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Soft tissue compartment bleed-the iceberg phenomenon:a case report

Emergency and Critical Care Medicine 2023年第1期3卷 32-35页

作者： Ramesh Vaidyanathan Parvez Mohi Ud Din Dar dinesh bagaria Amit Gupta Division of Trauma Surgery and Critical Care Jai Prakash Narayan Apex Trauma CenterAll India Institute of Medical SciencesNew DelhiIndia Department of Trauma and Emergency Medicine All India Institute of Medical SciencesVijaypurJammuJammu and KashmirIndia

Introduction:Hemorrhage control is the essence of trauma *** teaching is 1 on the floor(ie,external bleeding)and 4 more(thoracic cavity,abdomen,retroperitoneum,and long bones).In this case report,we present a unique case with concealed bleeding into the soft tissue compartment leading to *** case triggered to consider the soft tissue compartment as the sixth potential bleeding site in trauma patients in hemorrhagic *** presentation:We present the case with concealed bleeding into the soft tissue compartment posing a challenge in *** presentation,he had a pulse rate of 117 beats/min,a blood pressure of 90/60mmHg,and a Glasgow Coma Scale(GCS)score of *** resuscitation,the patient's blood pressure dropped to 70/46 mmHg with a GCS of 7 of *** was then intubated and ***-enhanced computed tomography of the torso revealed a right scapular fracture with a large soft tissue hematoma along the right side of the neck and chest wall,extending up to the right lumbar ***:We suggest that the soft tissue compartment is the sixth potential site of internal bleeding in trauma patients,which should not be overlooked after having ruled out the other 5 sites.

关键词： Case report Hemorrhage Shock Soft tissue injury Trauma

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Focused research in emergency medical systems in Asia: a necessity for trauma system advancement

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Emergency and Critical Care Medicine 2022年第2期2卷 87-93页

作者： Amila Ratnayake Shinji Nakahara dinesh bagaria Sohan De Silva Sri Lal De Silva April Llaneta Ratrawee Pattanarattanamolee Yonggang Li Bui Hai Hoang Army Hospital ColomboSri Lanka Kanagawa University of Human Services KawasakiJapan All India Institute of Medical Sciences New DelhiIndia 1990 Suwa Seriya Foundation ColomboSri Lanka University of the Philippines ManilaThe Philippines Khon Kaen Regional Hospital Khon KaenThailand Department of Emergency Surgery and Traumatic Orthopedics Qilu Hospital of Shandong UniversityJinanShandongChina Hanoi Medical University HanoiVietnam

Since trauma is a growing health problem worldwide,emergency trauma care including emergency medical services(EMS)is becoming an integral part of the healthcare *** optimal EMS which will improve access to trauma care,will be different in each country because of different healthcare systems,trauma etiology,and economic *** adopt models that have succeeded in developed countries is not always *** order to identify the optimal EMS model in developing countries,comparing the systems among many countries in detail and examining their advantages and disadvantages would be ***,this article tries to identify important elements of EMS to achieve mature EMS systems based on comparisons of 7 Asian countries,and discusses the need to conduct more detailed and extensive comparisons.

关键词： Asia Emergency medical services Healthcare system International comparison Trauma

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Varied presentations, magnitude, and outcome of traumatic neck injuries at a level I trauma center

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Emergency and Critical Care Medicine 2022年第2期2卷 45-49页

作者： Parvez Mohi Ud Din Dar Jogendra Boddeda Supreet Kaur Pratyusha Priyadarshini Abhinav Kumar dinesh bagaria Narendra Choudhary Junaid Alam Sushma Sagar Subodh Kumar Amit Gupta Biplab Mishra Division of Trauma Surgery and Critical Care Jai Prakash Narayan Apex Trauma CentreAll India Institute of Medical Sciences(AIIMS)New DelhiIndia Department of General Surgery All India Institute of Medical Sciences(AIIMS)JodhpurRajasthanIndia

Introduction:Traumatic neck injuries(TNIs)constitute 5%–10%of all trauma *** injuries can be caused by either penetrating or blunt *** can have a varied presentation like cut injury over the neck,bleeding,neck swelling,breathing difficulty,dysphagia,***:This was a retrospective observational study conducted at a level I trauma center in India from January 2016 to March *** hundred thirty patients who required admission and intervention due to TNIs were included in this ***:One hundred thirty patients with neck injuries were included in this *** were predominant(91.5%)with the age ranging from 10 to *** most common mechanism of injury was physical assault(40.7%),followed by road traffic injury(23.8%)and self-inflicted injuries(18.4%).Penetrating trauma was *** neck wound with bleeding was the most common presenting *** II injuries were more common(83.8%)followed by zone I(12.3%)and zone III(3.8%).Soft tissue injury including skin,platysma breach,and strap muscle injury was present in 46.9% of *** injury was present in 13.8%,tracheal injury in 28.5%,vascular injury in 13.8%,and esophageal injury in 4.6% of ***:Penetrating neck trauma is more common than blunt in developing countries like *** Trauma Life Support(ATLS)protocol guides the initial *** definitive management depends on the type and mechanism of injury,anatomical level,severity,and the organ injured.

关键词： Bleeding Neck trauma Resuscitation Trachea Vascular injury

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Management and outcome of pancreatic trauma:a 6-year experience at a level I trauma center

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Emergency and Critical Care Medicine 2023年第1期3卷 6-11页

作者： Abhinav Anand Parvez Mohi Ud Din Dar Preksha Rani Supreet Kaur Joses Dany James Junaid Alam Pratyusha Priyadarshini Abhinav Kumar dinesh bagaria Narendra Choudhary Subodh Kumar Amit Gupta Sushma Sagar Biplab Mishra Division of Trauma Surgery and Critical Care Jai Prakash Narayan Apex Trauma CentreAll India Institute of Medical Sciences(AIIMS)New DelhiIndia Department of Trauma and Emergency Medicine All India Institute of Medical Science(AIIMS)VijaypurJammuJammu and KashmirIndia Department of General Surgery All India Institute of Medical Science(AIIMS)JodhpurRajasthanIndia

Background: Pancreatic trauma (PT) accounts for less than 1% of all trauma admissions. Occasionally, PT is undetected during theprimary survey and becomes apparent only when complications arise. It occurs in up to 5% of blunt abdominal trauma cases and 12%of individuals with penetrating abdominal injuries. Management is determined by the status of the main pancreatic duct and ***: This was an ambispective study conducted at the Jai Prakash Narayan Apex Trauma Center, All India Institute ofMedical Sciences,New Delhi, from January 2015 to December 2017 (retrospective), and January 2019 to December 2020 (prospective). In total, 113patients with PT were included in this ***:We analyzed the data of 113 patients with PT included in this study, of whichmales predominated (93.7%). Blunt PT was presentin 101 patients (89.4%) and penetrating PT in 12 patients (10.6%). Half of the patients (51.3%) had the American Association for theSurgery of Trauma grade III PT, followed by grade II (18.6%), and grade I (15%). Of the total 113 patients, 68 (60.2%) were treated withoperative management, and 45 (39.8%) with nonoperative management. Distal pancreatectomy, with or without splenectomy, was themost common procedure performed in our study, followed by drainage. There were 27 mortalities (23.8%) during the study period, ofwhich 7 were directly related to PT and 20 were due to other organ-related sepsis and hemorrhagic ***: Pancreatic trauma is rare but challenging for trauma surgeons, with persistent management controversies. Early diagnosisis important for favorable results;however, a delay in diagnosis has been associated with higher morbidity and mortality. Low-grade pancreaticinjuries can be successfully managed nonoperatively, whereas high-grade pancreatic injuries require surgical intervention.

关键词： Abdominal trauma Distal pancreatectomy Management Pancreatic trauma

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