-
Mashup Score: 52Homepage | Trauma Surgery & Acute Care Open - 9 month(s) ago
TSACO is an open access journal publishing high-quality epidemiological, educational, and socioeconomic research on trauma surgery and critical care.
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 22Enhanced recovery after surgery (ERAS) in patients undergoing emergency laparotomy after trauma: a prospective, randomized controlled trial - 10 month(s) ago
Background The role of enhanced recovery after surgery (ERAS) has been established in elective operations. However, its role in emergency operations especially in trauma is under-recognized. The aim of this study was to explore the safety and efficacy of ERAS program in patients undergoing emergency laparotomy for trauma. Methods In this single-center study, patients who underwent emergency laparotomy after trauma were randomized to the ERAS protocol or conventional care. The ERAS protocol included early removal of catheters, early initiation of diet, use of postoperative prophylaxis and optimal usage of analgesia. The primary endpoint was duration of hospital stay. The secondary endpoints were recovery of bowel function, pain scores, complications and readmission rate. Results Thirty patients were enrolled in each arm. The ERAS group had significant reduction in duration of hospital stay (3.3±1.3 vs. 5.0±1.7; p<0.01). Time to remove nasogastric tube (1.1±0.1 vs. 2.2±0.9; p<0.01), urin
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 8Editorial Board | Trauma Surgery & Acute Care Open - 12 month(s) ago
TSACO is an open access journal publishing high-quality epidemiological, educational, and socioeconomic research on trauma surgery and critical care.
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 19In memory of Dr David Feliciano - 1 year(s) ago
Dr David Feliciano was born and raised in New York City before his family later moved to New Jersey. Dr Feliciano began his start into medicine as a young child as he watched his father, who was a community surgeon. In high school, he worked as an operating room technician and received his undergraduate degree and medical school training at Georgetown University. He then went on to complete his internship and general surgery residency at the Mayo Clinic, followed later by a trauma fellowship with Drs Charlie Lucas and Anna Ledgerwood at the Detroit Receiving Hospital, and a 6-month vascular fellowship at Baylor University. He began his career at Ben Taub County Hospital in Houston and then went to the University of Rochester. Dr Feliciano became the Surgeon-in-Chief at Grady Memorial Hospital in Atlanta, and then Chief of Surgery at the University of Indiana. In 2017, he joined the faculty at the University of Maryland Shock Trauma Center. I first met David in the late 1980s when I hea
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 17Long-term intra-arterial shunt - 1 year(s) ago
This is a case report of a patient who sustained a stab wound to the right axilla with injuries to the right axillary artery and vein. The patient had near-exsanguination in the field and no recordable blood pressure upon admission to the trauma center. Resuscitation was performed with endotracheal intubation, a left anterolateral resuscitative thoracotomy with cross-clamping of the descending thoracic aorta, and the rapid infusion of crystalloid solutions and packed red cells. In the operating room, the third portion of the right axillary artery and the adjacent right axillary vein were found to be transected. As part of a ‘damage control’ procedure, the ends of the right axillary vein were ligated. A 14 French intra-arterial shunt was inserted into the transected ends of the right axillary artery to restore the flow to the right upper extremity. The patient’s postoperative course was complicated by a coagulopathy, adult respiratory distress syndrome (ARDS), and anuria. The coagulopat
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 4Use of barium for diagnosis of colonic perforation leads to challenging barium peritonitis - 1 year(s) ago
A patient in their 60s with obesity (body mass index 49.3) presented with abdominal pain after a screening colonoscopy. At the outside hospital, a barium enema was performed which demonstrated extravasation of barium into the peritoneum. Figure 1A demonstrates the patient’s scout film from their CT abdomen/pelvis (CTAP) scan after barium enema. They were transferred to our quaternary referral center for emergent evaluation, and on arrival, they were afebrile and tachycardic. Abdominal examination demonstrated lower abdominal peritonitis and prominent ventral hernia with overlying skin changes. (figure 2A) Figure 1 (A) Patient’s scout CT film on presentation to emergency department and (B) 1 month after initial operation. Figure 2 Intraoperative photos including (A) external abdomen prior to exploratory laparotomy and (B) adherent serosal silver-white barium deposits present upon entry into the abdomen. 1. CTAP with intravenous contrast 2. CTAP with oral contrast 3. CTAP with water-solu
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 36Win or lose, nighttime transcystic laparoscopic common bile duct exploration is a win - 1 year(s) ago
Objectives Although controversial, recent data suggest nighttime versus daytime laparoscopic cholecystectomy (LC) have comparable outcomes. Laparoscopic common bile duct exploration (LCBDE) for choledocholithiasis decreases length of stay (LOS) as compared with LC with endoscopic retrograde cholangiopancreatography (ERCP) but increases case complexity/time. The influence of time of day on LCBDE outcomes has not been evaluated. Our aim was to examine outcomes and LOS for nighttime (PM) compared with daytime LC+LCBDE (DAY). Methods Consecutive patients who underwent LCBDE were reviewed. Demographics, operative duration, success of LCBDE, time to postoperative ERCP (if required), LOS, and complications were compared. PM procedures were defined as beginning 19:00–07:00 hours. Results Between 2018 and 2022, sixty patients underwent LCBDE (PM 42%). Groups had equivalent age/sex and preoperative liver function tests (LFTs). LCBDE success was 69% PM versus 71% DAY (p=0.78). Operative duration
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 38Open abdomen critical care management principles: resuscitation, fluid balance, nutrition, and ventilator management - 1 year(s) ago
The term “open abdomen” refers to a surgically created defect in the abdominal wall that exposes abdominal viscera. Leaving an abdominal cavity temporarily open has been well described for several indications, including damage control surgery and abdominal compartment syndrome. Although beneficial in certain patients, the act of keeping an abdominal cavity open has physiologic repercussions that must be recognized and managed during postoperative care. This review article describes these issues and provides guidelines for the critical care physician managing a patient with an open abdomen.
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 53Homepage | Trauma Surgery & Acute Care Open - 1 year(s) ago
TSACO is an open access journal publishing high-quality epidemiological, educational, and socioeconomic research on trauma surgery and critical care.
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
-
Mashup Score: 18Victory out of tragedy: organ donation - 1 year(s) ago
Major improvements in trauma care during the last decade have improved survival rates in the severely injured. The unintended consequence is the presentation of patients with non-survivable injuries in a time frame in which intervention is considered and often employed due to prognostic uncertainty. In light of this, discerning survivability in these patients remains increasingly problematic. Evidence-based cut-points of futility can guide early decisions for discontinuing aggressive treatment and use of precious resources in severely injured patients arriving in extremis.
Source: tsaco.bmj.comCategories: General Medicine News, CardiologistsTweet
Paying homage to @traumadoctors President @reillyp648 and President-Elect @Stewartr84 on behalf of #TSACO @TSACO_AAST https://t.co/MXOvhvXyLr https://t.co/iFsPE0EjbP