Multiple Trauma - Science topic

We want to take advantage of you please

What is this model ..?

Motor Vehicle Accident

OCCULT FRACTURES IN ELDERLY ARE BEST DETECTED BY MRI.

I would not do external massage, but open chest / clamp descending thoracic aorta/ open pericardium while ET intubation is being done. Others would argue REBOA is warranted because of dismal prognosis.

I´m sorry about the ambiguous question. I am interested in concentrations of these plasma protreins that can be achieved during a sepsis or a polytrauma (for example that have ever been measured). As in vitro assays often reveal unspecific effects due to the use of very high concentrations (in enzymes and inhibitors) and thereby do not reflect the clinical state, I assume that this is relevant to determine wether a protease activity seen in vitro has an in vivo relevance or not. Even more striking is the time course in of protein level that might vary very quickly (due to half life and the proteins cleavage) in polytrauma or sepsis.

I was wondering if there was any literature where these factors where measured during polytrauma or sepsis? Thanks again for your ideas

With proper trauma systems in place and the introduction of designated level one trauma hospitals for children, kids suffering from poly trauma tend to do very well in Australia even with high ISS scores. Our problem is more with the children who have sustained significant cerebral damage or hypoxia at the scene, whether from isolated head injuries, suffocation or non-fatal drownings.

as for Turkey, any driver involved in accidents (and who are intoxicated by alcohol or any other drugs) are taken in custody after discharge from ED or hospital until freed by court order.  if there is/are patients with serious injuries/death involved in the accident, usually prosecution office demand for jail time until the next trial (wihch usually takes 2-3 months).  i once asked an attorney general about the rationale for this practice and he said whether the driver is guilty or not, any alcohol involvement increases the chance for getting a sentence, and this practice is considered to "ease the pain of the" of the deceased ones.

I would prefer to avoid the prosthetic material in already infected patient.

Multiple trauma patients would have features of SIRS . The acid base disorder initially would be a mixed combination of Respiratory alkalosis with Metabolic acidosis , with near normal pH , low PCO2 & low HCO3 . This is because of respiratory center stimulation causing R.Alkalosis & decreased tissue perfusion causing  lactic Acidosis  . Later metabolic acidosis & Respiratory acidosis will dominate , depending on other organ damage , such as kidney & lung . Acute kidney injury can cause metabolic acidosis in addition to lactic acidosis & Acute lung injury can cause Type 1 & 2 respiratory failure with hypoxia & Respiratory acidosis .

Fortunately, Dr Tanchev, the patient is doing well. He has survived collision with a train, not an ax attack, as we taught initially. He was sent as nameless person, without any valid information from emergency personnel. As I said, it was an emergency at 3 a.m. and I had to perform a DCO. Few days after thorough diagnostics and police report, I have got a full picture of this case. There was a suspicion of possible scapulothoracic dissociation, which I confirmed afterwords. It seems that it is the first case (who survived) of an open scapulothoracic dissociation (STD) associated with floating shoulder and brachial plexus injury. Besides, he has suffered a cranio-facial and thoracic injuries. The wound over clavicle has healed with no signs of infection. The Schantz pin is doing fine. Although no evident signs of brachial plexus injury were found during wound exploration, the Erb`s palsy in its clinical expression was found after he became conscious. ЕMG will confirm the real extent and the level of brachial plexus injury. I postponed to inform followers of this particular case earlier, since I was busy with collecting data and with my schedule.

Kind regards

Personally I will suggest Cesare Scoffone who lives and works in Turin (scoof@libero.it). Please also consider an open access or at least a possible conversion... it can be very easy or a nightmare!