Journal of Trauma and Injury

Case Report

Delayed diagnosis of proximal ureter injury after a blunt abdominal trauma in Korea: a case report: Soon Ki Min, Byungchul Yu, Gil Jae Lee, Min A Lee, Yang Bin Jeon, Youngeun Park, Kang Kook Choi, Hyuk Jun Yang; J Trauma Inj. 2024;37(3):243-246. Published online September 3, 2024; DOI: https://doi.org/10.20408/jti.2024.0016

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Abstract PDF: Traumatic ureteral injuries account for fewer than 1% of traumatic urologic injuries, and those caused by blunt trauma are even rarer than those caused by penetrating trauma. The symptoms associated with ureteral injury may be subtle, with or without hematuria, making it difficult to diagnose. We report the case of a 31-year-old man with a delayed diagnosis of proximal ureter injury after abdominal blunt trauma sustained in a motorcycle traffic accident. The patient underwent emergency laparotomy on admission for liver injury, mesenteric injury, and resultant hemoperitoneum. On postoperative day 6, he underwent angioembolization for suspected remnant intra-abdominal bleeding. Persistent symptoms of flank pain and leukocytosis led to follow-up imaging studies that revealed proximal ureter injury, and the patient underwent unilateral nephrectomy. This case stresses the importance of clinical suspicion for genitourinary injuries in the presence of abdominal trauma.; Summary

Original Article

Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study: Youngmin Kim, Byungchul Yu, Se-Beom Jeon, Seung Hwan Lee, Jayun Cho, Jihun Gwak, Youngeun Park, Kang Kook Choi, Min A Lee, Gil Jae Lee, Jungnam Lee; J Trauma Inj. 2023;36(3):224-230. Published online December 21, 2022; DOI: https://doi.org/10.20408/jti.2022.0055

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Abstract PDF: Purpose
Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City.
Methods
Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded.
Results
Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals.
Conclusions
Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.; Summary

Case Reports

Salvation of a solitary kidney in a patient with grade IV renal trauma: a case report: Hyuntack Shin, Ae Jin Sung, Min A Lee, Jayun Cho, Gil Jae Lee, Byungchul Yu, Kang Kook Choi; J Trauma Inj. 2022;35(Suppl 1):S18-S22. Published online June 17, 2022; DOI: https://doi.org/10.20408/jti.2021.0091

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Abstract PDF: There are many reasons for solitary kidney. Congenital causes include renal agenesis and dysplasia. Acquired causes include nephrectomy performed for reasons including traumatic kidney injury, disease (e.g., renal cell carcinoma), and donation for kidney transplantation. According to the European Association of Urology, the World Society of Emergency Surgery, and the American Association for the Surgery of Trauma guidelines, it is important to preserve the remaining renal function as much as possible when a solitary kidney patient has suffered a traumatic kidney injury. The authors present a case of kidney preservation in a solitary kidney patient with a traumatic grade IV renal injury through non-operative management involving superselective renal artery angioembolization.; Summary

A case report of field amputation: the rescue of an entrapped patient through the "doctor car" system: Byungchul Yu, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Youngeun Park, Yong-Cheol Yoon, Jayun Cho, Seung Hwan Lee, Jungnam Lee; J Trauma Inj. 2022;35(Suppl 1):S27-S30. Published online June 15, 2022; DOI: https://doi.org/10.20408/jti.2022.0012

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Abstract PDF: In certain circumstances, invasive procedures such as creation of a surgical airway, insertion of a chest drain, intraosseous puncture, or amputation in the field are necessary. These invasive procedures can save lives. However, emergency medical service teams cannot perform such procedures according to the law in Korea. The upper arm of a 29-year-old male patient was stuck in a huge machine and the emergency medical service team could not rescue the patient. A doctor-car team was dispatched to the scene and the team performed the filed amputation to extricate the patient. He was brought to the trauma center immediately and underwent formal above-elbow amputation. Here we describe a case of field amputation to rescue a patient through a “doctor car” system, along with a literature review.; Summary

Original Articles

Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center: Min A Lee, Seung Hwan Lee, Kang Kook Choi, Youngeun Park, Gil Jae Lee, Byungchul Yu; J Trauma Inj. 2021;34(3):177-182. Published online September 30, 2021; DOI: https://doi.org/10.20408/jti.2021.0070

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Abstract PDF: Purpose
Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries.
Methods
We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records.
Results
A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3).
Conclusions
For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases.; Summary

Major Causes of Preventable Death in Trauma Patients: Youngeun Park, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Sung Youl Hyun, Yang Bin Jeon, Yong-Cheol Yoon, Jungnam Lee, Byungchul Yu; J Trauma Inj. 2021;34(4):225-232. Published online July 29, 2021; DOI: https://doi.org/10.20408/jti.2020.0074

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Abstract PDF

Purpose

Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care.

Methods

We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review.

Results

The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding.

Conclusions

Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.

Summary

Citations

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Charles D Mabry, Benjamin Davis, Michael Sutherland, Ronald Robertson, Jennifer Carger, Deidre Wyrick, Terry Collins, Austin Porter, Kyle Kalkwarf
Journal of the American College of Surgeons.2024; 238(4): 426. CrossRef
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Nomogram for predicting in-hospital mortality in trauma patients undergoing resuscitative endovascular balloon occlusion of the aorta: a retrospective multicenter study
Byungchul Yu, Jayun Cho, Byung Hee Kang, Kyounghwan Kim, Dong Hun Kim, Sung Wook Chang, Pil Young Jung, Yoonjung Heo, Wu Seong Kang
Scientific Reports.2024;[Epub] CrossRef
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Julia Dixon, Shaheem de Vries, Chelsie Fleischer, Smitha Bhaumik, Chelsea Dymond, Austin Jones, Madeline Ross, Julia Finn, Heike Geduld, Elmin Steyn, Hendrick Lategan, Lesley Hodsdon, Janette Verster, Suzan Mukonkole, Karlien Doubell, Navneet Baidwan, Nee
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Mengistu Abebe Messelu, Temesgen Ayenew, Tesfa Sewunet Alamneh, Tiruye Azene Demile, Aster Tadesse Shibabaw, Asnake Gashaw Belayneh
Frontiers in Medicine.2024;[Epub] CrossRef
The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study
Myung Jin Jang, Woo Sung Choi, Jung Nam Lee, Won Bin Park
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Anna Dąbrowska, Wiktoria Malik, Dorota Czachor, Weronika Jarych, Anna Wściślak, Zuzanna Świąder, Łucja Komisarczyk, Piotr Pałczyński
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A Deployable Viscoelastic Coagulation Monitor Enables Point-of-Care Assessment of Coagulopathy in Swine With Polytrauma
Teryn R Roberts, Isabella Garcia, Ivan Slychko, Heidi J Dalton, Andriy I Batchinsky
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Analysis of mortality over 7 years in a mature trauma center: evolution of preventable mortality in severe trauma patients
Sarah Guigues, Jean Cotte, Jean-Baptiste Morvan, Henry de Lesquen, Bertrand Prunet, Mathieu Boutonnet, Nicolas Libert, Pierre Pasquier, Eric Meaudre, Julien Bordes, Michael Cardinale
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Mengistu Abebe Messelu, Ambaye Dejen Tilahun, Zerko Wako Beko, Hussien Endris, Asnake Gashaw Belayneh, Getayeneh Antehunegn Tesema
European Journal of Medical Research.2023;[Epub] CrossRef
Characteristics and Clinical Outcomes of Elderly Patients with Trauma Treated in a Local Trauma Center
Kwanhoon Park, Geonjae Cho, Sungho Lee, Kang Yoon Lee, Ji Young Jang
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An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
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Comparison of Resting Energy Expenditure Using Indirect Calorimetry and Predictive Equations in Trauma Patients: A Pilot Study: Dae Sung Ma, Gil Jae Lee; J Trauma Inj. 2021;34(1):13-20. Published online March 31, 2021; DOI: https://doi.org/10.20408/jti.2021.0023

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Abstract PDF

Purpose

Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients.

Methods

Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/ day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%.

Results

Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO₂ was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/ day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127).

Conclusions

The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

Summary

Citations

Citations to this article as recorded by

Determining the appropriate resting energy expenditure requirement for severe trauma patients using indirect calorimetry in Korea: a retrospective observational study
Hak-Jae Lee, Sung-Bak Ahn, Jung Hyun Lee, Ji-Yeon Kim, Sungyeon Yoo, Suk-Kyung Hong
Journal of Trauma and Injury.2023; 36(4): 337. CrossRef

Special Article

Part 4. Clinical Practice Guideline for Surveillance and Imaging Studies of Trauma Patients in the Trauma Bay from the Korean Society of Traumatology: Sung Wook Chang, Kang Kook Choi, O Hyun Kim, Maru Kim, Gil Jae Lee; J Trauma Inj. 2020;33(4):207-218. Published online December 31, 2020; DOI: https://doi.org/10.20408/jti.2020.0084

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Abstract PDF: The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).; Summary

Editorial

To Celebrate the Publication of a Special Topic for REBOA: Min A Lee, Gil Jae Lee; J Trauma Inj. 2020;33(3):139-139. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0055

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PDF: Summary

Original Article

An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study: Joonhyeon Park, Sung Woo Jang, Byungchul Yu, Gil Jae Lee, Sung Wook Chang, Dong Hun Kim, Ye Rim Chang, Pil Young Jung; J Trauma Inj. 2020;33(3):144-152. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0051

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Abstract PDF

Purpose

This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea.

Methods

This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA).

Results

There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses.

Conclusions

This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

Summary

Citations

Citations to this article as recorded by

Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review
Marcelo Augusto Fontenelle Ribeiro Junior, Salman M Salman, Sally M Al-Qaraghuli, Farah Makki, Riham A Abu Affan, Shahin Reza Mohseni, Megan Brenner
Trauma Surgery & Acute Care Open.2024; 9(1): e001267. CrossRef
Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study
Yoonjung Heo, Sung Wook Chang, Byungchul Yu, Byung Hee Kang, Pil Young Jung, Kyounghwan Kim, Dong Hun Kim
Journal of Acute Care Surgery.2024; 14(1): 16. CrossRef
On the Feasibility of Using REBOA Technology for the Treatment of Patients with Polytrauma
A. I. Zhukov, N. N. Zadneprovsky, P. A. Ivanov, L. S. Kokov
Russian Sklifosovsky Journal "Emergency Medical Ca.2024; 13(1): 14. CrossRef
Editor's Choice – Systematic Review and Meta-Analysis of Lower Extremity Vascular Complications after Arterial Access for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): An Inevitable Concern?
Megan Power Foley, Stewart R. Walsh, Nathalie Doolan, Paul Vulliamy, Morgan McMonagle, Christopher Aylwin
European Journal of Vascular and Endovascular Surg.2023; 66(1): 103. CrossRef
Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study
Dong Hun Kim, Jonghwan Moon, Sung Wook Chang, Byung Hee Kang
European Journal of Trauma and Emergency Surgery.2023; 49(6): 2495. CrossRef
Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures
Ji Young Jang, Keum Soek Bae, Byung Hee Kang, Gil Jae Lee
Scientific Reports.2022;[Epub] CrossRef

Special Article

Part 3. Clinical Practice Guideline for Airway Management and Emergency Thoracotomy for Trauma Patients from the Korean Society of Traumatology: Chan Yong Park, O Hyun Kim, Sung Wook Chang, Kang Kook Choi, Kyung Hak Lee, Seong Yup Kim, Maru Kim, Gil Jae Lee; J Trauma Inj. 2020;33(3):195-203. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0050

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Abstract PDF: The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).; Summary

Original Article

Case Series of Zone III Resuscitative Endovascular Balloon Occlusion of the Aorta in Traumatic Shock Patients: Byungchul Yu, Gil Jae Lee, Kang Kook Choi, Min A Lee, Jihun Gwak, Youngeun Park, Jung Nam Lee; J Trauma Inj. 2020;33(3):162-169. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0031

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Abstract PDF

Purpose

There is increasing evidence in the literature regarding resuscitative endovascular balloon occlusion of the aorta (REBOA) globally, but few cases have been reported in Korea. We aimed to describe our experience of successful Zone III REBOA and to discuss its algorithm, techniques, and related complications.

Methods

We reviewed consecutive cases who survived from hypovolemic shock after Zone III REBOA placement for 4 years. We reviewed patients’ baseline characteristics, physiological status, procedural data, and outcomes.

Results

REBOA was performed in 44 patients during the study period, including 10 patients (22.7%) who underwent Zone III REBOA, of whom seven (70%) survived. Only one patient was injured by a penetrating mechanism and survived after cardiopulmonary resuscitation. All patients underwent interventions to stop bleeding immediately after REBOA placement.

Conclusions

This case series suggests that Zone III REBOA is a safe and feasible procedure that could be applied to traumatic shock patients with normal FAST findings who receive a chest X-ray examination at the initial resuscitation.

Summary

Citations

Citations to this article as recorded by

On the Feasibility of Using REBOA Technology for the Treatment of Patients with Polytrauma
A. I. Zhukov, N. N. Zadneprovsky, P. A. Ivanov, L. S. Kokov
Russian Sklifosovsky Journal "Emergency Medical Ca.2024; 13(1): 14. CrossRef

Special Article

Part 2. Clinical Practice Guideline for Trauma Team Composition and Trauma Cardiopulmonary Resuscitation from the Korean Society of Traumatology: Oh Hyun Kim, Seung Je Go, Oh Sang Kwon, Chan-Yong Park, Byungchul Yu, Sung Wook Chang, Pil Young Jung, Gil Jae Lee; J Trauma Inj. 2020;33(2):63-73. Published online June 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0020

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PDF

Summary

Citations

Citations to this article as recorded by

Variations in Trauma Education Practices Across Emergency Medicine Residencies: Insights from a National Survey of Program Directors
Stephanie Stroever, Colten Lanning, Miloš Buhavac, Cameran Mecham, Andrea Weitz, Frank Frankovsky, Andres Rios, James Morris
Advances in Medical Education and Practice.2024; Volume 15: 1059. CrossRef
An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
Journal of Medical Internet Research.2023; 25: e49283. CrossRef

Case Report

Pulmonary Contusion Similar to COVID-19 Pneumonia: Seung Hwan Lee, Sung Youl Hyun, Yang Bin Jeon, Jung Nam Lee, Gil Jae Lee; J Trauma Inj. 2020;33(2):119-123. Published online June 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0014

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Abstract PDF

The Coronavirus disease 2019 (COVID-19) has rapidly spread across the world and caused a pandemic. It can be transmitted by an infected person or an asymptomatic carrier and is a highly contagious disease. Prevention and early identification of COVID-19 are important to minimize the transmission of COVID-19. Chest computed tomography (CT) has a high sensitivity for detecting COVID-19, but relatively low specificity. Therefore, chest CT may be difficult to distinguish COVID-19 findings from those of other infectious (notably viral types of pneumonia) or noninfectious disease. Pulmonary contusion has also a lot of similarities on chest CT with COVID-19 pneumonia. We present trauma patients with pulmonary contusion whose CT scans showed findings similar to those of COVID-19, and we report our experience in the management of trauma patients during the COVID-19 pandemic.

Summary

Citations

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Comparison of chest CT scan findings between COVID-19 and pulmonary contusion in trauma patients based on RSNA criteria: Established novel criteria for trauma victims
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Original Article

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology: Pil Young Jung, Byungchul Yu, Chan-Yong Park, Sung Wook Chang, O Hyun Kim, Maru Kim, Junsik Kwon, Gil Jae Lee; J Trauma Inj. 2020;33(1):1-12. Published online March 30, 2020; DOI: https://doi.org/10.20408/jti.2020.015

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Abstract PDF

Purpose

Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent.

Methods

Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument.

Results

Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80–90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100–110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient’s initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C).

Conclusions

This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

Summary

Citations

Citations to this article as recorded by

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Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
Journal of Medical Internet Research.2023; 25: e49283. CrossRef
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Hyunseok Jang, Soon Tak Jeong, Yun Chul Park, Wu Seong Kang
Medicina.2023; 59(8): 1492. CrossRef

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