Needle thoracostomy in treatment of a tension pneumothorax in trauma patients.
*Regional Department of Thoracic SurgeryThe Journal of trauma (Impact Factor: 2.96). 11/2008; 65(4):964. DOI: 10.1097/TA.0b013e318184b508
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ABSTRACT: The presence of the sonographic sliding lung sign (SLS) is a sensitive indicator for the absence of a pneumothorax. The aim of this study was to determine if prehospital critical care providers (PHCPs) can acquire and maintain the necessary skills to determine the presence or absence of the SLS following a brief tutorial. This was a blinded randomized observational trial using a cadaveric model. The model was randomized to esophageal intubation (negative SLS) or tracheal intubation (positive SLS), and a SonoSite 180 plus (Bothel, WA) machine was used for the examination. After a 9-month period, the PHCPs were reevaluated without additional instruction. There were 8 PHCPs. A total of 6 intubations were performed yielding a total of 48 trials. The presence or absence of the SLS was correctly identified in 46 of the 48 trials, resulting in a sensitivity and specificity of 96.9% (95% confidence interval [CI], 89.6%-99.1%) and 93.8% (95% CI, 93.8%-79.3%), respectively. At the 9-month follow-up, 7 of the original PHCPs were available to participate. A total of 8 intubations were performed yielding a total of 56 trials. The presence or absence of the SLS was correctly identified in all 56 trials, resulting in a sensitivity and specificity of 100% (95% CI, 93.6%-100%). Prehospital critical care providers can accurately determine the presence or absence of the sonographic SLS following a brief tutorial and retain the skill set following a 9-month interval.The American journal of emergency medicine 02/2011; 30(3):485-8. DOI:10.1016/j.ajem.2011.01.009 · 1.15 Impact Factor
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ABSTRACT: To describe the patient population, injuries, and treatment received on the battlefield, and ultimate outcome of U.S. military working dogs that incurred gunshot wound (GSW) injury in Operation Enduring Freedom (Afghanistan) or Operation Iraqi Freedom (Iraq). Retrospective study between January 2003 and December 2009. Twenty-nine military working dogs from the U.S. military with confirmed GSW injuries incurred in combat in Operation Enduring Freedom or Operation Iraqi Freedom. None. Clinical data from battlefield treatment, which includes care from the point of injury through arrival to, but not including, a designated veterinary treatment facility. Twenty-nine dogs were injured between 2003 and 2009. All but one of the injuries were from high caliber, high velocity weapons. Of the 29 injured dogs, 11 survived the injuries and 18 died (38% survival rate). Of the dogs that died, all but 1 died from catastrophic nonsurvivable injuries before treatment or evacuation could be instituted. The thorax was the most common site of injury (50%) followed by extremity wounds (46%). The leading cause of death from GSWs was from thoracic wounds, followed by head wounds. Dogs with extremity wounds as their only injury were most likely to survive, and dogs with multiple injuries were least likely to survive. All surviving dogs received treatment at the point of injury by military medics and dog handlers consistent with Tactical Combat Casualty Care guidelines for combat injuries in human service members. Of the 11 that survived, all dogs returned to full duty with subsequent deployment to combat zones. Location of wounds and injury severity at the time of presentation to veterinary care was not correlated with length of time until return to duty.01/2013; 23(1):47-52. DOI:10.1111/j.1476-4431.2012.00823.x
Article: Prehospital Ultrasound[Show abstract] [Hide abstract]
ABSTRACT: Ultrasound is a commonly used diagnostic tool in clinical conditions. With recent developments in technology, use of portable ultrasound devices has become feasible in prehospital settings. Many studies also proved the feasibility and accuracy of prehospital ultrasound. In this article, we focus on the use of prehospital ultrasound, with emphasis on trauma and chest ultrasound.Journal of Medical Ultrasound 06/2014; DOI:10.1016/j.jmu.2014.05.008
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