The focused assessment with sonography for trauma (FAST) exam is a routine diagnostic adjunct in the initial assessment of blunt trauma victims but lacks the ability to reliably predict which patients require laparotomy. Physiologic data play a major role in decision making regarding the need for emergent laparotomy versus further diagnostic testing or observation. The need for laparotomy often influences the decision to transfer the patient to a trauma center. We set out to derive a simple scoring system using both ultrasound findings and immediately available physiologic data that would predict which patients require laparotomy.
Brief alcohol intervention may improve outcomes for injury patients with hazardous drinking but is less effective with increased severity of alcohol involvement. This study evaluated a brief method for detecting problem drinking in minor trauma patients and differentiating hazardous drinkers from those with more severe alcohol problems.
Luxatio erecta humeri is an uncommon form of glenohumeral dislocation, resulting in the inferior displacement of the humeral head. Treatment with traction-counter traction techniques is usually successful in reducing most cases. We describe an unusual complication of this condition where initial reduction attempts of a luxatio erecta humeri repositioned the shoulder to an anterior dislocation position. After a thorough search of the literature, we were unable to find a similar case report of this type of complication during the reduction of a luxatio erecta shoulder dislocation.
A 38-year-old male presented to the Emergency Department (ED) after a motorcycle crash. The patient was unable to walk because of isolated left knee pain.
To determine the incidence and frequency of follow-up instructions for incidental findings on computed tomography (CT) scanning of the abdomen and pelvis in trauma patients.
Glycemic control in the critically ill intensive care unit (ICU) patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED) patients in a small pilot trial.
Laryngeal mask airways (LMAs) are often used as airway rescue devices where laryngoscopy is difficult. The LMA does not protect the airway and is preferably replaced with a cuffed endotracheal tube. There are reports of cases where an Eschmann tracheal tube introducer (ETTI) was successfully used to bridge between a standard LMA and an endotracheal tube. This project was designed to determine whether an Eschmann stylet can reliably be passed through an LMA into the trachea as a means of rescue intubation.
Recent case reports have shown that ultrasonography can be used to diagnose ocular pathology in an emergency setting. Ultrasound may be especially useful when periorbital edema and pain interfere with the examination of the post-traumatic eye.
A 66-year-old man with a history of ankylosing spondylitis presented to the emergency department as a trauma activation after a fall backward onto his sacrum from the bottom rung of a ladder.
We sought to identify factors associated with need for mechanical ventilation (MV), length of intensive care unit (ICU) stay, length of hospital stay, and poor outcome in injection drug users (IDUs) with wound botulism (WB).
Many emergency department (ED) patients with cardiopulmonary symptoms such as chest pain or dyspnea are placed in observation units but do not undergo specific diagnostic testing for pulmonary embolism (PE). The role of observation units in the diagnosis of PE has not been studied. We hypothesized that there was a small but significant rate of unsuspected PE in our observation unit population.
The study objective was to determine whether surgeons and emergency medicine physicians (EMPs) have differing opinions on trauma residency training and trauma management in clinical practice.
Endotracheal tube cuff (ETTc) inflation by standard methods may result in excessive ETTc pressure. Previous studies have indicated that methods of cuff inflation most frequently used to inflate ETTcs include palpation of the tension in the pilot balloon or injection of a predetermined volume of air to inflate the pilot balloon. If a logarithmic relationship exists between ETTc volume and ETTc pressure, small volumes of additional air will result in dramatic pressure increases after a volume threshold is reached. Our goal was to determine whether the relationship between ETTc volume and ETTc pressure is linear or non-linear.
Author Affiliation Arif Alper Cevik, MD Eskisehir Osmangazi University Medical Center, Department of Emergency Medicine, Turkey Pulmonary embolism (PE) is a challenging diagnosis for emergency physicians because of its non-specific clinical presentation. Although “chest pain” is one of the major symptoms of PE,1 it can be part of other serious diagnoses, such as aortic dissection, […]
The accuracy of pre-hospital crash scene details and crash victim assessment has important implications for initial trauma care assessment and management. Similarly, it is known to influence physician perception of crash victim injury severity. The goal of this feasibility study was to examine paramedic accuracy in predicting crash victim injury profile, disability outcome at hospital discharge, and reporting vehicle damage with other crash variables.
A 26-year-old male presented to the emergency department for right foot pain and deformity after inverting his foot while base running playing baseball.
A 42-year-old male presented to the emergency department with pain and swelling of his distal right wrist. Bedside ultrasound placed over the swelling revealed a pseudoaneurysm of the radial artery. The patient received percutaneous thrombin injection of the aneurysm sac followed by direct ultrasound compression therapy of the pseudoaneurysm neck, resulting in thrombosis of the sac. The use of bedside ultrasound by the emergency physician led to appropriate care and proper disposition for definitive management.
To determine the point prevalence of urine bilirubin, urine hemoglobin and urobilinogen in blunt trauma patients, and to evaluate its utility as a screening tool for intra-abdominal injury.
To determine the prevalence of adverse events in elderly trauma patients with isolated blunt thoracic trauma, and to identify variables associated with these adverse events.
Spinal immobilization is one of the most commonly performed pre-hospital procedures. Little research has been done on the movement of the neck during immobilization and extrication.
