Browsing by Subject "Trauma Centers"

Now showing 1 - 4 of 4
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    Complications of tube thoracostomy for chest trauma
    (2009)
    OBJECTIVE: To determine the insertional and positional complications encountered by the placement of intercostal chest drains (ICDs) for trauma and whether further training is warranted in operators inserting intercostal chest drains outside level 1 trauma unit settings. METHODS: Over a period of 3 months, all patients with or without an ICD in situ in the front room trauma bay of Tygerberg Hospital were included in the study. Patients admitted directly via the trauma resuscitation unit were excluded. No long-term infective complications were included. A self-reporting system recorded complications, and additional data were obtained by searching the department's records and monthly statistics. RESULTS: A total of 3989 patients with trauma injuries were seen in the front room trauma bay during the study period; 273 (6.8%) patients with an ICD in situ or requiring an ICD were assessed in the trauma unit and admitted to the chest drain ward; 24 patients were identified with 26 complications relating to the insertion and positioning of the ICD; 22 (92%) of these had been referred with an ICD in situ. An overall complication rate of 9.5% was seen. Insertional complications numbered 7 (27%), with 19 (73%) positional complications. The most common errors were insertion at the incorrect anatomical site, and extrathoracic and too shallow placement (side portal of the drain lying outside the chest cavity). CONCLUSION: Operators at the referral hospitals have received insufficient training in the technique for insertion of ICDs for chest trauma and would benefit from more structured instruction and closer supervision of ICD insertion.
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    The history of paediatric trauma care in Cape Town
    (Health and Medical Publishing Group, 2006) van As, A B (Sebastian); Rode, Heinz
    Trauma is a leading cause of morbidity, mortality and disability in childhood. In most developed countries where 18% of the population are in the age group 0 - 15 years, injury exceeds all other causes of childhood mortality. In the developing countries of Africa, however, children aged 0 - 15 years constitute 43% of the population and trauma has an even bigger impact on child health.There is an erroneous perception that trauma is not a major health problem in Africa, derived from undue emphasis on mortality statistics alone. Yet, the impact of trauma ought to be measured not only in terms of death, but also the tremendous morbidity and disability caused by injuries, and their socioeconomic consequences.
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    Open Access
    The history of paediatric trauma care in Cape Town
    (Health and Medical Publishing Group, 2006) van As, A B; Rode, Heinz
    Trauma is a leading cause of morbidity, mortality and disability in childhood. In most developed countries where 18% of the population are in the age group 0 - 15 years, injury exceeds all other causes of childhood mortality. In the developing countries of Africa, however, children aged 0 - 15 years constitute 43% of the population and trauma has an even bigger impact on child health.There is an erroneous perception that trauma is not a major health problem in Africa, derived from undue emphasis on mortality statistics alone. Yet, the impact of trauma ought to be measured not only in terms of death, but also the tremendous morbidity and disability caused by injuries, and their socioeconomic consequences.
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    Open Access
    Temporary vascular shunting in vascular trauma: A 10-year review from a civilian trauma centre
    (2013) Oliver, J C; Gill, H; Nicol, A J; Edu, S; Navsaria, P H
    BACKGROUND: Temporary intravascular shunts (TIVSs) can replace immediate definitive repair as a damage control procedure in vascular trauma. We evaluated their use in an urban trauma centre with a high incidence of penetrating trauma. METHOD: A retrospective chart review of all patients treated with a TIVS in a single centre between January 2000 and December 2009. RESULTS: Thirty-five TIVSs were placed during the study period: 22 were part of a damage control procedure, 7 were inserted at a peripheral hospital without vascular surgical expertise prior to transfer, and 6 were used during fixation of a lower limb fracture with an associated vascular injury. There were 7 amputations and 5 deaths, 4 of the TIVSs thrombosed, and a further 3 dislodged or migrated. Twenty-five patients underwent definitive repair with an interposition graft, 1 primary anastomosis was achieved, and 1 extra-anatomical bypass was performed. Five patients with non-viable limbs had the vessel ligated. CONCLUSIONS: A TIVS in the damage control setting is both life- and limb-saving. These shunts can be inserted safely in a facility without access to a surgeon with vascular surgery experience if there is uncontrollable bleeding or the delay to definitive vascular surgery is likely to be more than 6 hours. A definitive procedure should be performed within 24 hours.