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Miscellaneous procedures
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The ATLS primary survey has five sequential elements: Airway assessment. This includes clearing and maintaining the airway. The cervical spine is immobilised and protected from further injury.Breathing and ventilation. The patient is assessed for signs of airway obstruction, tension or open pneumothorax, haemothorax, flail chest, pulmonary contusion and cardiac tamponade.Circulation and haemorrhage control. Venous access is established, and appropriate therapeutic interventions initiated.Disability and neurological assessment. The patient is assessed for their level of alertness, verbal stimuli response, painful stimuli response or unresponsive.Exposure and environment. The patient is made comfortable and kept warm.
Earthquakes and Medical Complications
Published in Ramesh P. Singh, Darius Bartlett, Natural Hazards, 2018
Scarlet Benson, Laura Ebbeling, Michael J. VanRooyen, Susan A. Bartels
Chest injuries vary in incidence and severity after major earthquakes. Following the 1995 Japan earthquake, approximately 13% of patients referred to tertiary care had chest injuries (Yoshimura et al. 1996). Many of these chest injuries (47/63) were mild to moderate in severity, with lacerations and contusions being the most common. Patients with mild to moderately severe chest injuries were often discharged from the emergency room after receiving initial treatment (Yoshimura et al. 1996). On the other hand, earthquakes also cause more serious chest injuries, and 8 of the 63 chest-injured patients in Japan had severe chest trauma resulting in death. Furthermore, in Turkey 7%–10% of victims had thorax and lung injuries (Ozdogan et al. 2001). Pneumothoraces accounted for 52.4% and haemothoraces accounted for 19%. Another 19% of patients developed crush syndrome and acute respiratory distress syndrome (ARDS) (Ozdogan et al. 2001). ARDS is reported to be a serious complication of chest injuries (Gonzalez 2005), and following the Marmara earthquake, it was a significant predictor of death (odds ratio [OR] = 4.53, p < 0.0001) (Sever et al. 2002a). Approximately 21% of patients with chest injuries develop respiratory failure, requiring mechanical ventilation (Hu et al. 2010). Risk factors for respiratory failure include flail chest, pulmonary contusion and crush syndrome (Hu et al. 2010).
A comparison of recreational skiing- and snowboarding-related injuries at a Colorado ski resort, 2012/13-2016/17
Published in Research in Sports Medicine, 2020
Lauren A. Pierpoint, Zachary Y. Kerr, Tessa L. Crume, Gary K. Grunwald, R. Dawn Comstock, Darcy K. Selenke, Morteza Khodaee
Some variables were categorized for analysis. Concussions, closed head injuries, or head trauma (excluding superficial injuries such as contusions, abrasions, lacerations) were categorized as head trauma. Internal chest injuries excluding uncomplicated rib fractures were categorized as blunt chest trauma (e.g., pneumothorax, myocardial contusion, flail chest). Internal abdominal injuries (e.g., spleen laceration) were categorized as blunt abdominal trauma. Lower leg fractures included only proximal or mid-shaft tibial or fibular fractures. Ankle fractures included distal tibial or fibular fractures. Tibial plateau fractures were categorized separately. Disposition was categorized as transferred to another facility or discharged home. Transferred patients included those sent to another medical facility via ambulance or helicopter, and those instructed to seek immediate further medical care but who chose to transport themselves.
Functional outcomes of motor vehicle crash thoracic injuries in pediatric and adult occupants
Published in Traffic Injury Prevention, 2018
Samantha L. Schoell, Ashley A. Weaver, Jennifer W. Talton, Ryan T. Barnard, Gretchen Baker, Joel D. Stitzel, Mark R. Zonfrillo
Due to the large variations in the DRMAIS as well as small sample sizes on an individual injury level basis, further analysis was conducted by grouping the thoracic injuries into 8 groups based on the structure of injury and injury type. Across the 4 age groups, there were 32 unique AIS thorax injury codes present. The 8 injury groups included diaphragm laceration/rupture, flail chest, heart laceration, hemo/pneumothorax, lung contusion/laceration, pneumomediastinum, rib fracture, and sternum fracture. The DRMAIS was calculated for each injury group by age group (Table 3). Sample sizes for the calculation can also be found in Table 3. Older adults had higher DRMAIS values for diaphragm laceration/rupture, heart laceration, hemo/pneumothorax, lung contusion/laceration, rib fracture, and sternum fracture compared to the other age groups. The pediatric population possessed a higher DRMAIS value for flail chest compared to the other age groups. Middle-aged adults had higher DRMAIS values for pneumomediastinum compared to the other age groups. For each individual thoracic injury plotted in Figure 3, the corresponding injury grouping is given in color to delineate the differences between the pediatric cohort and stratified adult groups.
Factors associated with chest injuries to front seat occupants in frontal impacts
Published in Traffic Injury Prevention, 2019
Karthikeyan Ekambaram, Richard Frampton, James Lenard
There were 427 AIS 2+ chest injuries (Table A3, see online supplement). Further details of these injuries are available in the Appendix. Some of the occupants had more than one AIS 2+ chest injury. If an occupant sustained skeletal fracture and pulmonary complications such as pneumothorax, hemothorax, hemo-pneumothorax, or flail chest, then the injuries were counted as a single injury. Skeletal injuries were the most common type of AIS 2+ chest injuries, followed by intrathoracic organ and vessel injuries.