Importance: Bleeding is the most common cause of preventable death after trauma.
Objective: To determine the effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) when used in the emergency department along with standard care vs standard care alone on mortality in trauma patients with exsanguinating hemorrhage.
Design, Setting, And Participants: Pragmatic, bayesian, randomized clinical trial conducted at 16 major trauma centers in the UK.
Background: Knife-related violence is of growing concern in the UK. This study aims to investigate the impact of the COVID-19 pandemic on the frequency of penetrating injuries at a UK major trauma centre.
Methods: This was a retrospective study comparing the number of patients attending the emergency department of King's College Hospital (KCH) with a penetrating injury (gunshot or stab wound) during the 'pandemic year' (1 March 2020-28 February 2021) compared with the equivalent time period in the previous year.
A variety of different external and internal medical devices are used in the acute setting to maintain life support and manage severely injured and unstable trauma or emergency patients. These devices are inserted into the acutely ill patient with the specific purpose of improving outcome, but misplacement can cause additional morbidity and mortality. Consequently, meaningful interpretation of the position of devices can affect acute management.
View Article and Find Full Text PDFIntroduction: Penetrating trauma to the head and neck presents specific clinical challenges. Aetiologies include interpersonal violence, deliberate self-harm and terror-related violence. King's College Hospital is a Major Trauma Centre serving inner-city London boroughs with a high incidence of knife and gun crime.
View Article and Find Full Text PDFScand J Trauma Resusc Emerg Med
June 2016
I1: Trauma, Pre-hospital and Cardiac Arrest Care 2015 Pascale Avery, Leopold Salm, Flora Bird A1: Retrospective evaluation of HEMS ‘Direct to CT’ protocol Anja Hutchinson, Ashley Matthies, Anthony Hudson, Heather Jarman A2 Rush hour – Crush hour: temporal relationship of cyclist vs. HGV trauma admissions. A single site observational study Maria Bergman Nilsson, Tom Konig, Nigel Tai A3 Semiprone position endotracheal intubation during continuous cardiopulmonary resuscitation in drowned children with regurgitation: a case report and experimental manikin study Espen Fevang, Børge Hognestad, Håkon B.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
January 2016
Background: Torso hemorrhage is the primary cause of potentially preventable mortality in trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been advocated as an adjunct to bridge patients to definitive hemorrhage control. The primary aim of this study was to assess whether contrast-enhanced ultrasonography can improve the accuracy of REBOA placement in the infrarenal aorta (Zone III).
View Article and Find Full Text PDFObjective: Hemorrhage identification in trauma care is a major priority. Focused assessment in sonography for trauma (FAST) offers a rapid, reliable means of detecting torso bleeding. The aims of this study were to conduct a face, content, and construct validity assessment of a FAST simulator and establish a rigorous assessment tool.
View Article and Find Full Text PDFBackground: The identification and control of traumatic hemorrhage from the torso remains a major challenge and carries a significant mortality despite the reduction of transfer times. This review examines the current technologies that are available for abdominal hemorrhage control within the prehospital setting and evaluates their effectiveness.
Methods: A systematic search of online databases was undertaken.
Objective: It has been suggested that diagnostic peritoneal lavage is now obsolete in UK hospitals with access to either skilled ultrasonography or emergency physician or surgeon-performed focused abdominal sonography in trauma. Diagnostic peritoneal lavage continues to be advocated and taught on Advanced Trauma Life Support courses. The aim of this study was to evaluate the experiences and attitudes of general-surgery trainees in one UK training region towards diagnostic peritoneal lavage and focused abdominal sonography in trauma in managing blunt abdominal trauma.
View Article and Find Full Text PDFCastleman's disease presents as a peculiar type of lymph node hyperplasia. Traditionally, the disease has been classified on clinical grounds (solitary or multicentric) and by histologic appearance (hyaline vascular pattern, plasma cell predominance, or mixed lesions). It is now increasingly clear that there are different etiologies for each of these different subtypes.
View Article and Find Full Text PDF