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Therapeutic Application Of Carbon Monoxide In Acute Limb Compartment Syndrome, Aurelia Bihari 2017 The University of Western Ontario

Therapeutic Application Of Carbon Monoxide In Acute Limb Compartment Syndrome, Aurelia Bihari

Electronic Thesis and Dissertation Repository

Acute limb compartment syndrome (CS), a devastating complication of musculoskeletal trauma, develops in response to elevation of the pressure within a closed osseofascial compartment, producing muscle- and limb-threatening ischemia. Full decompression of all involved compartments by fasciotomy is the current gold-standard therapy, but it must be performed within a surgical window of 6-8 hours, before tissue damage becomes permanent.

Carbon monoxide (CO), a byproduct of heme metabolism, has been shown protective in ischemia. While inhalation of CO leads to elevation of carboxyhemoglobin (COHb), recent development of transitional metal carbonyls, CO-releasing molecules (CO-RMs), particularly the water-soluble CORM-3, delivers CO in a ...


Emergency Department Approach To Electrical Toothbrush Associated Hand Injury, A Unique Case Of Non-Oropharyngeal Injury., Hannah Robinson, Neal Sikka, Chimere Little, Ali Pourmand 2017 George Washington University

Emergency Department Approach To Electrical Toothbrush Associated Hand Injury, A Unique Case Of Non-Oropharyngeal Injury., Hannah Robinson, Neal Sikka, Chimere Little, Ali Pourmand

GW Research Days 2016 - Present

Puncture wounds are common injuries treated in the emergency department (ED). Prior studies have shown that toothbrushes are common reservoirs for oral flora, especially in regions near the head of the toothbrush near the bristles. ED providers must be aware of the danger associated with bacterial contamination of the associated wound and should be familiar with different pathogens and options for treatment. We present a unique case of a 30-year-old male with non-intraoral injury who presented to the ED after puncturing his left palm with the metal post of an electric toothbrush.


Concussion Screening Evaluation: Bess Vs Sway, Zachariah Hatoum, Aidan Neustadtl, Jeremy Altman, Aurash Zarrinbakhsh, David Milzman 2017 George Washington University

Concussion Screening Evaluation: Bess Vs Sway, Zachariah Hatoum, Aidan Neustadtl, Jeremy Altman, Aurash Zarrinbakhsh, David Milzman

GW Research Days 2016 - Present

Introduction: Rapid evaluation of concussion is important in the pre-hospital setting as an easy test. It is also useful in the ED, as too often little is done for concussed patients. The Balance Error Scoring System (BESS) is the current gold standard for evaluating balance, one of the best predictors of concussion. SWAY, a new gyroscope based iPhone application, is being proposed as a more sensitive and more objective test than BESS. This study will compare Sway to BESS to determine if there is equal efficacy.
Method: 74 scholastic and collegiate athletes were administered baseline balance evaluations using Sway. Sway ...


Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell 2017 George Washington University

Dysuria: An Uncommon Presentation In Emergency Department Following Bladder Neck Disruption., Ali Pourmand, Assya Abdallah, Hamid Shokoohi, Mindy Park, Marie White, Francis O'Connell

Emergency Medicine Faculty Publications

Prostate cancer is the most common life-threatening cancer diagnosed in men. Complications of prostatectomies vary and often include urinary incontinence, erectile dysfunction and pain, while other complications go unreported. While emergency physicians are already familiar with the more common post-operative complications presenting to their departments, including urinary retention, ileus, surgical site infections, venous thromboembolisms and urinary tract infections, they must have a high index of suspicion for rarer complications. We report a case of posterior bladder neck disruption as a complication of a robotic assisted laparoscopic prostatectomy that presented to the emergency department as dysuria and abdominal pain following urination.


Inferior Stemi Complicated By Retroperitoneal Hemorrhage Due To Ruptured Aaa, Farley B. Neasman III, Melissa D. Lester, Nepal C. Chowdhury 2017 Marshall University

Inferior Stemi Complicated By Retroperitoneal Hemorrhage Due To Ruptured Aaa, Farley B. Neasman Iii, Melissa D. Lester, Nepal C. Chowdhury

Marshall Journal of Medicine

When patients present with life threatening conditions, a rapid cost-benefit analysis prioritizes care and commits treatment to a certain course that, in the case of ST Elevation Myocardial Infarction (STEMI) treated with drug-eluting stents (DES), could be fatal if there is any deviation. Antiplatelet therapy is vital and secondary concerns (i.e. bleeding diatheses) may accept suboptimal outcomes – in rare cases, another life-threatening condition may be unmasked, the treatment for which runs directly counter to the first. We present a case of STEMI with high clot burden treated with multiple DES, complicated by retroperitoneal hemorrhage due to a ruptured abdominal ...


The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar 2016 University of Southern Mississippi

The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar

Doctoral Nursing Capstone Projects

Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in ...


Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, MD, Chadwick J. Knight, MD 2016 Marshall University

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Errington Thompson

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.


Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, MD, Zachary Sanford, Constantinous Constantinou, MD 2016 Marshall University: School of Medicine

Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, Md, Zachary Sanford, Constantinous Constantinou, Md

Constantinous Constantinou

Posterior tibial artery pseudoaneurysms are extremely rare. They commonly present as a late complication of trauma or iatrogenic injury. Diagnosis can be elusive. Treatment has been described in the context of open primary repair, endovascular stenting, and coil embolization. There has been increasing interest in the use of endovascular treatment options for this type of injury. If left untreated, pseudoaneurysms can rupture, partially thrombose, expand and cause adjacent local compression and compartment syndrome. The following case presented is of a young gentleman with a posterior tibial pseudoaneurysm incidentally discovered after stepping on glass and the management of his posterior tibial ...


Blog And Podcast Watch: Pediatric Emergency Medicine, Fareen Zaver, Michael Hansen, C. Leibner, A. Little, M. Lin 2016 George Washington University

Blog And Podcast Watch: Pediatric Emergency Medicine, Fareen Zaver, Michael Hansen, C. Leibner, A. Little, M. Lin

Emergency Medicine Faculty Publications

Introduction: By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM.

Methods: The Approved Instructional Resources - Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is ...


Webpoisoncontrol: Can Poison Control Be Automated?, Toby Litovitz, Blaine E Benson, Susan Smolinske 2016 George Washington University

Webpoisoncontrol: Can Poison Control Be Automated?, Toby Litovitz, Blaine E Benson, Susan Smolinske

Emergency Medicine Faculty Publications

BACKGROUND: A free webPOISONCONTROL app allows the public to determine the appropriate triage of poison ingestions without calling poison control. If accepted and safe, this alternative expands access to reliable poison control services to those who prefer the Internet over the telephone. This study assesses feasibility, safety, and user-acceptance of automated online triage of asymptomatic, nonsuicidal poison ingestion cases.

METHODS: The user provides substance name, amount, age, and weight in an automated online tool or downloadable app, and is given a specific triage recommendation to stay home, go to the emergency department, or call poison control for further guidance. Safety ...


Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, MD, Zachary Sanford, Constantinous Constantinou, MD 2016 Marshall University: School of Medicine

Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, Md, Zachary Sanford, Constantinous Constantinou, Md

Marshall Journal of Medicine

Posterior tibial artery pseudoaneurysms are extremely rare. They commonly present as a late complication of trauma or iatrogenic injury. Diagnosis can be elusive. Treatment has been described in the context of open primary repair, endovascular stenting, and coil embolization. There has been increasing interest in the use of endovascular treatment options for this type of injury. If left untreated, pseudoaneurysms can rupture, partially thrombose, expand and cause adjacent local compression and compartment syndrome. The following case presented is of a young gentleman with a posterior tibial pseudoaneurysm incidentally discovered after stepping on glass and the management of his posterior tibial ...


Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos 2016 University of Massachusetts Medical School

Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos

GSBS Dissertations and Theses

Background: Traumatic injury remains a major cause of mortality in the US. Older Americans experience lower rates of injury and higher rates of death at lower injury severity than their younger counterparts. The objectives of this study were to explore pre-injury factors and injury patterns that are associated with post-discharge mortality among injured elderly surviving index hospitalization.

Methods: We queried a 5% random sample of Medicare beneficiaries (n=2,002,420) for any hospitalization with a primary ICD-9 diagnosis code for injury. Patients admitted without urgent/emergent admission were excluded, as well as patients presenting from inpatient hospitalization or rehabilitation ...


Working With Mild Traumatic Brain Injury: Voices From The Field, Page Walker Buck, Rebecca G. Laster, Jocelyn Spencer Sagrati, Rachel Shapiro Kirzner 2016 West Chester University of Pennsylvania

Working With Mild Traumatic Brain Injury: Voices From The Field, Page Walker Buck, Rebecca G. Laster, Jocelyn Spencer Sagrati, Rachel Shapiro Kirzner

Page Buck

No abstract provided.


Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, MD, Chadwick J. Knight, MD 2016 Marshall University

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Marshall Journal of Medicine

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.


Recommendation For Permissive Hypotension For Trauma Patients In The Prehospital Setting In Peninsulas Emergency Medical Services Council, Inc., Seth Craig 2016 Rappahannock Community College

Recommendation For Permissive Hypotension For Trauma Patients In The Prehospital Setting In Peninsulas Emergency Medical Services Council, Inc., Seth Craig

Student Writing

Permissive hypotension should be part of the Trauma Protocol of the Peninsulas Emergency Medical Service (PEMS) Region to prevent further injury to patients with traumatic injuries. Currently the Trauma Protocol states: “Suspected hypovolemia 20 mL/kg 0.9% normal saline up to 1000 mL bolus, continuously reassess need for further fluid” (page 1 of 2, Trauma). There is no guidance in the current PEMS Trauma Protocol to indicate how to determine the “need for further fluid,” which would lead a prehospital medical provider to attempt to achieve a normotensive blood pressure. Current research, however, supports permissive hypotension.

The importance of ...


Geriatric Psychology, Robert D. Barraco MD 2016 Lehigh Valley Health Network

Geriatric Psychology, Robert D. Barraco Md

Robert D Barraco MD, MPH

No abstract provided.


School-Based Injury Outcomes In Children From A Low-Income Setting: Results From The Pilot Injury Surveillance In Rawalpindi City, Pakistan, Uzma Khan, Junaid Bhatti, Nukhba Zia, Umar Farooq 2016 Aga Khan University

School-Based Injury Outcomes In Children From A Low-Income Setting: Results From The Pilot Injury Surveillance In Rawalpindi City, Pakistan, Uzma Khan, Junaid Bhatti, Nukhba Zia, Umar Farooq

Uzma R. Khan

Background School-based injuries account for one in five unintentional childhood injuries. Little is known about the epidemiology of school-based injuries in low-income settings. The objective of our study was to compare emergency department (ED) outcomes of the school-based injuries with respect to age, sex, and injury mechanisms in a Pakistani urban setting. Findings A pilot injury surveillance study was conducted at the EDs of three major tertiary-care hospitals of Rawalpindi city from July 2007 to June 2008 and included children of less than 15 years injured at school. The World Health Organization’s questionnaire for injury surveillance was used. There ...


Intentional And Unintentional Poisoning In Pakistan: A Pilot Study Using The Emergency Departments Surveillance Project., Nadeem Ullah Khan, Ricardo Pérez-Núñez, Nudrat Shamim, Uzma Khan, Naureen Naseer, Asher Feroze, Junaid Razzak, Adnan Hyder 2016 Aga Khan University

Intentional And Unintentional Poisoning In Pakistan: A Pilot Study Using The Emergency Departments Surveillance Project., Nadeem Ullah Khan, Ricardo Pérez-Núñez, Nudrat Shamim, Uzma Khan, Naureen Naseer, Asher Feroze, Junaid Razzak, Adnan Hyder

Uzma R. Khan

Background

Acute poisoning is one of the most common reasons for emergency department visits around the world. In Pakistan, the epidemiological data on poisoning is limited due to an under developed poison information surveillance system. We aim to describe the characteristics associated with intentional and unintentional poisoning in Pakistan presenting to emergency departments.

Methods

The data was extracted from the Pakistan National Emergency Department Surveillance (Pak-NEDS) which was an active surveillance conducted between November 2010 and March 2011. All patients, regardless of age, who presented with poisoning to any of Pakistan's seven major tertiary care centers' emergency departments, were ...


Clothing-Related Motorcycle Injuries In Pakistan: Findings From A Surveillance Study, Uzma R. Khan, Junaid Bhatti, M. Shamim, Nukhba Zia, Junaid Razzak, Rashid Jooma 2016 Aga Khan University

Clothing-Related Motorcycle Injuries In Pakistan: Findings From A Surveillance Study, Uzma R. Khan, Junaid Bhatti, M. Shamim, Nukhba Zia, Junaid Razzak, Rashid Jooma

Uzma R. Khan

This study aims to assess the burden and patterns of clothing-related motorcycle injuries in Karachi, Pakistan. Data were extracted from an ongoing traffic injury surveillance system. In three years (2007-2009), out of 99155 road traffic injury cases there were 986 (0.9%) cases of clothing-related motorcycle injuries. Most cases were females (73.9%) and pillion riders (80.6%). The crashes involving clothing-related injuries were mostly single vehicle (98.5%), and largely resulted in injuries to the external body (60.3%), limbs (51.0%), head (41.5%) and face (35.9%). One-third of injuries were either moderate (26.7%) or severe ...


The Effects Of A Trauma-Informed Care Training Program On Mental Health Professionals Knowledge, Skills, And Attitudes With The Smi, Angelina Pelletier 2016 Philadelphia College of Osteopathic Medicine

The Effects Of A Trauma-Informed Care Training Program On Mental Health Professionals Knowledge, Skills, And Attitudes With The Smi, Angelina Pelletier

PCOM Psychology Dissertations

Trauma has been found to be highly prevalent among individuals diagnosed with SMIs. Mental health professionals have been reported to misdiagnose or avoid addressing trauma in this population. There is a need to provide information about trauma and to foster awareness among mental health professionals who are treating individuals diagnosed with SMIs. With a TIC approach, operating from a recovery-oriented philosophy, there have been interventions created to address trauma and SMIs with the aim of developing awareness about trauma and the impact it may have on someone’s life. With these factors in mind, mental health professionals should be competent ...


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