Ruling out intra-abdominal injuries in blunt trauma patients using clinical criteria and abdominal ultrasound.

Objective: to identify victims of blunt abdominal trauma in which intra-abdominal injuries can be excluded by clinical criteria and by complete abdominal ultrasonography.

Methods: retrospective analysis of victims of blunt trauma in which the following clinical variables were analyzed: hemodynamic stability, normal neurologic exam at admission, normal physical exam of the chest at admission, normal abdomen and pelvis physical exam at admission and absence of distracting lesions (Abbreviated Injury Scale >2 at skull, thorax and/or extremities). The ultrasound results were then studied in the group of patients with all clinical variables evaluated.

Trauma mechanism predicts the frequency and the severity of injuries in blunt trauma patients.

Objective: to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients.

Methods: retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL).

Predictors of "occult" intra-abdominal injuries in blunt trauma patients.

Objective: to assess predictors of intra-abdominal injuries in blunt trauma patients admitted without abdominal pain or abnormalities on the abdomen physical examination.

Methods: We conducted a retrospective analysis of trauma registry data, including adult blunt trauma patients admitted from 2008 to 2010 who sustained no abdominal pain or abnormalities on physical examination of the abdomen at admission and were submitted to computed tomography of the abdomen and/or exploratory laparotomy. Patients were assigned into: Group 1 (with intra-abdominal injuries) or Group 2 (without intra-abdominal injuries).

Comparative analysis of the frequency and the severity of diagnosed lesions between pedestrians struck by motor vehicles and other blunt trauma mechanisms victims.

Objective: to compare the frequency and the severity of diagnosed injuries between pedestrians struck by motor vehicles and victims of other blunt trauma mechanisms.

Methods: retrospective analysis of data from the Trauma Registry, including adult blunt trauma patients admitted from 2008 to 2010. We reviewed the mechanism of trauma, vital signs on admission and the injuries identified.

Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months.

Objective: to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.

Methods: the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool.

Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team.

Objective: to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.

Methods: we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma.

Severity and treatment of "occult" intra-abdominal injuries in blunt trauma victims.

Background: to assess the severity and treatment of "occult" intra-abdominal injuries in blunt trauma victims.

Method: Retrospective analysis of charts and trauma register data of adult blunt trauma victims, admitted without abdominal pain or alterations in the abdominal physical examination, but were subsequently diagnosed with intra-abdominal injuries, in a period of 2 years. The severity was stratified according to RTS, AIS, OIS and ISS.

Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma.

Objective: to identify predictors of death in blunt trauma patients sustaining pelvic fractures and, posteriorly, compare them to a previously reported series from the same center.

Method: Retrospective analysis of trauma registry data, including blunt trauma patients older than 14 y.o.

Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma.

Objective: To analyze the lesions diagnosed in victims of falls, comparing them with those diagnosed in other mechanisms of blunt trauma.

Methods: We conducted a retrospective study of trauma protocol charts (prospectively collected) from 2008 to 2010, including victims of trauma over 13 years of age admitted to the emergency room. The severity of injuries was stratified by the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS).

Identifying severe abdominal injuries during the initial assessment in blunt trauma patients.

Objective: To evaluate the predictive factors of severe abdominal injuries (SAI) identified in the initial assessment of blunt trauma victims.

Methods: A retrospective analysis of data from blunt trauma victims older than 13 years undergoing abdominal computed tomography and/or laparotomy was carried out. Serious injuries were considered with an Abbreviated Injury Scale (AIS) greater than or equal to three.

Comparative analysis of trauma characteristics between elderly and superelderly.

Objective: To compare the characteristics of trauma in the elderly under and over 80-years-old.

Methods: We conducted a retrospective analysis of protocols of blunt trauma victims aged over 70 years. Individuals aged between 70 and 79 years were included in group I, those aged 80 years or greater in group II.

Predictors of abdominal injuries in blunt trauma.

Objective: To identify predictors of abdominal injuries in victims of blunt trauma.

Method: retrospective analysis of trauma protocols (collected prospectively) of adult victims of blunt trauma in a period of 15 months. Variables were compared between patients with abdominal injuries (AIS>0) detected by computed tomography or/and laparotomy (group I) and others (AIS=0, group II).

[Comparative analysis of injuries observed in motorcycle riders involved in traffic accidents and victims of other blunt trauma mechanisms].

Objective: To conduct a comparative analysis of the lesions found among motorcycle riders involved in traffic accidents and victims of other mechanisms of blunt trauma.

Methods: Analysis of data prospectively collected on protocols for trauma patients older than 13 years, admitted from 06/10/2008 to 09/01/2009, victims of blunt trauma. Data collected included trauma mechanism, vital signs at admission, laboratory tests, injuries, and treatment.

Pelvic fractures as a marker of injury severity in trauma patients.

Objective: To assess whether the presence of a pelvic fracture is associated with greater severity and worse prognosis in victims of blunt trauma.

Methods: A retrospective analysis of protocols and records of victims of blunt trauma admitted from June 2008 to March 2009 was separated into two groups: those with pelvic fracture (Group I) and those without it (Group II). Data were collected from pre-hospital admission rates of trauma, laboratory tests, diagnosed lesions, treatment and outcome.

[Severe injuries from falls on the same level].

Objective: Assess characteristics of trauma patients who sustained falls from their own height, more specifically focusing on presence of severe injuries, diagnosis and treatment.

Methods: Retrospective study including all adult blunt trauma patients admitted in the emergency room in a period of 9 months. Lesions with AIS (Abbreviated Injury Scale)>3 were considered "severe".

Comparative analysis of the characteristics of traumas suffered by elderly and younger patients.

Objective: To assess the characteristics of traumas suffered by the elderly by comparison with a group of younger trauma victims.

Methods: Trauma protocols from June 10, 2008 to March 9, 2009 were evaluated including all trauma patients above 13 years of age admitted to the emergency room. Data were collected on trauma mechanism, preexisting diseases, vital signs on admission, injuries diagnosed, trauma index scores, tests and treatment.

[Undetected surgical glove perforation during emergency procedures].

Objective: Gloves are the most important barriers that protect hospital personnel and patients. Unfortunately, glove perforation rates reach up to 78% in high risk procedures. The purpose of this prospective study was to evaluate the glove perforation rate in emergency procedures carried out in the Emergency Service of 'Santa Casa de São Paulo', School of Medicine.

[Hemodynamic and respiratory changes caused by CO2 laparoscopy in an experimental model of diaphragmatic injury].

Objective: The objective of this study was to analyze the hemodynamic and respiratory changes caused by CO2 laparoscopy in an experimental model of diaphragmatic injury.

Methods: Fifteen animals chosen at random were submitted to diaphragmatic injury by means of CO2 laparoscopy. Evaluation consisted of drawing blood samples to analyze blood gases, as well as the hemodynamic and respiratory variables.

Natural course of penetrating diaphragmatic injury: an experimental study in rats.

There are controversies about the fate of penetrating diaphragmatic injuries not diagnosed and treated. The objective was to evaluate the evolution of untreated diaphragmatic injury on an experimental model. Fifty-six rats suffered diaphragmatic injuries.

Right hemicolectomy for nontraumatic surgical emergencies.

The objective of this study was to assess the main indications, expected complications, and mortality of right hemicolectomy in nontraumatic surgical emergencies. Fifty-eight patients were analyzed. We concluded that the mortality after right hemicolectomy in nontraumatic surgical emergencies is related to systemic rather than local complications.