RESUMO
In Denmark, head injuries are generally managed according to the Scandinavian Neurotrauma Committee Guideline (SNC), which aims to safely reduce head CTs. This review investigates how pre-injury vitamin K-antagonist treatment is associated with adverse outcome in head injury patients, but the significance of other antithrombotics is uncertain. Implementation of S100B in the SNC Guideline has reduced CT usage by approx. 30%. However, S100B could likely be used in a wider array of patients. Despite its usefulness, S100B's popularity is still hampered, likely due to poor practical implementation in Danish emergency rooms.
Assuntos
Traumatismos Craniocerebrais , Humanos , Traumatismos Craniocerebrais/complicações , Traumatismos Craniocerebrais/terapia , Biomarcadores , Medição de Risco , Anticoagulantes , Serviço Hospitalar de EmergênciaRESUMO
INTRODUCTION: During the lockdown of the COVID-19 pandemic in Denmark in March 2020, the trauma Accidents and Emergency (A and E) Department of Odense University Hospital, Denmark, experienced a marked decline in visits. We had the impression that the decline in visits for non-severe injuries was larger than that for severe injuries. METHODS: We analysed the incident rate ratio (IRR) between the first month of the lockdown with the IRR recorded in the month leading up to the lockdown. We then compared this IRR with the IRR for the equivalent periods of 2019. The outcomes were: diagnoses (or diagnosis groups), activity during injury (ADI), mechanisms of injury, age group and gender. Secondarily, certain specific diagnoses (or diagnosis groups) were analysed by ADI and mechanism of injury. RESULTS: We observed a significant reduction by 30.6% of all hand injuries in 2020. The non-severe injuries had a significant IRR reduction of 58.7% and the severe injuries a reduction of 15.3%, which was non-significant. The IRR in 2020 was significantly lower in 2020 for the age groups: 0-14, 15-17 and 25-49 years. The relative reduction in IRR was markedly larger for men (40.8%) than for women (22.3%), although this difference was not significant. CONCLUSION: We observed a greater reduction in non-severe injuries than in severe injuries compared with 2019. Further studies are needed to fully examine the cause of this phenomenon. The reduction may be caused, in part, by a more restrictive attitude towards seeking medical help at a trauma A and E during the first COVID-19 lockdown. FUNDING: none TRIAL REGISTRATION. not relevant.
Assuntos
COVID-19 , Traumatismos da Mão , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Dinamarca/epidemiologia , Serviço Hospitalar de Emergência , Feminino , Traumatismos da Mão/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Estudos Retrospectivos , Adulto JovemRESUMO
Septic abortion is a rare, but potentially life-threatening condition. Quick diagnosis and treatment is essential for the outcome. This case report describes a healthy 34-year-old woman who was admitted with abdominal pain, fever and an ongoing spontaneous abortion at gestational age week 13 + 6 days. During evacuation severe bleeding and coagulopathy was seen. She was treated with multiple coagulation products but due to a life-threatening situation an acute hysterectomy was performed. She was discharged after nine days.