摘要:

During a 6-month period approximately 20% of the 589 patients admitted to the Maryland Institute for Emergency Medical Services Systems (MIEMSS), and who did not die, stayed less than 48 hours. About two thirds of these short-stay admissions (13% of the total number of admissions during the study period) were judged inappropriate on clinical grounds. This percentage is lower than the inappropriate rate (20%) experienced at areawide trauma centers in Maryland and may approximate the lower limit of the rate of inappropriate admissions due to unavoidable errors in triage. The inappropriately admitted patients did not impose a large fiscal or service drain on MIEMSS and did not interfere with the care of patients with more serious problems.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

An air-fluidized bed was found to be a potential bacteriologic hazard when used by heavily infected burned patients. Even after following the manufacturer's protocol for eliminating bacteria from the bed and for cleaning the filter sheet,Staphylococcus aureus, Staphylcoccus epidermidis, Streptococcus fecalis, Escherichia coli, andSerratia marcescenswere recovered. Use of the bed was suspended until an effective disinfecting procedure was developed for the filter sheet and weekly removal of solid materials from the bed was instituted.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Trauma is an unusual cause of fistula formation between the aorta and the inferior vena cava. Two cases of traumatic aorto-caval fistula treated at the New Jersey Medical School affiliated hospitals are presented and the literature on traumatic aorto-caval fistula reviewed. We found 14 previously reported cases. Delayed repair was performed in 12 (86%). Delays ranged from 5 days to 12 years postinjury. Cardiac decompensation, judged either clinically or by cardiomegaly evident on chest X-ray, was present in 75% of the patients undergoing delayed repair. The techniques available for repair and the criteria for utilizing delayed repair are discussed. In young, previously healthy patients, usually with smaller fistulae, we conclude that delayed repair can be used.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Fractures of the acromion are rare. Conservative therapy in the majority of cases results in return to full function of the shoulder. Occasionally, however, a painful pseudoarthrosis will develop and surgical care is required. The American literature reports several cases of acromial fracture but has not specifically addressed the treatment of pseudoarthrosis with open reduction and internal fixation. We report such a case and review the American and European literature.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Traumatic herniae are uncommon. We describe two patients with traumatic hernine and review the literature. Operative treatment may be early or late. It is mandatory that traumatic herniae be differentiated from hematomata. Diagnosis is usually clinical but X-rays including barium studies, may be useful.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Two cases of traumatic rupture of the iliacus muscle are reported. The clinical picture of this condition is characterized by pain in the groin, a tender mass in the iliac fossa, flexion contracture of the hip, and a femoral nerve palsy. Presence of a bleeding tendency should be investigated. Operative treatment is recommended for large hematomas.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Simple ligation of major venous injury can be both limb threatening and create chronic disability (9). A case of penetrating trauma to the thigh producing isolated major venous injury is presented. An aggressive approach, immediate exploration, and lateral suture and non-reversed saphenous vein graft, are advocated for the diagnosis and treatment of venous trauma.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Two cases of impalement injuries seen at the Maryland Institute of Emergency Medical Services Systems are presented. A short literature review and recommendations for management including employment of an incision connecting entry and exit sites but avoiding essential structures, plus antibiotics and standard techniques for management of penetrating trauma are described.

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1983

数据来源: OVID