Combat Application Tourniquet fares well in a chemical, biological, radiological or nuclear dress state.

Introduction: There is a need for a military tourniquet to control catastrophic haemorrhage in a chemical, biological, radiological or nuclear (CBRN) threat environment. No published data exist as to the efficacy of tourniquets while wearing British military CBRN individual protective equipment (IPE).

Methods: 12 volunteers from the counter CBRN instructors' course allowed testing on 24 legs.

Depiction of personal protective equipment in popular war films.

. Personal protective equipment (PPE) is worn by military personnel to protect from combat trauma. War films may not represent PPE accurately, even when considered realistic.

Does the Use of Blocking Screws Improve Radiological Outcomes Following Intramedullary Nailing of Distal Tibia Fractures?

Aim: The aim of this study is to assess whether the addition of blocking screws during intramedullary nailing of a distal tibia fracture improved the radiological outcome and prevented a loss of fracture alignment. As a secondary outcome, the time to radiographic union was compared to see if a more rigid bone-implant construct had an effect on healing.

Methods: We searched computerized records at a UK level 1 major trauma center.

Magnetically Controlled Growing Rods: The Experience of Mechanical Failure from a Single Center Consecutive Series of 28 Children with a Minimum Follow-up of 2 Years.

Study Design: Retrospective observational study of a continuous series of 28 children.

Purpose: To determine the mechanical failure rate in our cohort of children treated with magnetically controlled growth rods (MCGRs).

Overview Of Literature: Previous studies report a MCGR mechanical failure rate of 0%-75%.

Two New Effective Tourniquets for Potential Use in the Military Environment: A Serving Soldier Study.

Background: Limb tourniquets have been used extensively during modern Middle Eastern conflicts. Despite its undeniable successes, the combat applied tourniquet (C-A-T) has some shortfalls, principally its inability to reliably control lower limb bleeding when applied to the mid-thigh. We tested two tourniquets which may represent an improvement to the combat applied tourniquet; the tactical mechanical tourniquet and the tactical pneumatic tourniquet.

An adapted Clavien-Dindo scoring system in trauma as a clinically meaningful nonmortality endpoint.

Background: There is no consensus on reporting nonmortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery and requires adaptation to provide meaningful data for trauma patients. In particular, the original score does not account for those treated without surgery.

Searching For the Optimal Fluid to Restore Microcirculatory Flow Dynamics After Haemorrhagic Shock: A Systematic Review of Preclinical Studies.

Background: Increased microcirculatory flow and perfusion has been reported to improve clinical outcomes following shock. The optimal resuscitation fluid to restore the flow dynamics of the microcirculation is unknown. This review summarizes the preclinical literature to inform the direction and most important hypotheses for future clinical interventional studies.

Ovarian vein thrombosis in a polytrauma patient.

A young mother presented to a major trauma centre following a road traffic collision. Her admission CT traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised C reactive protein.

Preoperative warfarin reversal for early hip fracture surgery.

Purpose: To evaluate our hospital protocol of low-dose vitamin K titration for preoperative warfarin reversal for early hip fracture surgery.

Methods: Records of 16 men and 33 women aged 63 to 93 (mean, 81) years who were taking warfarin for atrial fibrillation (n=40), venous thromboembolism (n=9), cerebrovascular accident (n=3), and prosthetic heart valve (n=3) and underwent surgery for hip fractures were reviewed. The 3 patients with a prosthetic heart valve were deemed high risk for thromboembolism and the remainder low-risk.