n engl j med 372;1 nejm.org january 1, 2015 92 for transfusion in our clinical setting.3 The benefit of using the lactate level and Scvo2 to initiate and guide early resuscitation, including transfusion, in patients with septic shock may be questioned after the results of recent randomized trials.4,5 As compared with the high-quality data from these trials, the results of any post hoc subgroup ...

Introduction: Haemodynamically unstable pelvic fracture carries a high mortality rate of up to 60%. Being one of the trauma centers in Hong Kong, we have been developing and modifying a protocol for unstable pelvic fracture since 1996, with continuous improvement in survival rate. In the most updated 3-in-1 Pelvic Damage Control Protocol, three different sources of bleeding, including bony, ven...

OBJECTIVE To analyze the experience of nonoperative management (NOM) of renal injuries caused by a firearm projectiles (FAP) in the right thoraco-abdominal region in patients with hemodynamic stability and no signs of peritoneal irritation, highlighting the assessment of the safety of this approach. METHODS This was a prospective study with patients sustaining injuries by FAP in the right tho...

STUDY OBJECTIVES To determine the effect of immediate two-dimensional echocardiography on the time to diagnosis, survival rate, and neurologic outcome of patients with penetrating cardiac injury. DESIGN A ten-year retrospective review. SETTING Regional trauma center serving a population base of 1.25 million with 85,000 visits yearly. TYPE OF PARTICIPANTS All patients presenting to the eme...

OBJECTIVE Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database. METHODS Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients. RESULTS The project was initiated in 2011 and from Janu...

INTRODUCTION A mixed score to predict the probability of survival has a key role in the modern trauma systems. The aim of the current studies is to summarize the current knowledge about estimation of survival in major trauma patients, in different trauma registries. METHOD Systematic review of the literature using electronic search in the PubMed/Medline, Web of Science Core Collection and EBS...

OBJECTIVE To study de prognostic value and the difference between genders in the injury mechanism and pattern of multiple trauma patients. DESIGN Prospective descriptive observational study. SETTING Trauma Intensive Care Unit (ICU) of a tertiary hospital equipped with an heliport. Patients. 953 patients consecutively admitted to ICU between 2003 and 2005. MAIN VARIABLES OF INTEREST We des...

Trauma is an ever increasing problem and it is the leading cause of morbidity and mortality in the under 40s age group. The main purpose of this study is to determine the pattern of death related to trauma cases presenting to the emergency department (ED) of a university hospital. This was a retrospective analysis of 75 consecutive trauma case records at a university hospital for a one year per...

We report a case of bronchial rupture in a five-year-old boy with polytrauma after being hit by a motor vehicle. He was initially found to have a base of skull fracture, bilateral pulmonary contusions, lacerations and haemopneumothoraces, cardiac contusion, left first rib and right scapula fracture, extensive surgical emphysema, liver laceration and splenic laceration. At exploratory laparotomy...