Brian J Daley

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I. STATEMENT OF THE PROBLEM Hypoxia and obstruction of the airway are linked to preventable and potentially preventable acute trauma deaths. There is substantial documentation that hypoxia is common in severe brain injury and worsens neurologic outcome. The primary concern with acute postinjury respiratory system insufficiency is hypoxemic hypoxia and(More)
STUDY OBJECTIVE Determine reintubation rate, identify its cause, and detail adverse outcomes from reintubation. DESIGN Retrospective review of extubation failures in the trauma ICU. SETTING University hospital and regional trauma center. PATIENTS Four hundred five patients arriving intubated or requiring intubation during hospitalization after 2,516(More)
BACKGROUND Historically, arteriography has been used routinely in patients with knee dislocations. Recently, selectivity based on physical examination (PE) has emerged. Critics cite limited clinical evidence. We sought to determine whether PE accurately confirms or excludes surgically significant vascular injuries associated with knee dislocations. (More)
BACKGROUND The differentiation of duodenal perforation from duodenal hematoma is not always possible with computed tomography (CT). Our diagnostic guideline has included duodenography to investigate CT findings of periduodenal fluid or wall thickening. However, the utility of duodenography as a diagnostic study in blunt abdominal trauma is not defined. We(More)
BACKGROUND Efficacy of chest radiograph protocol after tube thoracostomy tube (CT) removal. METHODS Retrospective review (July of 1995 to July of 1996) of 141 patients with CT followed throughout their hospitalization. Excluded patients died (23 patients) or had thoracotomy (13 patients) before CT removal. RESULTS A total of 105 patients had 113 CT(More)
BACKGROUND For patients > 55 years, nonoperative management (NOM) of blunt splenic injury remains controversial. Conflicting reports of excessively high or acceptably low failure rates have discouraged widespread application of NOM in these older patients. However, the small number of patients in these studies limits the impact of their conclusions. (More)
STATEMENT OF THE PROBLEM Severely injured trauma victims are at high risk of development of the multiple organ dysfunction syndrome (MODS) or death. To maximize chances for survival, treatment priorities must focus on resuscitation from shock (defined as inadequate tissue oxygenation to meet tissue O2 requirements), including appropriate fluid resuscitation(More)
OBJECTIVE The predictive value of application data for future general surgery resident performance and attrition are poorly understood. We sought to determine what variables obtained in the application process might predict future resident success. METHODS We performed an 18-year review (1990-2008) of all matched residents (n = 101) to a university(More)
BACKGROUND A rapid computed tomography technique or "trauma scan" (TS) provides high-resolution studies of the head, cervical spine, chest, abdomen, and pelvis. We sought to determine whether TS has decreased missed injuries. A previous study of TS found a 3% missed rate. METHODS After institutional review board approval, trauma patients from January 2001(More)
The frequency of computed tomography (CT) ordered by emergency department physicians at our facility was noted to sharply increase in early 1998 after a New England Journal of Medicine (NEJM) article recommending routine CT in patients with suspected appendicitis. Numerous studies have proven the accuracy of CT for detecting acute appendicitis; however, the(More)