Femur fractures in chest-injured patients: is reaming contraindicated?

Objective: To determine if reamed femoral intramedullary nailing increases the pulmonary complications seen in chest-injured patients.

Design: Retrospective review of prospectively collected trauma database data from January 1991 to October 1994.

Setting: Methodist Hospital, Indianapolis, Indiana, Level I Trauma Center.

Surgical cricothyroidotomy in trauma patients: analysis of its use by paramedics in the field.

Objective: To analyze the indications for and the success rate, complications, and neurologic outcomes of surgical cricothyroidotomy when performed in the field by ambulance paramedics.

Methods: The ambulance and hospital records of all trauma patients on whom a surgical cricothyroidotomy was attempted in the field by ambulance paramedics over a 5-year period were reviewed. A telephone survey of survivors was used to assess long-term complications and neurologic outcome.

Model for trauma outcomes management in patients with multiple trauma.

Critically injured patients with chest trauma generally sustain severe life-threatening injuries. Post-operative care tends to be complex, and all aspects of care from pre-hospital through rehabilitation must be coordinated and communicated to maximize patient outcomes. The Trauma Outcomes Management Model allows clinicians to assess, track, and analyze the relationship among interventions, outcomes, and the cost of care for each phase of the trauma care continuum.

Myocardial reperfusion injury.

A review of the mechanism of ischemic-reperfusion injury, proposed interventions to prevent injury, and future directions have been presented to enhance the practitioner's knowledge of this new, exciting concept in myocardial injury. There is increasing evidence in the literature that reperfusion injury may occur in other organ systems and is responsible for some of the more prevalent pathologies seen in critically ill patients. Investigators have indicated that the tissue damage in sepsis, the development of adult respiratory distress syndrome (ARDS), delayed organ recovery in transplanted organs, and delayed ventricular recovery after cardiopulmonary bypass may be attributed to reperfusion injury.