Hemostatic resuscitation during surgery improves survival in patients with traumatic-induced coagulopathy.

Background: Although hemostatic resuscitation with a 1:1 ratio of fresh-frozen plasma (FFP) to packed red blood cells (PRBC) after severe hemorrhage has been shown to improve survival, its benefit in patients with traumatic-induced coagulopathy (TIC) after >10 units of PRBC during operation has not been elucidated. We hypothesized that a survival benefit would occur when early hemostatic resuscitation was used intraoperatively after injury in patients with TIC.

Methods: A 7-year retrospective study of patients with emergency department diagnosis of TIC after transfusion of >10 units of PRBC in the operating room.

Large pedunculated polyps originating in the esophagus and hypopharynx.

Large pedunculated esophageal and hypopharyngeal polyps are uncommon. Clinical presentation most commonly includes dysphagia and mass regurgitation. If left untreated the patient may develop polyp aspiration complicated by fatal asphyxiation.

Thoracic packing for uncontrolled bleeding in penetrating thoracic injuries.

We present a series of three patients who suffered penetrating thoracic injury, and in whom thoracic packing was used as a life-saving procedure. Survival among these patients paralleled the severity and extent of the original injuries. Restriction of cardiac filling and lung expansion are potential deterrents from using this technique; however, its use seems to be a valid adjunct, especially in the setting of chest wall bleeding coming from the intercostal arteries.

Accuracy of administrative and trauma registry databases.

Objective: Accurate data are needed to evaluate clinical outcomes, therapeutic modalities, and quality of care in trauma. Administrative data, usually used for billing, and trauma registries, have been used to perform these functions. This study compares data for trauma patients from administrative and trauma registry databases at a Level I trauma center.

Accuracy of administrative data in trauma: splenic injuries as an example.

Background: Accurate data are needed to evaluate clinical outcomes, therapeutic modalities, and quality of care in trauma. Administrative data, usually used for billing, have been used to evaluate performance and assess therapy in other medical specialties. This study was performed to determine whether administrative databases are accurate in the recording of information about trauma patients with splenic injuries.