Anteroposterior chest radiograph vs. chest CT scan in early detection of pneumothorax in trauma patients.

Pneumothorax is a common complication following blunt chest wall trauma. In these patients, because of the restrictions regarding immobilization of the cervical spine, Anteroposterior (AP) chest radiograph is usually the most feasible initial study which is not as sensitive as the erect chest X-ray or CT chest for detection of a pneumothorax. We will present 3 case reports which serve for better understanding of the entity of occult pneumothorax.

Guidelines for prehospital fluid resuscitation in the injured patient.

Although the need and benefit of prehospital interventions has been controversial for quite some time, an increasing amount of evidence has stirred both sides into more frequent debate. Proponents of the traditional "scoop-and-run" technique argue that this approach allows a more timely transfer to definitive care facilities and limits unnecessary (and potentially harmful) procedures. However, advocates of the "stay-and-play" method point to improvement in survival to reach the hospital and better neurologic outcomes after brain injury.

Traumatic brain injury in intoxicated patients.

Background: We sought to evaluate the effect alcohol intoxication may have had in nonsurgically treated patients with severe traumatic brain injury.

Methods: The Montreal General Hospital Traumatic Brain Injury Registry was used to identify all adult patients with a Glasgow Coma Scale score < or =8 at admission, within a 15-month period. All charts were retrospectively reviewed.

Spill your guts! Perceptions of Trauma Association of Canada member surgeons regarding the open abdomen and the abdominal compartment syndrome.

Background: To survey surgeon opinion regarding the management of the open abdomen (OA) and abdominal compartment syndrome (ACS) to assess current practice and direct future prospective clinical studies.

Methods: Opinions of self-designated trauma, general, pediatric, and vascular surgeons belonging to the Trauma Association of Canada (TAC), were surveyed through a mixed-mode (mail and Web based) questionnaire.

Results: Among 102 eligible candidates, 86 (84%) responded; 83% did regular trauma call, 45% regular critical care call being a separate call 79% of the time; 79% worked in centers serving >500,000 people; the median year of practice entry was 1997.