Tag Archives: Trauma

Tactical Combat Casualty Care

The brave men and women of the military not only risk their lives for us – they also provide a wealth of trauma experience and publish interesting stuff. This month’s Journal of Trauma contains a military trauma supplement. One of … Continue reading

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Military pre-hospital thoracotomy

Military doctors in Afghanistan reviewed their experience of thoracotomy done within 24 hours of admission to their hospital. The ballistic nature of thoracic penetrating trauma (mainly Afghan civilians without body armour) differs from the typical knife-wound related injury seen in … Continue reading

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Traumatic Aortic Injury

Two recent papers expand our knowledge of blunt traumatic aortic injury. UK crash data identified risk factors for low impact blunt traumatic aortic rupture, or ‘LIBTAR’ (crashes at relatively low speed): age >60, lateral impacts and being seated on the … Continue reading

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The myth of ketamine and head injury

A literature review addresses the myth that ketamine is contraindicated in head injured patients. They summarise articles from the 1970’s which identified an association between ketamine and increased ICP in patients with abnormal cerebrospinal fluid pathways (such as those caused … Continue reading

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Battlefield resuscitation

An excellent review of the current British military practice to prevent and treat the acute coagulopathy of trauma shock (ACoTS) describes pathophysiology and treatment options and offers an algorithm for management. Key components of the system (when indicated according to … Continue reading

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Sorting ABCD issues pre-hospital

Prospectively collected data on 727 major trauma patients from a Portugese trauma centre registry enabled the comparison of mortality between three groups of patients with a priori defined life threatening ‘ABCD’ problems: those whose ABCD issues were treated in the … Continue reading

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Spine immobilisation in penetrating trauma

In a retrospective study of 45,284 penetrating trauma patients, unadjusted mortality was twice as high in the 4.3% of  patients who underwent spine immobilisation, compared with those who were not immobilised. An accompanying editorial comments: ‘The number needed to treat with … Continue reading

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Better TBI outcome with HEMS

A retrospective study from Italy compared outcomes of head injured patients cared for by a ground ambulance service (GROUND) with those managed by a HEMS team that included an experienced pre-hospital anaesthetist. Interestingly 73% of the ground group were also … Continue reading

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Pre-hospital thoracotomy and aortic clamping in blunt trauma

This is one of those ‘wow they really do that!?‘ papers…Patients undergoing thoracotomy and aortic clamping for pre-hospital blunt traumatic arrest either in the field or in the ED were evaluated for the outcome of survival to ICU admission. None … Continue reading

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Is cervical spine protection always necessary following penetrating neck injury?

This short cut review in the Best Bets format attempted to answer the question: “is cervical spine protection always necessary following penetrating neck injury?” From the available evidence they draw the following conclusions: In stab wounds to the neck (with … Continue reading

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