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Journal of Trauma-injury Infection and Critical Care
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BACKGROUND: Coronavirus patients demonstrate varying degrees of respiratory insufficiency; many will progress to respiratory failure with a severe version of acute respiratory distress syndrome (ARDS) refractory to traditional supportive strategies. Providers must consider alternative therapies to deter or prevent the cascade of decompensation to fulminant respiratory failure. METHODS: This is a case-series of five COVID-19 positive patients who demonstrated severe hypoxemia, declining respirato...
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The COVID-19 pandemic has led to unprecedented stresses on modern medical systems, overwhelming the resource infrastructure in numerous countries while presenting a unique series of pathophysiologic clinical findings. Thrombotic coagulopathy is common in critically ill patients suffering from COVID-19, with associated high rates of respiratory failure requiring prolonged periods of mechanical ventilation. Here we report a case series of five patients suffering from profound, medically refractory...
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INTRODUCTION: The COVID-19 virus is highly contagious and thus there is a potential of infecting operating staff when operating on these patients. This case series describes a method of performing open tracheostomy for COVID-19 patients while minimizing potential aerosolization of the virus using typically available equipment and supplies. METHODS: This is a case series of 18 patients who were COVID-19 positive and underwent open tracheostomy in the operating room under a negative pressure plast...
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BACKGROUND: Epidemiologic assessment of surgical admissions into intensive care units (ICU) provides a framework to evaluate healthcare system efficiency and project future healthcare needs. METHODS: We performed a 9-year (2008-2016), retrospective cohort analysis of all adult admissions to 88 SICUs using the prospectively and manually abstracted, Cerner APACHE Outcomes database. We stratified patients into 13 surgical cohorts and modeled temporal-trends in admission, mortality, SICU length of s...
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#1Emily A. Norris (NMCP: Naval Medical Center Portsmouth)
#2Christian S. McEvoy (NMCP: Naval Medical Center Portsmouth)H-Index: 2
Last. Travis M Polk (LAC+USC Medical Center)
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BACKGROUND: Little is known regarding the effect of hemorrhagic shock on the diagnosis and treatment of tension pneumothorax (tPTX). Recently, the Tactical Combat Casualty Care (TCCC) guidelines included the 10-gauge angiocatheter (10g AC) as an acceptable alternative to the 14g AC. This study sought to compare these two devices for decompression of tPTX and rescue from tension-induced pulseless electric activity (tPEA) in the setting of a concomitant 30% estimated blood volume (EBV) hemorrhage....
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BACKGROUND: Modeling approaches offer a novel way to detect and predict coagulopathy in trauma patients. A dynamic model, built and tested on thromboelastogram (TEG) data, was used to generate a virtual library of over 160,000 simulated RapidTEGs. The patient-specific parameters are the initial platelet count, platelet activation rate, thrombus growth rate, and lysis rate (P(0), k1, k2, and k3, respectively). METHODS: Patient data from both STAAMP (n=182 patients) and PAMPer (n=111 patients) cli...
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