Patients with acute colonic pseudo-obstruction (ACPO) who underwent surgery experienced lower mortality rates than previously reported. Surgical interventions, including colectomies and stomas, effectively treated refractory cases. Severe postoperative complications were observed in a minority of patients, with no recurrences or reoperations needed. Further research is needed to optimize surgical strategies for ACPO management. Surgical treatment […]
Category: Appendix, Gallbladder and Surgical Emergencies
Antegrade Balloon Dilatation: Superior Approach for Choledocholithiasis
Antegrade balloon dilatation during laparoscopic cholecystectomy showed significantly fewer interventions and reduced treatment time compared to endoscopic retrograde cholangiography in patients with acute obstructive common bile duct stones. The ‘abd-during-che’ technique had a lower overall complication index and fewer major complications, highlighting its potential as an alternative one-stop-shop treatment option for this patient population. Journal […]
Robotic surgery in emergency settings
Robotic surgery’s role in emergency interventions remains underexplored. The ROEM study, involving 500 patients from 50 centers, aims to assess the feasibility, safety, and cost-effectiveness of using robotic platforms in treating acute pathologies like diverticulitis and cholecystitis. With a focus on specific pathologies, the study addresses challenges like staff training and increased costs, aiming to […]
Trauma Care Access in South Chicago
Opening in 2018, the University of Chicago Medicine trauma center has significantly reduced patient transport time on the south side by up to 8.9 minutes, with a 40% penetrating trauma rate. The violence intervention program, engaging over 8000 patients, has strengthened community partnerships. This system change, driven by community efforts, has greatly enhanced trauma care […]
TraumaICDBERT Excels in Predicting Injury ICD-10 Codes
A natural language processing algorithm, traumaicdbert, demonstrated superior performance in predicting injury ICD-10 diagnosis codes compared to existing tools. Analyzing over 3000 tertiary survey notes, traumaicdbert outperformed Amazon Web Services Comprehend Medical, showing potential for improved real-time availability of diagnosis codes in clinical settings. Each survey note, on average, had 3.8 extracted injury ICD-10 codes, […]
Reevaluating EMS Impact Assessment in LMICs
Emergency medical services impact evaluations in low and middle-income countries must prioritize community-led approaches, moving beyond mortality outcomes to consider factors like response times, economic impacts, and inclusion of underprivileged minorities. By co-creating context-tailored measures of success with local stakeholders, a decolonial holistic approach can shift focus towards long-term wellbeing and sustainability, challenging neocolonial hegemony […]
Improved Outcomes with Splenic Artery Embolization in High-Grade Splenic Injuries
Splenic artery embolization (SAE) demonstrates a 72% reduction in in-hospital mortality, shorter ICU length of stay, and lower transfusion requirements compared to splenectomy for hemodynamically stable adult trauma patients with high-grade blunt splenic injuries (Grade ≥ IV). SAE is associated with significantly improved outcomes, making it a potentially safer and more effective management approach for […]
Dependent functional status as a risk factor for 30-day mortality after colectomy
Dependent functional status significantly increases the risks of mortality, pulmonary complications, sepsis, extended postoperative NPO/NGT use, non-home discharge, 30-day readmission, and longer hospital stays post-colectomy for volvulus. Identifying DFS as an independent risk factor emphasizes its impact on postoperative outcomes, enabling tailored preoperative assessments and care strategies for these at-risk patients. Journal Article by Li […]
Guidelines for Managing Trauma in Elderly and Frail Patients
Higher trauma mortality rates are observed in elderly patients due to physiological changes and frailty. Evidence-based guidelines emphasize knowledge of aging physiology, focused triage, frailty assessment, and early trauma protocol activation to improve outcomes. Recommendations include multimodal pain management, selective antibiotic prophylaxis, thromboembolism prophylaxis, and palliative care involvement for end-of-life discussions in a multidisciplinary approach. […]
Shock index and modified shock index as predictors of outcomes in trauma patients following traffic collisions
Shock index (SI) and modified shock index (MSI) are valuable tools for predicting mortality and blood transfusion needs in trauma patients involved in traffic collisions. An SI threshold of 1.11 indicates increased mortality risk, while an SI of 0.84 predicts the need for blood transfusion. Both SI and MSI show high predictive power for mortality […]