total of 150 patients, and FAST scans were performed in all cases. The sensitivity and specificity were 92.6% and 100%, respectively

2017 Chinese Journal of Traumatology

123. Indications for CT-Angiography of the Vertebral Arteries After Trauma. (Abstract)

Indications for CT-Angiography of the Vertebral Arteries After Trauma. Retrospective.The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk.VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular (...) physical examination trended toward predicting VAI without achieving significance.Several independent predictors of VAI were identified. This study highlights the importance of identifying patients at a higher risk for VAI and indicating CT-A of the neck versus those who are at low risk and can be evaluated without undergoing advanced imaging, as CT-A appears unnecessary for most trauma patients.3.

2017 Spine

124. Isolated LOC in head trauma associated with significant injury on brain CT scan Full Text available with Trip Pro

Isolated LOC in head trauma associated with significant injury on brain CT scan A report of loss of consciousness (LOC) is frequently considered reason enough to obtain a computed tomography (CT) scan in the evaluation of head trauma. We conducted this study to reduce exposure to radiation from CT, while still not overlooking clinically significant injuries.The objective of the study is to determine the correlation between LOC status and brain CT scan results in patients with blunt head trauma (...) and to determine whether there is a subset of patients for whom CT scan need not be performed, without missing clinically significant intracranial injuries.This is a retrospective study conducted in the emergency department of an inner-city hospital. The patient population included patients ranging between 13 and 35 years of age, with blunt head trauma, who presented to the emergency department (ED) between January 2010 and December 2013. Patients were divided into two groups: "LOC" group and "no LOC" group

2017 International journal of emergency medicine

125. Pan vs. Selective Computed Tomography Scans in Management of Multiple Trauma Patients; a Brief Report Full Text available with Trip Pro

, Tehran, Iran, following blunt multiple trauma over a 1-year period, from March 2014 to March 2015. Findings regarding presence or absence of injury in head, face, neck, chest, abdomen and hip were compared between patients that underwent pan and selective CT using SPSS 21.443 patients with the mean age of 34.54 ± 17.88 years were evaluated (78% male). 248 (56%) patients underwent selective CT scan and 195 (44%) underwent pan CT scan. The 2 groups were similar regarding vital signs and mean age. Mean (...) Pan vs. Selective Computed Tomography Scans in Management of Multiple Trauma Patients; a Brief Report Using pan or selective computed tomography (CT) scan in management of multiple trauma patient is a matter of debate. Therefore, the present study was designed aiming to compare the findings of pan and selective CT scans in management of multiple trauma patients.This is a prospective cross-sectional study, on patients presented to the emergency department (ED) of Shohadaye Haftome Tir Hospital

2017 Emergency

126. ACR-ASNR-SPR Practice Guideline for the Performance of Computed Tomography (CT) of the Extracranial Head and Neck

and Neck PRACTICE GUIDELINE 3. Infections and inflammatory processes. 4. Trauma. 5. Vascular malformations. 6. Evaluation of palpable masses. 7. Radiation therapy treatment planning. 8. Follow-up after surgery, chemotherapy, or radiation therapy. 9. Hemorrhage/epistaxis. 10. Thyroid conditions. 11. Intraoperative and procedural guidance. B. Indications for CT of the paranasal sinuses include, but are not limited to [11,35,38-51]: 1. Congenital anomalies. 2. Fibro-osseous disease. 3. Sinonasal neoplasm (...) with a history of infection, tumor, or trauma. Intravenous contrast is recommended in patients without contraindications. A noncontrast study may be performed to evaluate for salivary stones or for patients undergoing radioiodine therapy for thyroid cancer. If the examination is performed for a vocal cord tumor, axial sections should be parallel to the vocal cords or hyoid bone. Most indications for soft tissue neck CT can be evaluated with scans from the skull base (sellar floor) to the top of the aortic

2011 American Society of Neuroradiology

127. Soft tissue hematoma of the neck due to thyroid rupture with unusual mechanism Full Text available with Trip Pro

without further complications and was discharged 36days after admission.Airway management is the most important consideration in patients with thyroid injury. Treatment should be customized depending on the degree of respiratory distress resulting from of either involvement of the direct airway or secondary compression.Although hemorrhage from the thyroid gland without blunt trauma is rare, emergency physicians should regard possible thyroid gland rupture in patients with swelling of the neck or acute (...) Soft tissue hematoma of the neck due to thyroid rupture with unusual mechanism Massive bleeding from the thyroid gland causing airway compromise secondary to indirect neck trauma is rare.An 89-year-old woman was transferred to our emergency department due to anterior neck pain after a traffic accident. She had been propelled forward and struck her head on the front mirror during emergency braking. Airway patency was confirmed at the first contact. Although her vital signs were stable

2016 International journal of surgery case reports

128. Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography. Full Text available with Trip Pro

Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography. OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to identify patients with TCVI. The reliability (...) of this scale, with injuries assessed using CTA, has not yet been determined. METHODS Seven independent raters, including 2 neurosurgeons, 2 neuroradiologists, 2 neurosurgical residents, and 1 neurosurgical vascular fellow, independently reviewed each presenting CTA of the neck performed in 40 patients with confirmed TCVI and assigned a Biffl grade. Ten images were repeated to assess intrarater reliability, for a total of 50 CTAs. Fleiss' multirater kappa (κ) and interclass correlation were calculated

2016 Journal of Neurosurgery

129. Penetrating Trauma

Penetrating Trauma Penetrating 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 Penetrating Trauma Penetrating Trauma Aka (...) : Penetrating Trauma , Gunshot Wound , Bullet Wound , Missile Wound , Stab Wound , Knife Wound From Related Chapters II. Definitions Sharp object pierces the skin and creates a small hole without entering a body cavity (e.g. ) Penetrating Sharp object pierces the skin, creating a single open wound, AND enters a tissue or body cavity (e.g. knife stab) Perforating Object passes completely through the body, having both an entry and exit wound (e.g. Gunshot Wound) III. Pathophysiology Stab Wounds (or other hand

2018 FP Notebook

130. Pediatric Trauma

Pediatric Trauma Pediatric 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 Pediatric Trauma Pediatric Trauma Aka: Pediatric (...) BSA to Mass ratio) Waddell triad (child pedestrian struck by car) Intraabdominal Midshaft Airway See for airway related precautions in children Higher risk of soft tissue upper airway obstruction (small, narrow funnel shaped upper airway) Head and Neck See ( ) MVAs are the most common cause of neck Trauma in Children Proportionally larger head predisposes to higher risk of and Upper is more susceptible to restraint related injury in children <8 years old Younger children are prone to spinal (see

2018 FP Notebook

131. Trauma in the Elderly

Trauma in the Elderly Trauma in the Elderly 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 Trauma in the Elderly Trauma (...) See ral Geriatric Trauma patients are frequently much more ill than they appear Maintain a high index of suspicion for serious injury, even in low mechanism injuries s Initiate early hemodynamic monitoring Normal and normal are not equivalent to normovolemia Physiologic markers ( , ) are blunted by medication, comorbidity Systolic <110 mmHg over age 65 years may represent shock Abdominal exam abdominal exam misses same occult serious findings as Common sites in the elderly and proximal Humerus

2018 FP Notebook

132. Chest Trauma

Chest Trauma Chest 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 Chest Trauma Chest Trauma Aka: Chest Trauma , Chest Injury (...) , Blunt Chest Trauma , Blunt Thoracic Injury , Thoracic Injury From Related Chapters II. Precautions Seemingly mild Chest Trauma may result in serious respiratory compromise and acute distress Intrathoracic injury is common without signs of external thoracic III. Exam: Red Flags Asymmetric breath sounds Hypertympanic or chest dull to percussion Parodoxical chest wall movement ( ) Palpate thorax for s ( , , , ) IV. Diagnostics Portable Preferred first-line study CT See Indicated for suspected injury

2018 FP Notebook

133. Diagnostic Testing in Trauma

Diagnostic Testing in Trauma Diagnostic Testing in 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 Diagnostic Testing in Trauma (...) Diagnostic Testing in Trauma Aka: Diagnostic Testing in Trauma , Lab Testing in Trauma , Radiographic Evaluation in Trauma , Trauma Diagnostic Testing From Related Chapters II. Evaluation: Bedside Monitoring y rate ( ) Early marker of shock (with caveat of in some patients) Poor measure of tissue perfusion See III. Labs Blood Type and cross match Chemistry Panel Indicated in all women of childbearing age Indicated for abdominal or pelvic to evaluate for in retroperitoneal injury (or ) Coagulation studies

2018 FP Notebook

134. Secondary Trauma Evaluation

Secondary Trauma Evaluation Secondary Trauma Evaluation 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 Secondary Trauma Evaluation (...) (mal- ) Facial s with delayed presentation (reassess) Nondisplaced zygomatic Orbital rim Pitfalls Pending airway obstruction or airway status changes from mid-face Lacrimal duct injury V. Evaluation: Neck and Cervical Spine See Precautions Blunt neck injury may result in occult and initially masked major neck vascular injury Risk of dissection and thrombosis May be initially asymptomatic with subsequent vessel thrombosis and hemispheric stroke within 72 hours See for CT Angiography criteria Assume

2018 FP Notebook

135. Trauma Evaluation

Trauma Evaluation Trauma Evaluation 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 Trauma Evaluation Trauma Evaluation Aka: Trauma (...) -2 units of Replace 1 unit of apheresis platelets for every 8 units of References Inaba and Herbert in Majoewsky (2013) EM:Rap 13(7): 4 XI. Management: Disposition of Seriously Injured Patient See See (TTA) XII. Management: Disposition of patients with Trauma and reassuring clinical findings Neuroimaging negative in See for discharge criteria Abdominal imaging negative in stable blunt Adults: Abdominal imaging may miss a serious adult injury in 0.5% of cases Overall safe to disharge if exam

2018 FP Notebook

136. Trauma in Pregnancy

Trauma in Pregnancy Trauma in Pregnancy 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 Trauma in Pregnancy Trauma in Pregnancy Aka (...) : Trauma in Pregnancy , Obstetrical Trauma , Blunt Trauma in Pregnancy II. Epidemiology Unintentional occurs in 7% of pregnancies (30,000 acute visits per year) Obstetric is responsible for 20% of maternal mortality (esp. MVA) Fetal mortality approaches 60% in maternal III. Precautions: Pearls Assume pregnancy in all females of reproductive age Seemingly minor injuries (e.g. fall from standing) can have major maternal and fetal complications Minor is responsible for 60-70% of fetal losses

2018 FP Notebook

137. Transection of the aerodigestive tract after blunt neck trauma. (Abstract)

Transection of the aerodigestive tract after blunt neck trauma. Survival after blunt neck trauma resulting in combined tracheal and esophageal injury is uncommon. We present the case of a young boy who sustained complete transection of the trachea and subtotal transection of the esophagus after a clothes line type injury.Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2011 Annals of Thoracic Surgery

138. Natural History and Management of Blunt Traumatic Pseudoaneurysms of the Internal Carotid Artery: The Harborview Algorithm Based on a 10-year Experience. (Abstract)

Natural History and Management of Blunt Traumatic Pseudoaneurysms of the Internal Carotid Artery: The Harborview Algorithm Based on a 10-year Experience. To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms.The natural history and management of traumatic ICA pseudoaneurysms is controversial.We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on head/neck computed tomographic angiography at a high-volume (...) trauma center over a 10-year period. Radiographic and clinical data were recorded, and a treatment algorithm was derived.Forty-three pseudoaneurysms were diagnosed in 39 patients. All patients were treated with daily aspirin unless contraindicated, and 82% underwent daily transcranial Doppler ultrasonography with embolic monitoring. A rate of 8 or more emboli per hour was predictive of embolic stroke (P = 0.0076). Acute ischemic or embolic stroke was seen in 7 patients (16%) with an overall mortality

2015 Annals of Surgery

139. When Physics Meets Biology: Low and High-Velocity Penetration, Blunt Impact, and Blast Injuries to the Brain Full Text available with Trip Pro

When Physics Meets Biology: Low and High-Velocity Penetration, Blunt Impact, and Blast Injuries to the Brain The incidence of traumatic brain injuries (TBI) in the US has reached epidemic proportions with well over 2 million new cases reported each year. TBI can occur in both civilians and warfighters, with head injuries occurring in both combat and non-combat situations from a variety of threats, including ballistic penetration, acceleration, blunt impact, and blast. Most generally, TBI (...) is a condition in which physical loads exceed the capacity of brain tissues to absorb without injury. More specifically, TBI results when sufficient external force is applied to the head and is subsequently converted into stresses that must be absorbed or redirected by protective equipment. If the stresses are not sufficiently absorbed or redirected, they will lead to damage of extracranial soft tissue and the skull. Complex interactions and kinematics of the head, neck and jaw cause strains within the brain

2015 Frontiers in neurology

140. Extracapsular Mandibular Condyle Fractures Are Associated With Severe Blunt Internal Carotid Artery Injury: Analysis of 605 Patients. (Abstract)

Extracapsular Mandibular Condyle Fractures Are Associated With Severe Blunt Internal Carotid Artery Injury: Analysis of 605 Patients. Mandibular condyle fractures are common following facial trauma and carry an increased risk for concomitant blunt carotid artery injuries. Further elucidation of this relationship may improve vascular injury screening and management.A retrospective cohort study was performed for all patients sustaining condylar fractures presenting to a large trauma center over (...) condylar base. The incidence of vascular injuries in this population was 5.5 percent (n = 33), of which 75.8 percent (n = 25) were severe. Severe vascular injuries occurred in 1.6 percent (n = 2) of condylar head, 2.5 percent (n = 4) of condylar neck, and 6.0 percent (n = 19) of extracapsular condylar base fractures (p < 0.05). Extracapsular condylar base fractures were independently associated with a 2.94-fold increased risk of a severe blunt carotid artery injury compared with other condyle fractures

2015 Plastic and reconstructive surgery

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