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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 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 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)
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)
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)
BACKGROUND The Tennessee Surgical Quality Collaborative analyzes NSQIP data from 21 participating hospitals. The Tennessee Surgical Quality Collaborative has reduced surgical complications, but causative factors are unclear. We sought to correlate surgical duration with complications to reveal mitigating strategies. STUDY DESIGN Risk-adjusted Tennessee(More)
Minimally invasive surgery has found many applications in general surgery. The role of laparoscopy in trauma has been debated as a diagnostic, as well as therapeutic, tool in hemodynamically stable patients. This study evaluated laparoscopy in the trauma population. A retrospective review of all laparoscopies performed in hemodynamically stable trauma(More)