Laparoscopy and work-hour restrictions are altering surgical training. We hypothesized interns were no longer gaining experience in open appendectomy, historically an intern index case. We retrospectively reviewed Accreditation Council for Graduate Medical Education (ACGME) case logs of postgraduate Year (PGY) 1 general surgery trainees from our academic teaching program for the last 9 years.
View Article and Find Full Text PDFElderly trauma patients have worse outcomes than their younger counterparts. Early risk stratification remains difficult, particularly because traditional vital signs are less reliable. We hypothesized that arrival lactate and base deficit (BD) could be used to predict mortality in elderly trauma patients with a normal admission blood pressure.
View Article and Find Full Text PDFBackground: In both urban and military settings, penetrating thoracic injuries remain a significant source of trauma-related mortality, and many patients require resuscitative thoracotomy. Existing literature emphasizes relief of pericardial tamponade and aortic clamp application as the key therapeutic maneuvers. The purpose of this report is to revisit pulmonary hilar clamping and highlight its application for hemorrhage control, air embolism prevention, and other benefits in the setting of massive hemothorax.
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