• Journal of Acupuncture Research
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• v.34 no.1
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• pp.81-87
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• 2017

Objectives : Chronic post-thoracotomy pain is a refractory condition that responds poorly to existing pain treatments. The aim of this report is to describe favorable symptom changes in a patient with chronic post-thoracotomy pain after major chest trauma who received a series of manual acupuncture treatments over 3 months. Methods : Twelve sessions of manual acupuncture were provided to the patient, once or twice a week. Results : The manual acupuncture sessions were well tolerated. Minor adverse events, including temporary minor bleeding at the needled sites, were intermittently observed. The patient's symptoms, including pain, sleep disturbance, and anxiety gradually resolved and had almost completely disappeared after 12 sessions of acupuncture treatment. Conclusion : This single case report cannot confirm whether the observed positive changes in the patient's symptoms and dysfunctions are associated with the acupuncture treatments. Randomized controlled trials are necessary to explore the role of acupuncture in chronic post-thoracotomy pain in patients with major chest trauma.

• Journal of Trauma and Injury
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• v.35 no.2
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• pp.71-75
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• 2022

Trauma care is evolving throughout the world to meet the demand resulting from rapidly increasing rates of mortality and morbidity related to external injuries. The State Major Trauma Service was designated to Royal Perth Hospital in 2004 to provide comprehensive care for trauma patients in Western Australia (WA), which is the largest state by area in the country. The State Major Trauma Unit, which was established in 2008, functions as a level I center and admits over 1,000 major trauma patients per year, making it the second busiest trauma center in Australia. The importance of recording data related to trauma was identified by the trauma service in WA to inspire higher standards of patient care and injury prevention. In 1994, the service established a trauma registry, which has undergone significant changes over the last two decades. The current State Trauma Registry is linked to a statewide database called the Data Linkage System. The linked data are available for policy development, quality assurance, and research. This article discusses the evolution of the trauma service and the registry database in the WA health system. The State Trauma Registry has enormous potential to contribute to research and quality improvement studies along with its ability to link with other databases.

• Journal of Trauma and Injury
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• v.24 no.1
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• pp.37-44
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• 2011

Purpose: Recently, social interest in an organized trauma system for the treatment of patients has been increasing in government and academia and the establishment of trauma center is being considered across the country. However, establishing such a system has not been easy in Korea, because enormous experiences and resources are necessary. The objectives of this study were (1) to estimate a trauma patient's demands during the course of treatment and (2) to provide appropriate direction for trauma centers to be established in Korea. Methods: The records of 207 patients who were admitted to the Department of Trauma Surgery in Ajou University Medical Center due to trauma were retrospectively reviewed for a 1 year period from March 2010 to February 2011. Patients were reviewed for general characteristics, number of hospital days, numbers and kinds of surgeries, numbers and kinds of consultations, ISS (Injury Severity Score) and number of patients with ISS more than 15. Results: All 207 patients were enrolled. The average number of hospital days was 36.7 days. The ICU stay was 15.9 days, and the general ward stay was 20.8 days. Admitted patients occupied 9.02 beds in ICU and 11.80 beds in the general ward per day. The average number of surgeries per patient was 1.4, and surgery at the Department of Trauma Surgery was most common. Number of consultations per patient was 14.23, and consultations with orthopedic surgeons were most common. The average ISS was 18.6. The number of patients with ISS more than 15 was 141 (61.8%) and the average number of patients treated per trauma surgeon as a major trauma patient was 94.3. The number of mortalities was 20, and the mortality rate was 9.7%. Conclusion: To reduce mortality and to provide proper treatment of patients with major trauma, hospitals need some number of beds, especially in the ICU, to treat patients and to prepare them for emergent surgery. An appropriate number of trauma surgeons and various specialists for consultation are also needed.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.181-185
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• 2020

Damage control surgery (DCS) is an abbreviated laparotomy procedure that focuses on controlling bleeding to limit the surgical insult. It has become the primary treatment modality for patients with exsanguinating truncal trauma. Herein, we present the case of a 47-year-old woman with liver, kidney, and superior mesenteric vein (SMV) injuries caused by a motor vehicle collision. The patient underwent DCS following resuscitative endovascular balloon occlusion of the aorta (REBOA). In this case report, we discuss the importance of priority setting in DCS for the treatment of multisystem damage of several abdominal organs, particularly when the patient has incurred a combination of major vascular injuries. We also discuss the implications of damage control of the SMV, perihepatic packing, and right-sided medial visceral rotation. Further understanding of DCS, along with REBOA as a novel resuscitation strategy, can facilitate the conversion of uniformly lethal abdominal injuries into rescuable injuries.

• Journal of Trauma and Injury
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• v.31 no.2
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• pp.72-75
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• 2018

Acetabular and Pelvic ring fractures are major high-energy trauma injuries and are often combined with other injuries. In particular, cause of long duration of immobilization and combined injuries, venous thromboembolism is a common complication in trauma patients with pelvic or acetabular fractures. We report a case of a fatal pulmonary thromboembolism during the acetabulum fracture operation in a 62-year-old male patient.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.151-158
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• 2018

Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.296-299
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• 2012

The aorta is the most common major thoracic artery injured by blunt chest trauma. Injuries to major aortic arch branch arteries can also occur but are much less common than aortic injuries in the setting of blunt trauma. Although internal mammary artery (IMA) injury is uncommon and rarely diagnosed in cases of blunt chest trauma, it is one of the important sources of bleeding in chest trauma. IMA bleeding can cause ongoing blood loss and may lead to serious conditions such as extensive hemothorax, anterior mediastinal hematoma or its catastrophic complication, cardiac tamponade. However such arotic and branch artery injuries are not easily detected by plain radiograph, and are detected indirectly because of associated mediastinal hematoma. Herein, we report a case of IMA injury caused by blunt chest trauma secondary to pedestrian traffic accident. The injured patient was successfully treated by transcatheter arterial embolization (TAE).

• Korean Institute of Interior Design Journal
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• v.26 no.6
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• pp.172-179
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• 2017

The regional trauma center should be a trauma treatment center equipped with facilities, equipments, and manpower capable of providing optimal treatment from emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. This study analyzes the connectivity, control, integration, and mean depth of current trauma centers using the convex map of space syntax, And to provide basic data for building for more efficient regional trauma center. The major areas that must be included in the regional trauma center are trauma resuscitation room, trauma operating room, trauma intensive care unit, and trauma general ward. It is necessary to carry out the architectural planning to increase the interconnection of the four areas. Also, the elevator plan for trauma patients should be emphasized. In addition, a regional trauma center should be separated from the existing facility for independent operation. According to the case analysis of the space configuration of the regional trauma center, the location of the operating room is most important considering the connection with each department of the hospital and the treatment flow of the severe trauma patients.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.224-228
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• 2014

Pelvic ring and acetabular fractures are major high-energy trauma injuries and are often associated with other injuries or fractures. In particular, a venous thromboembolism is an important common complication in trauma patients with pelvic or acetabular fractures. We report a case of a fatal pulmonary thromboembolism after a pelvic fracture in a 60-year-old female patient.