Search results for "Polytrauma"

PHARMACOLOGICAL MANAGEMENT OF THE POLYTRAUMA PATIENT. ON ANALGESIC THERAPY GUIDELINES

2022

In consideration of the constant, if not increasing number of polytrauma patients arriving in emergency rooms, the pharmacological treatment of pain is a topic that is always under observation and innovation. Even more important is the global management of pain in the polytrauma patient, i.e. its treatment in the phases even after hospitalisation. The existence of pharmacotherapeutic protocols is today an aid for the physician in order to act in the most appropriate way in the shortest possible time. This brief commentary is intended to be a practical guide to the analgesic treatment of the polytrauma patient, in the light of the most recent scientific evidence.

Effektivit�t pr�klinischer Notfallversorgung Fiktion oder Fakt?

1996

The current increase in the cost of health care must be considered as a severe threat to the prehospital emergency services system. Two examples have been selected--the patient with polytrauma and the patient in cardiac arrest--to demonstrate the dilemma between a need for objective data and the requirements of emergency patients. Study results obtained in trauma patients indicating that total prehospital time, including scene time, is correlated to patient outcome have led to the conclusion that at the scene treatment by emergency physicians may be dispensable. It has, however also been demonstrated that the time required for medical treatment at the scene is equivalent to 20% of the total…

2014

Circulating CD34+ progenitor cells () gained importance in the field of regenerative medicine due to their potential to home in on injury sites and differentiate into cells of both endothelial and osteogenic lineages. In this study, we analyzed the mobilization kinetics and the numbers of CD34+, CD31+, CD45+, and CD133+ cells in twenty polytrauma patients (n = 13 male, n = 7 female, mean age 46.5±17.2 years, mean injury severity score (ISS) 35.8±12.5 points). In addition, the endothelial differentiation capacity of enriched CD34+cells was assessed by analyzing DiI-ac-LDL/lectin uptake, the expression of endothelial markers, and the morphological characteristics of these cells in Matrigel an…

Role of Negative Pressure Therapy as Damage Control in Soft Tissue Reconstruction for Open Tibial Fractures.

2017

AbstractThe concept of damage control orthopaedics (DCO) is a strategy that focuses on managing orthopaedic injuries in polytrauma patients who are in an unstable physiological state. The concept of DCO is an extension of damage control surgery or damage limitation surgery (DCS/DLS). Recently, it has become clear that certain patients, following extensive soft tissue trauma, could benefit from the idea of DCS. In the management of severe lower extremity trauma with exposed fracture sites, aggressive early wound excision debridement, early internal fixation, and vascularized wound coverage within a few days after trauma were proposed. A negative-pressure dressing can be easily and rapidly ap…

Principles of Damage Control in the Elderly

2017

A steadily increase of severely injured elderly patients may be expected. Comorbidities are present in the majority of these patients and negatively influence outcome. Blunt trauma is the leading cause of high-energy injuries in the elderly. Motor vehicle accidents, either as driver or as pedestrian hit by a car, and falls from height are the most important mechanisms of polytrauma. The principles of advanced trauma life support (ATLS) should also apply for elderly persons. Underestimation of the severity of injury is a common problem leading to undertriage. A basic rule of primary care is to avoid the lethal triad of hypothermia, coagulopathy and acidosis. Emergent invasive monitoring redu…

Errors in imaging patients in the emergency setting

2016

Emergency and trauma care produces a "perfect storm" for radiological errors: uncooperative patients, inadequate histories, time-critical decisions, concurrent tasks and often junior personnel working after hours in busy emergency departments. The main cause of diagnostic errors in the emergency department is the failure to correctly interpret radiographs, and the majority of diagnoses missed on radiographs are fractures. Missed diagnoses potentially have important consequences for patients, clinicians and radiologists. Radiologists play a pivotal role in the diagnostic assessment of polytrauma patients and of patients with non-traumatic craniothoracoabdominal emergencies, and key elements …

Effects of systemically transplanted allogeneic bone marrow multipotent mesenchymal stromal cells on rats' recovery after experimental polytrauma.

2013

Background The aim of this study was to evaluate impact of transplantation of bone marrow mesenchymal stromal cells (BM MMSCs) on recovery after polytrauma and bone fracture repair. Methods A total 27 Wistar-Kyoto rats were divided into three groups (n = 9): normal control (A), polytrauma (B), and polytrauma treated with BM MMSC transplantation (C). The experimental polytrauma model was made on male rats by causing multiple fractures and hemorrhagic shock. At 36 hours 9 days after surgery, nine rats received allogeneic BM MMSCs (1 × 10(6) cells per kilogram) intravenously. The day before operation and at Days 3 and 10 after surgery as well as at the end of the experiment, blood analysis was…

Ganzkörper-Spiral-CT zur Primärdiagnostik polytraumatisierter Patienten unter Notfallbedingungen

1997

PURPOSE The aim of this study was to evaluate the role of a fast whole body helical CT scanner for primary diagnosis in trauma patients. METHODS 27 severely injured patients (9 women, 18 men; mean age 43 years) were first examined with a helical CT scanner allowing for digital radiograms up to a length of 1024 mm and continuous helical scans of up to 70 seconds (slice thickness 3 to 10 mm, pitch factor up to 2). The primary CT diagnosis was verified either by x-ray after the CT examination or during the subsequent days, by abdominal ultrasound, by additional CT scans in the following days, and by clinical follow-up. RESULTS CT showed all clinically relevant injuries of the head, spine, ches…

Bone Marrow Multipotent Mesenchymal Stromal Cells Transplantation Effects after Experimental Polytrauma in Rats

2013

The aim of this study was to evaluate impact of transplantation of bone marrow mesenchymal stromal cells on recovery after polytrauma and bone fracture repair.

The Benefit of Multislice CT in the Emergency Room Management of Polytraumatized Patients

2006

The early treatment of polytraumatized patients needs an effective and standardized approach. Reducing time requirements for the primary diagnostic evaluation is a major concern in the early phase of polytrauma management. Multislice-CT (MSCT) is a quick and reliable method for the initial diagnostic evaluation. Computed tomography provides more detailed and more consistent information than conventional radiography. It has the great advantage of allowing rapid examination of the head, vertebral column, chest, abdomen and pelvis during one single examination. The CT-suite needs to be adequately equipped for resuscitation and reanimation, which is done parallel to the radiological investigati…