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BACKGROUND Several small series have had mixed conclusions regarding the impact of obesity on outcomes of trauma patients. The purpose of the present study was to evaluate a large cohort of critically injured patients to better understand the influence of obesity on the outcomes of patients after severe blunt trauma. METHODS Retrospective review using the(More)
BACKGROUND Emergency department thoracotomy (EDT) has become standard therapy for patients who acutely arrest after injury. Patient selection is vitally important to achieve optimal outcomes without wasting valuable resources. The aim of this study was to determine the main factors that most influence survival after EDT. STUDY DESIGN Twenty-four studies(More)
Appropriate triage is critical to optimizing outcome from battle related injuries. The Glasgow Coma Scale (GCS) is the primary means by which combat casualties, who have suffered head injury, are triaged. For the GCS to be reliable in this critical role, it must be applied accurately. To determine the level of knowledge of the GCS among military physicians(More)
The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the course content. New materials related to principles of(More)
BACKGROUND The combination of bicarbonate and mannitol (BIC/MAN) is commonly used to prevent renal failure (RF) in patients with rhabdomyolysis despite the absence of sufficient evidence validating its use. The purpose of this study was to determine whether BIC/ MAN is effective in preventing RF in patients with rhabdomyolysis caused by trauma. METHODS(More)
HYPOTHESIS Nonoperative management of liver injuries (NOMLI) is highly successful and rarely leads to adverse events. DESIGN Prospective observational study. SETTING High-volume academic level I trauma center. PATIENTS For 26 months, 78 consecutive unselected patients with liver injuries were followed up prospectively. In the absence of hemodynamic(More)
OBJECTIVE To assess the feasibility and safety of selective nonoperative management in penetrating abdominal solid organ injuries. BACKGROUND Nonoperative management of blunt abdominal solid organ injuries has become the standard of care. However, routine surgical exploration remains the standard practice for all penetrating solid organ injuries. The(More)
BACKGROUND Near-infrared spectroscopy (NIRS) can continuously and noninvasively monitor tissue oxygen saturation (StO2) in muscle and may be an indicator of shock severity. Our purpose was to evaluate how well StO2 predicted outcome in high-risk torso trauma patients presenting in shock. METHODS The primary outcome in this prospective study was multiple(More)
BACKGROUND Trimodal distribution of trauma deaths, described more than 20 years ago, is still widely taught in the design of trauma systems. The purpose of this study was to examine the applicability of this trimodal distribution in a modern trauma system. STUDY DESIGN A study of trauma registry and emergency medical services records of trauma deaths in(More)
OBJECTIVE The objective of this study was to determine the optimal use of fresh-frozen plasma (FFP) in trauma. Our hypothesis was that a higher FFP: packed red blood cells (PRBC) ratio is associated with improved survival. METHODS This is a 6-year retrospective trauma registry and blood bank database study in a level I trauma center. All massively(More)