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The objective was to test prospectively supranormal values of cardiac index (CI), oxygen delivery index (DO2I), and oxygen consumption index (VO2I) as resuscitation goals to improve outcome in severely traumatized patients. We included patients > or = 16 years of age who had either (1) an estimated blood loss > or = 2000 mL or (2) a pelvic fracture and/or(More)
The Taser is an electrical weapon used for immobilization. Two hundred eighteen patients who were shot by police with a Taser for violent or criminal behavior were compared to 22 similar patients shot by police with .38 Specials. The long-term morbidity rate was significantly different for "tasered" victims (0%) and for those with bullet wounds (50%) (P(More)
Selective management of 110 patients with bullet wounds to the neck resulted in 31 explored and 79 observed. There was an overall mortality rate of 2.7%, well within that reported in the literature, which ranges from 2 to 6%. At our institution, it is believed that a substantial number of patients can be selectively managed, depending on the signs and(More)
Of the 3684 patients enrolled in our study, 3390 were available for follow-up, of which 62 patients developed wound infections related to minor gunshot wounds (1.8%). Of these patients, all sustained entry/exit-type wounds while 60% of these patients sustained more than one injury. Complications were more likely to occur when a prolonged period occurred(More)
Coagulation abnormalities can pose a threat to hemorrhaging patients and to attempts at surgical correction. We have shown that 97.2% of our 180 patients who died of trauma had evidence of coagulation defects prior to fluid or blood treatment. Twelve of 180 patients could not be cross-matched due to inability of their blood to coagulate in the tube.(More)
In this study, 40 patients whose active vomiting stemmed from various causes were given 2.5 mg of prochlorperazine by slow intravenous push. If no response was observed within 20 minutes, the dosage was repeated. Of 35 patients, 32 responded to doses of 2.5 to 5.0 mg. Three patients experienced no relief of vomiting while in the emergency department, after(More)
Sixteen patients with acute myocardial infarctions who were either vomiting or nauseated were given an intravenous injection of prochlorperazine. All patients obtained relief with exception of one patient who was in acute renal failure. No patient developed symptomatic hypotension. Intravenous prochlorperazine in the dose of 2.5 mg is a rapid, effective,(More)
In a prospective study of 4,106 consecutive cases of initially asymptomatic stab wounds of the chest, 88% were successfully treated as outpatients after negative findings on a repeat chest x-ray film 6 hours after presentation, 12% of patients required tube thoracostomy for delayed pneumothoraces of hemothoraces, 0.2% required thoracotomy for delayed and(More)
Shotguns are popular world wide and more of these weapons exist than the rifled types. With an increasing incidence and prevalence of gunshot wounds it is important for traumatologists to be familiar with shotgun wound ballistics. Shotgun wounds differ from those of other missiles because the spectrum of wound severity is large owing to the fact that the(More)