1
40
10
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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n/a
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Pages
361-361
Issue
2
Volume
48
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Dublin Core
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Title
A name given to the resource
Untitled - Reply
Publisher
An entity responsible for making the resource available
Journal of Trauma-Injury Infection and Critical Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
2000-02
Subject
The topic of the resource
General & Internal Medicine; Surgery
Creator
An entity primarily responsible for making the resource
Porter J M
Identifier
An unambiguous reference to the resource within a given context
n/a
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2000
General & Internal Medicine
Journal Article
Journal of Trauma-Injury Infection and Critical Care
Porter J M
Surgery
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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n/a
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
360-360
Issue
2
Volume
48
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Untitled
Publisher
An entity responsible for making the resource available
Journal of Trauma-Injury Infection and Critical Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
2000-02
Subject
The topic of the resource
General & Internal Medicine; Surgery
Creator
An entity primarily responsible for making the resource
Porter J M
Identifier
An unambiguous reference to the resource within a given context
n/a
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2000
General & Internal Medicine
Journal Article
Journal of Trauma-Injury Infection and Critical Care
Porter J M
Surgery
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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n/a
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
427-429
Issue
5
Volume
67
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Title
A name given to the resource
Should trauma surgeons render definitive vascular repair in peripheral vascular injuries?
Publisher
An entity responsible for making the resource available
American Surgeon
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
2001-05
Subject
The topic of the resource
arterial trauma; care; extremity; management; Surgery
Creator
An entity primarily responsible for making the resource
Porter J M; Ivatury R R
Description
An account of the resource
Our hypothesis is that in an established Level I trauma center general trauma surgeons should repair peripheral vascular injuries even in stable patients when there is time for a vascular consult. We reviewed all penetrating peripheral vascular injuries in stable patients operated on by nine experienced general trauma surgeons (1993-1996). Outcome measures were amputation, nerve damage, and vascular complications. There were 43 patients with 44 peripheral vascular injuries identified. Sixty per cent were from stab wounds. There were 27 arterial injuries (carotid four, subclavian one, vertebral two, axillary three, brachial eight, ulnar one, radial two, femoral five, and anterior tibial one). There were three venous injuries (one each subclavian, axillary, and popliteal). There were 14 combined injuries (vertebral two, femoral nine, and popliteal three). There were no mortalities. Morbidity was limited to patients with lower extremity injuries. In the nine patients with combined femoral vessel injury there were three complications (nerve damage, thrombosed arterial repair, and thrombosed venous repair). In the four patients with popliteal venous injuries there were two complications, both venous thrombosis. Our early arterial patency rate was 97.6 per cent. These data support the hypothesis that general surgeons with trauma experience can provide effective treatment of peripheral vascular injuries. The significance of these findings in improving the image of trauma surgery as a career is discussed.
Identifier
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n/a
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The file format, physical medium, or dimensions of the resource
Journal Article
2001
American Surgeon
arterial trauma
care
extremity
Ivatury R R
Journal Article
Management
Porter J M
Surgery
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
n/a
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
35-36
Issue
1
Volume
49
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Title
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Maintaining survivors' values of left ventricular power output during shock resuscitation: A prospective pilot study - Editorial comment
Publisher
An entity responsible for making the resource available
Journal of Trauma-Injury Infection and Critical Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
2000-07
Subject
The topic of the resource
end-points; General & Internal Medicine; oxygen delivery; Surgery; trauma patients
Creator
An entity primarily responsible for making the resource
Porter J M
Identifier
An unambiguous reference to the resource within a given context
n/a
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2000
end-points
General & Internal Medicine
Journal Article
Journal of Trauma-Injury Infection and Critical Care
oxygen delivery
Porter J M
Surgery
trauma patients
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
n/a
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
438-441
Issue
5
Volume
67
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Title
A name given to the resource
Digital rectal examination for trauma: Does every patient need one?
Publisher
An entity responsible for making the resource available
American Surgeon
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
2001-05
Subject
The topic of the resource
injuries; management; Surgery
Creator
An entity primarily responsible for making the resource
Porter J M; Ursic C M
Description
An account of the resource
The digital rectal examination is widely accepted as an essential component in the initial assessment of trauma. However, no data have been published that justify its routine use in all seriously injured patients. The objective of this study was to determine what if any impact on subsequent treatment and management decisions the initial digital rectal examination had on injured patients arriving at our emergency department (ED). We conducted a prospective observational study of all injured patients arriving at a Level II trauma center over a period of 6 months. A digital rectal examination was performed on all patients during the secondary survey phase of their initial evaluation shortly after arrival to the ED. The results of the rectal examination were noted for each patient with particular attention placed on the presence or absence of gross blood, Hemoccult result, prostatic examination, rectal vault integrity, and rectal sphincter tone. In addition the patients hemodynamic parameters while in the ED and the injuries that were sustained were noted, as was their final disposition. Four hundred twenty-three patients were admitted to the ED after sustaining serious injuries. The mean Injury Severity Score was 9.96. The prostatic examination was normal in more than 99 per cent of patients; no high-riding or nonpalpable prostate glands were noted. Twenty-two patients (5.2%) were Hemoccult positive, but in none of these cases did the presence of occult blood in the stool lead to a change in the initial management or diagnostic approach. Three patients (0.7%) with penetrating injuries to the perineal/pelvic area had gross blood on digital rectal examination that prompted operative exploration to rule out a lower gastrointestinal injury. All three had rectal injuries confirmed at surgery. Rectal sphincter tone was normal in 406 (96%) patients, weak in 17 (4%), and absent in none. The only patient in whom the sphincter tone influenced management was an individual complaining of complete paralysis after a blunt mechanism of injury. He had normal rectal sphincter tone and admitted to malingering shortly thereafter. Overall the rectal examination influenced therapeutic decision making in five cases (1.2%). The digital rectal examination is unlikely to affect initial management when applied indiscriminately to all seriously injured patients during the secondary survey. Patients in whom the rectal examination may have a higher probability of influencing management are those with penetrating injuries in proximity to the lower gasstrintestinal tract, questionable spinal cord damage, and severe pelvic fractures with potential urethral disruption or open fractures in continuity with the rectal vault. The Hemoccult test does not add useful information and should be discontinued as part of the secondary survey of injured patients.
Identifier
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n/a
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Journal Article
2001
American Surgeon
Injuries
Journal Article
Management
Porter J M
Surgery
Ursic C M
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/00005373-200106000-00036" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00005373-200106000-00036</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
1161-1161
Issue
6
Volume
50
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Title
A name given to the resource
Untitled
Publisher
An entity responsible for making the resource available
Journal of Trauma-Injury Infection and Critical Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
2001-06
Subject
The topic of the resource
General & Internal Medicine; Surgery
Creator
An entity primarily responsible for making the resource
Porter J M
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00005373-200106000-00036" target="_blank" rel="noreferrer noopener">10.1097/00005373-200106000-00036</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2001
General & Internal Medicine
Journal Article
Journal of Trauma-Injury Infection and Critical Care
Porter J M
Surgery
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/00005373-199908000-00047" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00005373-199908000-00047</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
437-437
Issue
2
Volume
47
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Dublin Core
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Title
A name given to the resource
Letters to the editor
Publisher
An entity responsible for making the resource available
Journal of Trauma-Injury Infection and Critical Care
Date
A point or period of time associated with an event in the lifecycle of the resource
1999
1999-08
Subject
The topic of the resource
General & Internal Medicine; Surgery
Creator
An entity primarily responsible for making the resource
Porter J M
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00005373-199908000-00047" target="_blank" rel="noreferrer noopener">10.1097/00005373-199908000-00047</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article
1999
General & Internal Medicine
Journal Article
Journal of Trauma-Injury Infection and Critical Care
Porter J M
Surgery
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1097/00005373-200201000-00009" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00005373-200201000-00009</a>
Pages
40–46
Issue
1
Volume
52
Dublin Core
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Title
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Correlation of noninvasive cerebral oximetry with cerebral perfusion in the severe head injured patient: a pilot study.
Publisher
An entity responsible for making the resource available
Journal of Trauma
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
2002-01
Subject
The topic of the resource
Adult; Female; Male; Prospective Studies; Confidence Intervals; Human; Convenience Sample; Chi Square Test; Data Analysis Software; Pilot Studies; Middle Age; Fisher's Exact Test; Pearson's Correlation Coefficient; T-Tests; Oximetry; Monitoring; Linear Regression; Tissue Perfusion; Intracranial Pressure; Head Injuries – Therapy
Creator
An entity primarily responsible for making the resource
Dunham CM; Sosnowski C; Porter J M; Siegal J; Kohli C
Description
An account of the resource
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in trauma patients. Cerebral perfusion pressure (CPP) directed ICU management is recommended for patients with severe TBI. It, however, requires an invasive device to measure intracranial pressure (ICP). Transcranial cerebral oximetry is a noninvasive method utilizing near-infrared technology to indirectly measure cerebral saturation (StCO2). METHODS: A prospective observational study was performed at a Level I trauma center. Data were collected hourly for the first 6 days on four patients with severe TBI. Each patient had ICP monitoring and StCO2 (INVOS, Somanetics) assessed from each frontal lobe. CPP directed care was used. RESULTS: Four patients with TBI, with admission GCS scores of 4, 4, 7, and 8, all had subdural hematomas and contusions; three had subarachnoid hemorrhage (SAH); one had an epidural hematoma (the only death; day 6); two had craniotomies. In the first 48 hours when CPP \textgreater or = 70, StCO2 was 71 +/- 9, while it was 61 +/- 9 when CPP \textless 70 (p \textless 0.0001). This relationship was constant for all study days, with p \textless 0.0001. Moreover, CPP \textless 70 correlated with StCO2 with r = 0.8l and r(2) = 0.66. StCO2 \textgreater or = 75 was associated with CPP \textgreater or = 70 96.4% of the time (95% CL, 94.3-98.5%). StCO2 \textless 55 was associated with CPP \textless 70 68.2% of the time (95% CL, 57-79.4%). Also, 13.4% of observations with CPP \textgreater or = 70 had StCO2 \textless 60, suggesting the potential of cerebral ischemia in the face of 'normal' CPP. The StCO2 patches were user-friendly and not technically finicky. CONCLUSION: In this pilot study, StCO2 correlated significantly with CPP. A StCO2 \textgreater or = 75 suggests that CPP is adequate, while \textless 55 suggests an inadequate CPP. Although these results should be confirmed in a larger study, StCO2 may serve as a noninvasive measurement of cerebral perfusion in the patient with a TBI or, at the very least, a sensitive indicator for the need to begin monitoring the ICP.
Identifier
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<a href="http://doi.org/10.1097/00005373-200201000-00009" target="_blank" rel="noreferrer noopener">10.1097/00005373-200201000-00009</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2002
Adult
Chi Square Test
Confidence Intervals
Convenience Sample
Data Analysis Software
Dunham CM
Female
Fisher's Exact Test
Head Injuries – Therapy
Human
Intracranial Pressure
Journal of Trauma
Kohli C
Linear Regression
Male
Middle Age
Monitoring
Oximetry
Pearson's Correlation Coefficient
Pilot Studies
Porter J M
Prospective Studies
Siegal J
Sosnowski C
T-Tests
Tissue Perfusion
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Pages
684–686
Issue
7
Volume
67
Dublin Core
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Title
A name given to the resource
Cyanide toxicity in the surgical intensive care unit: a case report.
Publisher
An entity responsible for making the resource available
The American surgeon
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
2001-07
Subject
The topic of the resource
Female; Humans; Aged; Intensive Care Units; Cyanides/*poisoning; Hypertension/complications/*drug therapy; Nitroprusside/administration & dosage/pharmacokinetics/*poisoning; Poisoning/diagnosis/therapy; Wounds and Injuries/complications/therapy
Creator
An entity primarily responsible for making the resource
Sipe E K; Trienski T L; Porter J M
Description
An account of the resource
Hypertension is a widespread entity in the surgical intensive care unit. Not only is the clinical spectrum varied, but the armamentarium available to the clinician is also wide-ranging. Sodium nitroprusside, a potent vasodilator with a short half-life, is often used for hypertensive crisis and to deliberately maintain a low blood in certain clinical conditions. Cyanide toxicity is a known complication of sodium nitroprusside use. Herein is reported a case of probable cyanide toxicity in an elderly trauma patient. The pharmacology of sodium nitroprusside and the pitfalls of making the diagnosis of cyanide toxicity are discussed.
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2001
Aged
Cyanides/*poisoning
Female
Humans
Hypertension/complications/*drug therapy
Intensive Care Units
Nitroprusside/administration & dosage/pharmacokinetics/*poisoning
Poisoning/diagnosis/therapy
Porter J M
Sipe E K
The American surgeon
Trienski T L
Wounds and Injuries/complications/therapy
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Pages
611–614
Issue
7
Volume
67
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Trauma attending in the resuscitation room: does it affect outcome?
Publisher
An entity responsible for making the resource available
The American surgeon
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
2001-07
Subject
The topic of the resource
Adult; Humans; Time Factors; Retrospective Studies; Workforce; Survival Rate; Quality of Health Care; *Outcome and Process Assessment (Health Care); *Resuscitation; *Trauma Centers; Personnel Staffing and Scheduling; Wounds and Injuries/mortality/therapy; Emergency Service; Hospital; Hospital/*statistics & numerical data; Medical Staff
Creator
An entity primarily responsible for making the resource
Porter J M; Ursic C
Description
An account of the resource
Although there are no Class I data supporting the regionalization of trauma care the consensus is that trauma centers decrease morbidity and mortality. However, the controversy continues over whether trauma surgeons should be in-house or take call from home. The current literature does not answer the question because in all of the recent studies the attendings who took call from home were in the resuscitation room guiding the care. We believe the correct question is: Does the presence of the trauma attending in the resuscitation room make a difference? At a university-affiliated Level II trauma center data from the trauma registry, resuscitation room flowsheet, and dictated admission notes were reviewed on all patients over a 6-month period. Data points were: attending present in the resuscitation room, standard demographics, resuscitation room time, time to operating room (OR), time to CT scan, length of stay, complications, and mortality. A total of 943 patients were studied with 216 (23%) having the attending present in the resuscitation room and 727 (77%) without the attending present. The groups were similar in terms of age, sex, Injury Severity Score, percentage Injury Severity Score greater than 15 (16-17.1%), and mechanism of injury (24-29% penetrating). Of all the data points studied only time to the OR had a statistically significance difference (P \textless 0.05) with it taking 43.8 minutes (+/-20.1) when the attending was present and 109.4 minutes (+/-107) when the attending was absent. There were also no missed injuries, delays to the OR, or inappropriate workups when the attendings were present. Only the time to the OR reached statistical significance. The time to the OR is indicative of the decision-making process in the resuscitation room, and it is in this area that the attendings' presence is the most useful. Also, we believe that it is important that there were no missed injuries, delays to the OR, or inappropriate workups when the attendings were present in the resuscitation room. This again speaks to the decision-making process. We believe that these data support the need for the attending to be present in the resuscitation room to facilitate accurate and timely decisions regardless of whether they take the call from home or in-house.
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Outcome and Process Assessment (Health Care)
*Resuscitation
*Trauma Centers
2001
Adult
Emergency Service
Hospital
Hospital/*statistics & numerical data
Humans
Medical Staff
Personnel Staffing and Scheduling
Porter J M
Quality of Health Care
Retrospective Studies
Survival Rate
The American surgeon
Time Factors
Ursic C
Workforce
Wounds and Injuries/mortality/therapy