Dataset Information

Open pelvic fracture with bilateral common iliac arteriovenous injury successfully treated with hemicorporectomy following damage control interventional radiology in a hybrid emergency room.

ABSTRACT: Background:In severe pelvic fracture, keys of successful treatment are early hemostasis and timely definitive care. We present a case in which the patient was treated by fast and reliable hemostasis and subsequent comprehensive hemicorporectomy. Case Presentation:We describe the case of a 47-year-old man with severe pelvic trauma. He received early intervention by the helicopter emergency medical service, which included rapid transarterial embolization as damage control interventional radiology in the hybrid emergency room, and hemicorporectomy as a multidisciplinary approach. This series of treatments saved his life and he was discharged home. Conclusion:Hemicorporectomy could be the only treatment option in patients with severe pelvic injury when there are no reconstruction options. To the best of our knowledge, this is the first case of severe open pelvic fractures with blood vessel damage, successfully treated by initial hemostasis using the helicopter emergency medical service, hybrid emergency room system, and following hemicorporectomy as a definitive care.

SUBMITTER: Omura T

PROVIDER: S-EPMC7594704 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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Open pelvic fracture with bilateral common iliac arteriovenous injury successfully treated with hemicorporectomy following damage control interventional radiology in a hybrid emergency room.

Omura Takeshi T Omichi Yasuyuki Y Kosaka Hirofumi H

Acute medicine & surgery 20200101 1

<h4>Background</h4>In severe pelvic fracture, keys of successful treatment are early hemostasis and timely definitive care. We present a case in which the patient was treated by fast and reliable hemostasis and subsequent comprehensive hemicorporectomy.<h4>Case presentation</h4>We describe the case of a 47-year-old man with severe pelvic trauma. He received early intervention by the helicopter emergency medical service, which included rapid transarterial embolization as damage control interventi ...[more]

PMID: 33145026

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Project description:BackgroundPain is one of the most common, yet challenging problems leading to emergency department (ED) presentation, despite the availability of a wide range of pharmacological therapies. Virtual reality (VR) simulations are well studied in a wide variety of clinical settings, including acute and chronic pain management, as well as anxiety disorders. However, studies in the busy environment of an adult ED are scarce. The aim of this study is to explore the feasibility and effectiveness of a VR simulation for pain and anxiety control in a convenience sample of adult ED patients presenting with traumatic and non-traumatic pain triaged 2-5 (i.e., urgent to non-urgent) with a pain rating of ≥ 3 on a numeric rating scale (NRS 0-10).MethodsProspective within-subject, repeated measures interventional feasibility pilot study at a Swiss University ED. The intervention consisted of a virtual reality simulation in addition to usual care. Pain and anxiety levels were measured using a verbally administered numeric rating scale (NRS) before and after the intervention. Information on patient experience was collected using established rating scales.ResultsFifty-two patients were enrolled. The most common pain localisations were extremities (n = 15, 28.8%) and abdomen (n = 12, 23.1%). About one third of patients presented with trauma-associated pain (n = 16, 30.8%). Duration of pain was mainly acute (< 24 h) (n = 16, 30.8%) or subacute (> 24 h) (n = 32, 61.5%). The majority of patients were triage category 3, i.e. semi-urgent (n = 48, 92.3%). Significant reduction in pain (NRS median pre-VR simulation 4.5 (IQR 3-7) vs. median post-VR simulation 3 (IQR 2-5), p < 0.001), and anxiety levels (NRS median pre-VR simulation 4 (IQR 2-5) vs. median post-VR simulation 2 (IQR 0-3), p < 0.001) was achieved, yielding moderate to large effect sizes (Cohen's d estimate for pain reduction = 0.59 (95% CI 0.19-0.98), for anxiety level on NRS = 0.75 (95% CI 0.34-1.15). With medium immersion and good tolerability of the VR simulation, user satisfaction was high.ConclusionsVirtual reality analgesia for pain and anxiety reduction in the busy setting of an ED is feasible, effective, with high user satisfaction. Further randomized controlled studies are needed to better characterize its impact on pain perception and resource utilization.

Dataset Information

Open pelvic fracture with bilateral common iliac arteriovenous injury successfully treated with hemicorporectomy following damage control interventional radiology in a hybrid emergency room.

Publications

Open pelvic fracture with bilateral common iliac arteriovenous injury successfully treated with hemicorporectomy following damage control interventional radiology in a hybrid emergency room.

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