ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Albumin, when added to a standard resuscitation regimen, is purported to enhance plasma volume, improve pulmonary function by its oncotic effect, and prevent renal failure by augmenting salt and water excreation. These factors were evaluated in a prospective randomized manner in 52 injured patients who received an average of 15.3 transfusions, 9.6 L balanced electrolyte solution, and 9.8 L fresh frozen plasma prior to and during operation; 27 patients received an average of 25 gm albumin (Alb) during operation and 150 gm/day for 3 to days thereafter.Alb caused a significant (p= < 0.05) increase in total protein and serum Alb levels. Plasma volume averaged 3,987 ml in Alb patients and 3,693 ml in non-Alb patients. Despite this urine output and sodium clearance were less, averaging 2.5 and 1.1 ml/min compared to 3.6 and 2.6 ml/min in non-Alb patients. Alb patients also had greater dependency on ventilatory support, averaging 8 days compared to 3 days in non-Alb patients. Central venous and pulmonary wedge pressures were higher in Alb patients.Alb, when added to a standard resuscitation regimen for hypovolemic shock, increases plasma volume both by its oncotic effects and by its interference with saline diuresis. Its subsequent effects on cardiopulmonary function appear to be detrimental and are under investigation.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A zero to 100 digital scoring system for brain injury has been devised. Items scored are vital signs, ability to speak and follow commands, or when unable to do so, a nonverbal response to pain, pupillary reactivity and equality, eyelied opening, and extremity strength. Certain parameters are weighted more heavily than others. The system also allows the examiner to modify serial scores by up to four points in a positive or negative direction based on clinical judgment of improvement or worsening. Over 100 adults patients have been scored, and when evaluated simulataneously by two physicians, the two objective score varies less. It is possible to express the clinical course of brain-injured patients numerically. Those with an initial score of 25 or less have an extremely poor prognosis and those with 75 or more do very well.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Eighteen low-velocity gunshot wounds of the abdominal aorta and inferior vena cava were analyzed. Injury to the aorta and inferior vena cava occurred in 9.2% of all penetrating abdominal injuries due to gunshot wounds in our series. The mortality rate was 33% for the suprarenal and 25% for the infrarenal inferior vena cava, 50% for the infrarenal aorta, 100% for the suprarenal aorta and for the combined injuries. Control of active bleeding is more closely related to survival than any other single factor.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A planned treatment program for burned hands has been developed and was used in 72 burns of the dorsum of the hands. Treatment was individualized on the basis of whether hand burns were superficial or deep. In the former, there was evidence of spontaneous reepithelialization within 14 to 21 days. In the latter, immediate or delayed excision, followed by resurfacing with autografts was done. Both groups received topical antibiotic creaming, elevation, an exercise program as soon as they were able, and splinting of the burned hand in the antideformity position. Hypertrophic scars and unacceptable epithelium were excised when they interfered with function. Initially, this program allowed us to avoid unnecessary surgical procedures in 94% of the second-degree burns of the dorsum of the hand. The third-degree burned hand needed excision and autografting in 100% of the burned hands. This treatment program has as its goals: prevention of deformity by early motion and protection of the unburned and regenerating epithelium by creaming with topical antibiotic ointment.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A survey of off-road vehicle accident injuries indicates a significant incidence of trauma: means of 931 serious injuries and 15 fatalities/year were reported for a three-county region of Southern California. A representative 78-bed community hospital in the desert region saw 542 patients with injuries related to off-road vehicle accidents over 3 years. Characteristic injuries often could be vehicle enthusiasts showed that 21% had had an accident resulting in injury. Driver immaturity, poor judgment and alcohol were identified as causative factors. Future planning must include attention to the sports enthusiast and medical services planning as well as an appreciation of the characteristic injuries resulting from this sport.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

This report describes a new hand injury seen in passengers in dune buggies having rollover accidents. Since these vehicles are usually driven off the road and far from treatment centers the treatment of these injuries is often delayed. As the rollover takes place, the reflex action—usually of the passenger—is to grasp the roll bar. A crush-avulsion injury occurs at the level of the metacarpals, with the thumb frequently spared. Wound contamination, delay in treatment, and the frequency of other serious injuries add to the seriousness of this injury. Redesign of the roll bar, provision of better passenger protection, and an internal grasp support are suggested to reduce its incidence.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

Eleven patients were treated for rollover injuries of the upper extremities from 1971 to 1976 resulting from the rollover accidents of off-road vehicles in rough terrain. Injuries to the volar surfaces of the extremity were most common, but injury to the extensor surfaces seemed to be more severe. Soft-tissue injuries predominated as did injury to the nondominant hand. The majority of patients returned to their original jobs after sometimes prolonged recovery and rehabilitation. A redesign of the rollover cage with interior hand holds could reduce the frequency and severity of these novel injuries.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

A case of urinothorax is reported in a 19-year-old girl with multiple injuries sustained in an auto accident. Thus blunt injury to the right kidney was followed 8 days later by reduced urinary output and serous chest tube drainage. Intravenous dye injection showed dye in urine and in chest tube fluid, and the macerated right kidney was removed. The right pleural effusion then cleared with further drainage. The mechanism by which urine is transferred across the intact diaphragm is thought to be lymphatic drainage.

ISSN:0022-5282    

出版商:OVID    

年代:1978

数据来源: OVID