Purpose： Maxillofacial injuries are commonly encountered in the practice of emergency medicine. More than 50% of patients with these injuries have multisystem trauma that requires coordinated manage- ment between eme...Purpose： Maxillofacial injuries are commonly encountered in the practice of emergency medicine. More than 50% of patients with these injuries have multisystem trauma that requires coordinated manage- ment between emergency physicians and surgical specialists in oral and maxillofacial surgery, otolar- yngology, plastic surgery, ophthalmology, and trauma surgery. The aim of this study is to identify the patterns of brain injuries associated with maxillofacial trauma and its outcome. Methods： This descriptive study （cross-sectional） was carried out among 90 polytrauma patients with maxillofacial fractures attending the Emergency Department at Suez Canal university Hospital and fulfilling our inclusion and exclusion criteria. Results： This study demonstrates the relation between type of maxillofacial fracture and type of trau- matic brain injuries in which the majority of patients with epidural hemorrhage presented with mid face fractures （60%）, while the minority of them presented with upper and lower face fractures （20% for each of them）. The majority of patients with subdural hemorrhage were associated with mid face fractures （75%）, the majority of patients with brain contusions associated with mid face fractures （75%）, and all of the patients presented by pneumocephalus were associated with mid face fractures （100%）. Conclusion： The results of this study confirm the value of quick diagnosis and early intervention, which is fundamental to prevent morbidity as well as mortality especially with regards to prevention of traumatic brain injury as even a short duration of hvpoxia and edema will lead to significant permanent neurological deficits.展开更多
Purpose： ＂Polytrauma＂ patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to ...Purpose： ＂Polytrauma＂ patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension （RUSH） significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma. Methods： This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography （pan-CT） were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support （ATLS） guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome. Results： The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock （64%）, followed by obstructive shock （14%）, distributive shock （12%） and cardiogenic shock （10%） respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%. Conclusion： RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.展开更多
文摘Purpose： Maxillofacial injuries are commonly encountered in the practice of emergency medicine. More than 50% of patients with these injuries have multisystem trauma that requires coordinated manage- ment between emergency physicians and surgical specialists in oral and maxillofacial surgery, otolar- yngology, plastic surgery, ophthalmology, and trauma surgery. The aim of this study is to identify the patterns of brain injuries associated with maxillofacial trauma and its outcome. Methods： This descriptive study （cross-sectional） was carried out among 90 polytrauma patients with maxillofacial fractures attending the Emergency Department at Suez Canal university Hospital and fulfilling our inclusion and exclusion criteria. Results： This study demonstrates the relation between type of maxillofacial fracture and type of trau- matic brain injuries in which the majority of patients with epidural hemorrhage presented with mid face fractures （60%）, while the minority of them presented with upper and lower face fractures （20% for each of them）. The majority of patients with subdural hemorrhage were associated with mid face fractures （75%）, the majority of patients with brain contusions associated with mid face fractures （75%）, and all of the patients presented by pneumocephalus were associated with mid face fractures （100%）. Conclusion： The results of this study confirm the value of quick diagnosis and early intervention, which is fundamental to prevent morbidity as well as mortality especially with regards to prevention of traumatic brain injury as even a short duration of hvpoxia and edema will lead to significant permanent neurological deficits.
文摘Purpose： ＂Polytrauma＂ patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension （RUSH） significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma. Methods： This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography （pan-CT） were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support （ATLS） guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome. Results： The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock （64%）, followed by obstructive shock （14%）, distributive shock （12%） and cardiogenic shock （10%） respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%. Conclusion： RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.
