- Inadvertent Arterial Catheterization of Central Venous Catheter: A Case Report
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Seung Young Oh
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J Trauma Inj. 2015;28(4):292-294. Published online December 31, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.4.292
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 Abstract
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- Central venous catheterization is one of the most important procedures for initial resuscitation of hemodynamically unstable patients including multiple trauma patients. Inadvertent arterial placement of the large caliber central venous catheter can results in resuscitation failure as well as unnecessary invasive treatment. Here, we report an arterial puncture during central venous catheterization which may lead to inadvertent arterial catheterization. We recommend that arterial catheterization should be evaluated before dilator insertion during Seldinger's method. Ultrasound can help in preventing the inadvertent arterial catheterization of central venous catheter.
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Summary
- Nonoperative Treatment for Abdominal Injury in Multiple Trauma Patients: Experience in the Metropolitan Tertiary Hospital in Korea (2009~2014)
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Seung Young Oh, Gil Joon Suh
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J Trauma Inj. 2015;28(4):284-291. Published online December 31, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.4.284
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Abstract
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- The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers.
We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays.
Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups.
In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.
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