Publications by authors named "Rovinder Sandhu"

12 Publications

  • Page 1 of 1

Resuscitation of Severe Accidental Hypothermia to Normal Neurologic Outcome With Use of Extracorporeal Membrane Oxygenation.

Cureus 2021 Jun 5;13(6):e15456. Epub 2021 Jun 5.

Department of Emergency Medicine, Morsani College of Medicine/Lehigh Valley Health Network, Allentown, USA.

Accidental hypothermia is a condition associated with significant morbidity and mortality. A 48-year-old male with a history of alcohol use disorder and optic neuropathy presented to the emergency department after being found unresponsive with an unknown downtime. One hundred four minutes passed from resuscitation, to pre-hospital discovery, until cannulation with extracorporeal membrane oxygenation. Here, a rare case of successful resuscitation of a profoundly hypothermic patient to normal neurologic outcome is presented.
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http://dx.doi.org/10.7759/cureus.15456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256448PMC
June 2021

Large bowel obstruction secondary to gallstones.

J Surg Case Rep 2021 May 18;2021(5):rjab137. Epub 2021 May 18.

Department of Surgery, Lehigh Valley Health Network, Allentown, PA, USA.

Gallstone ileus is a rare complication of cholelithiasis, representing 1% of bowel obstructions. The usual site of obstruction is the ileocecal valve, though other sites have been reported. Here, we present two cases of gallstone ileus within the distal colon requiring surgical intervention. Two elderly females presented with vague abdominal symptoms secondary to large bowel obstruction from gallstone impaction. Both underwent attempted endoscopic retrieval without success. Patient 1 required laparoscopy converted to exploratory laparotomy with colotomy and removal of the stone. Patient 2 required partial colectomy and end colostomy formation due to acute sigmoid inflammation. Gallstone ileus is a rare cause of intestinal obstruction, though incidence increases with age. Cholecystocolonic fistulas allow stones to bypass the ileocecal valve, with the potential for impaction in the colon at the site of a stricture or tortuosity. Surgical intervention may be required in cases not amenable to successful endoscopic retrieval.
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http://dx.doi.org/10.1093/jscr/rjab137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130875PMC
May 2021

Development and Implementation of a Pilot Radiation Reduction Protocol for Pediatric Head Injury.

J Surg Res 2020 11 16;255:111-117. Epub 2020 Jun 16.

Division of Pediatric Surgical Specialties, Lehigh Valley Reilly Children's Hospital, Lehigh Valley Health Network, Allentown, Pennsylvania. Electronic address:

Background: Traumatic brain injury is the leading cause of morbidity and mortality for children in the United States. The aim of this study was to develop and implement a guideline to reduce radiation exposure in the pediatric head injury patient by identifying the patient population where repeat imaging is necessary and to establish rapid brain protocol magnetic resonance imaging as the first-line modality.

Methods: A retrospective chart review of trauma patients between 0 and 14 y of age admitted at a pediatric level 2 trauma center was performed between January 2013 and June 2019. The guideline established the appropriateness of repeat scans for patients with Glasgow Coma Scale >13 with clinical neurological deterioration or patients with Glasgow Coma Scale ≤13 and intracranial hemorrhagic lesion on initial head computed tomography (CT).

Results: Our trauma registry included 592 patients during the study period, 415 before implementation and 161 after implementation. A total of 132 patients met inclusion criteria, 116 pre-guideline and 16 post-guideline. The number of patients receiving repeat head CTs significantly decreased from 34.5% to 6.3% (P < 0.02). There was also a significant decrease in the mean number of head CT/patient pre-guideline 1.63 (range 1-7) compared with post-guideline 1.06 (range 1-2) (P < 0.02).

Conclusions: CT head imaging is invaluable in the initial trauma evaluation of pediatric patients. However, it can be overused, and the radiation may lead to long-term deleterious effects. Establishing a head imaging guideline which limits use with clinical criteria can be effective in reducing radiation exposure without missing injuries.
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http://dx.doi.org/10.1016/j.jss.2020.05.051DOI Listing
November 2020

Extracorporeal Membrane Oxygenation (ECMO) for Hypothermic Cardiac Deterioration: A Case Series.

Prehosp Disaster Med 2016 Oct 5;31(5):570-1. Epub 2016 Aug 5.

1Department of Emergency Medicine,Lehigh Valley Hospital and Health Network,Allentown,PennsylvaniaUSA.

Accidental hypothermia can lead to untoward cardiac manifestations and arrest. This report presents a case series of severe accidental hypothermia with cardiac complications in three emergency patients who were treated with extracorporeal membrane oxygenation (ECMO) and survived after re-warming. The aim of this discussion was to encourage more clinicians to consider ECMO as a re-warming therapy for severe hypothermia with circulatory collapse and to prompt discussion about decreasing the barriers to its use. Niehaus MT , Pechulis RM , Wu JK , Frei S , Hong JJ , Sandhu RS , Greenberg MR . Extracorporeal membrane oxygenation (ECMO) for hypothermic cardiac deterioration: a case series. Prehosp Disaster Med. 2016;31(5):570-571.
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http://dx.doi.org/10.1017/S1049023X16000637DOI Listing
October 2016

Child passenger safety: an evidence-based review.

J Trauma 2010 Dec;69(6):1588-90

Department of Surgery, Lehigh Valley Health Network, Allentown, Pennsylvania 18105-1556, USA.

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http://dx.doi.org/10.1097/TA.0b013e3181fbc69cDOI Listing
December 2010

Clinical practice guideline: red blood cell transfusion in adult trauma and critical care.

Crit Care Med 2009 Dec;37(12):3124-57

Objective: To develop a clinical practice guideline for red blood cell transfusion in adult trauma and critical care.

Design: Meetings, teleconferences and electronic-based communication to achieve grading of the published evidence, discussion and consensus among the entire committee members.

Methods: This practice management guideline was developed by a joint taskforce of EAST (Eastern Association for Surgery of Trauma) and the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM). We performed a comprehensive literature review of the topic and graded the evidence using scientific assessment methods employed by the Canadian and U.S. Preventive Task Force (Grading of Evidence, Class I, II, III; Grading of Recommendations, Level I, II, III). A list of guideline recommendations was compiled by the members of the guidelines committees for the two societies. Following an extensive review process by external reviewers, the final guideline manuscript was reviewed and approved by the EAST Board of Directors, the Board of Regents of the ACCM and the Council of SCCM.

Results: Key recommendations are listed by category, including (A) Indications for RBC transfusion in the general critically ill patient; (B) RBC transfusion in sepsis; (C) RBC transfusion in patients at risk for or with acute lung injury and acute respiratory distress syndrome; (D) RBC transfusion in patients with neurologic injury and diseases; (E) RBC transfusion risks; (F) Alternatives to RBC transfusion; and (G) Strategies to reduce RBC transfusion.

Conclusions: Evidence-based recommendations regarding the use of RBC transfusion in adult trauma and critical care will provide important information to critical care practitioners.
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http://dx.doi.org/10.1097/CCM.0b013e3181b39f1bDOI Listing
December 2009

Renal failure and exercise-induced rhabdomyolysis in patients taking performance-enhancing compounds.

J Trauma 2002 Oct;53(4):761-3; discussion 763-4

R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore 21201, USA.

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http://dx.doi.org/10.1097/00005373-200210000-00024DOI Listing
October 2002