Experience with temporary intravascular shunts (TIVS) for vessel injury comes from the military sector and while the indications might be clear in geographically isolated and under resourced war zones, this may be an uncommon scenario in civilian trauma. Data supporting TIVS use in civilian trauma have been extrapolated from the military literature where it demonstrated improved life and limb salvage. Few non-comparative studies from the civilian literature have also revealed similar favorable outcomes. Still, TIVS placement in civilian vascular injuries is uncommon and by some debatable given the absence of clear indications for placement, the potential for TIVS-related complications, the widespread resources for immediate and definitive vascular repair, and the need for curtailing costs and optimizing resources. This article reviews the current evidence and the role of TIVS in contemporary civilian trauma management.
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http://dx.doi.org/10.3389/fsurg.2017.00039 | DOI Listing |
BMC Emerg Med
January 2025
Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, CNY149, 13th St, Charlestown, 02129, MA, USA.
Background: The use of emergency tourniquets among military personnel has helped to dramatically reduce battlefield deaths and has recently gained popularity in the civilian sector. Yet, even well-trained individuals can find it difficult to assess proper tourniquet application. Emergency tourniquets are typically deemed sufficiently tightened through cursory visual confirmation or pulse assessment.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
January 2025
From the Department of Surgery (J.-M.V., T.W.C., B.A.C.), McGovern Medical School, University of Texas Health Science Center, Houston, Texas; Department of Epidemiology (B.L.R.-R., S.R.W.) and Department of Surgery (J.W.C.), University of Pennsylvania, Philadelphia, Pennsylvania; Donald D. Trunkey Center for Civilian and Combat Casualty Care (M.A.S.), Oregon Health & Science University, Portland, Oregon; Department of Surgery, Ernest E. Moore Shock Trauma Center at Denver Health (E.E.M.), University of Colorado Health Sciences Center, Denver, Colorado; Department of Surgery (N.N.), University of Miami/Jackson Memorial Hospital, Miami, Florida; and Department of Surgery (J.L.S.), Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.
View Article and Find Full Text PDFJ Surg Res
January 2025
Department of Surgery - Regions Hospital, Saint Paul, Minnesota. Electronic address:
Introduction: Damage Control Surgery (DCS) is a surgical technique used to manage critically ill and injured patients. This study examines the most recent 10-y outcomes related to DCS, with the secondary goal of scrutinizing the outcomes after DCS across surgical theaters.
Methods: Studies published between 2012 and 2021 that described adult patients undergoing Abdominal DCS after traumatic injury were included.
J Head Trauma Rehabil
January 2025
Author Affiliations: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (Drs Bale and Hoffman); and Craig Hospital Research Department, Englewood, Colorado (Mr Sevigny).
Objective: To determine whether there are differences in healthcare utilization for chronic pain based on location (rural vs urban/suburban) or healthcare system (civilians vs Military Service Members and Veterans [SMVs]) after moderate-severe TBI.
Setting: Eighteen Traumatic Brain Injury Model Systems (TBIMS) Centers.
Participants: A total of 1,741 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview.
Brain Inj
January 2025
St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.
Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults.
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