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Journal of Emergencies, Trauma, and Shock

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https://www.readbyqxmd.com/read/29628674/the-intensive-care-unit-perspective-of-becoming-a-level-i-trauma-center-challenges-of-strategy-leadership-and-operations-management
#1
Richard H Savel, Wess Cohen, Dena Borgia, Ronald J Simon
The primary purpose of this narrative is to elucidate the numerous significant changes that occur at the intensive care unit (ICU) level as a medical center pursues becoming a Level I trauma center. Specifically, we will focus on the following important areas: (1) leadership and strategy issues behind the decision to move forward with becoming a trauma center; (2) preparation needed to take a highly functioning surgical ICU and align it for the inevitable changes that happen as trauma go-live occurs; (3) intensivist staffing changes; (4) roles for and training of advanced practice practitioners; (5) graduate medical education issues; (6) optimizing interactions with closely related services; (7) nursing, staffing, and training issues; (8) bed allocation issues; and (9) reconciling the advantages of a "unified adult critical care service" with the realities of the central relationship between trauma and surgical critical care...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628673/the-case-based-learning-conference-model-at-emindia2017-a-novel-implementation-of-problem-based-educational-paradigm
#2
Vivek Chauhan, Sagar Galwankar, Stanislaw P Stawicki, Naman Agrawal, S Vimal Krishnan, Sanjeev Bhoi, Tej Prakash Sinha, Praveen Aggarwal
INDUSEM was established as an INDO-US Satellite Knowledge Network in 2005. It brought together the academic leaders and innovators from India and the US with the goal of creating collaborative synergies and creative solutions to advance the knowledge and science of emergency medicine (EM) in India. Since 2005, the leadership of INDUSEM devoted substantial resources, effort, and expertise to ensure that newly implemented clinical institutes and training programs have the necessary resources and logistical support to effectively advance EM and Traumatology Sciences in India...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628672/globe-luxation-and-optic-nerve-avulsion-by-dog-bite
#3
Justin B Hellman, Lily Koo Lin
No abstract text is available yet for this article.
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628671/scrotal-reconstruction-with-integra-following-necrotizing-fasciitis
#4
Briar L Dent, Anant Dinesh, Khuram Khan, Ryan Engdahl
Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. IntegraTM bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. We report the successful use of Integra and a subsequent split-thickness skin graft for reconstruction of the anterior scrotum and coverage of the exposed testes in a 43-year-old man who developed Group A Streptococcus necrotizing fasciitis of his right lower extremity, groin, and scrotum requiring serial operative debridements...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628670/bilateral-hip-dislocation-an-indicator-for-emergent-full-body-computed-tomography-scan-in-polytraumatized-patients-a-case-report-and-review-of-the-literature
#5
Benjamin Rufer, Marius Johann Baptist Keel, Beat Schnüriger, Moritz Caspar Deml
We present a rare case of traumatic bilateral asymmetric hip dislocation with pelvic fractures and a traumatic diaphragmatic hernia. A 53-year-old machinist was transferred to our emergency department with the suspicion of a bilateral hip dislocation after he was trapped between an elevator and the roof. Immediate closed reduction of the hips was not performed because of the expected risk of increasing hemodynamic instability with muscular relaxation. An emergent full-body computed tomography (CT) scan was made to assess injuries with need for further operative treatment...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628669/variation-in-the-practice-of-central-venous-catheter-and-chest-tube-insertions-among-surgery-residents
#6
Edward Eun Cho, Elizabeth Bevilacqua, Jeffrey Brewer, James Hassett, Weidun Alan Guo
Objectives: Central venous catheter (CVC) and chest tube (CT) insertions are common bedside procedures frequently performed by surgery residents. Despite published guidelines, variability in the practice exists. We sought to characterize the surgery residents' practice patterns surrounding these two bedside procedures. Materials and Methods: Over the last 1½ months of the academic year in 2012 and 2013, surgery residents across the US were surveyed online. Participants reported levels of agreement for 15 questions in a 5-point Likert scale format...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628668/evaluation-of-change-in-knowledge-and-attitude-of-emergency-medicine-residents-after-introduction-of-a-rotation-in-emergency-medical-services-and-disaster-medicine
#7
Nawfal Aljerian, Aamir Omair, Sami A Yousif, Abdulrahman S Alqahtani, Faisal A Alhusain, Bader Alotaibi, Mohammad F Alshehri, Majed Aljuhani, Saad Albaiz, Yasser Alaska, Abdullah F Alanazi
Background: Saudi Board of Emergency Medicine (SBEM) graduates are involved in a 1-month rotation in emergency medical services (EMSs) and disaster medicine. The purpose of this study was to evaluate change in knowledge and attitude of EM residents after the introduction of the EMS and disaster medicine rotation. Materials and Methods: The study included 32 3rd -year SBEM residents. A pretest/posttest design and a five-point Likert scale were used. The data included a response to a questionnaire developed by EMS and disaster experts...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628667/early-predictive-factors-of-hypofibrinogenemia-in-acute-trauma-patients
#8
Shahram Paydar, Behnam Dalfardi, Zahra Shayan, Leila Shayan, Jalal Saem, Shahram Bolandparvaz
Background: Uncontrolled hemorrhage still remains a major cause of trauma-associated mortality. The events resulting in acute traumatic coagulopathy, particularly hypofibrinogenemia, make control of bleeding difficult. It is essential to timely predict, diagnose, and manage trauma-induced coagulopathy. Aims: The aim of this study is to determine clinical and easily available laboratory variables that are predictive of hypofibrinogenemia in acute trauma patients...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628666/cardiopulmonary-resuscitation-unusual-techniques-for-unusual-situations
#9
Vidhu Bhatnagar, Kavitha Jinjil, Deepak Dwivedi, Rohit Verma, Urvashi Tandon
Background: The cardiopulmonary resuscitation (CPR) in prone position has been dealt with in 2010 American Heart Association (AHA) guidelines but have not been reviewed in 2015 guidelines. The guidelines for patients presenting with cardiac arrest under general anesthesia in lateral decubitus position and regarding resuscitation in confined spaces like airplanes are also not available in AHA guidelines. This article is an attempt to highlight the techniques adopted for resuscitation in these unusual situations...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628665/computed-tomography-profile-and-its-utilization-in-head-injury-patients-in-emergency-department-a-prospective-observational-study
#10
Archana Waganekar, Jagadish Sadasivan, A Sathia Prabhu, K T Harichandrakumar
Context: Based on Glasgow Coma Scale (GCS), head injury can be classified as minor (GCS 13-15), moderate (GCS 9-12), and severe (GCS 3-8). There is a lot of controversy in the use of computed tomography (CT) in head injury patients. Aims: This study was intended to estimate the rate of CT positivity in head injury patients and to define the criteria for doing CT in head injury patients. Settings and Design: This was a prospective observational study in the emergency department (ED) over a 12-month period...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628664/7-5-nacl-resuscitation-leads-to-abnormal-clot-fibrinolysis-after-severe-hemorrhagic-shock-and-its-correction-with-7-5-nacl-adenosine-lidocaine-and-mg-2
#11
Hayley Louise Letson, Geoffrey Phillip Dobson
Background: Hyperfibrinolysis is a common complication of hemorrhagic shock. Our aim was to examine the effect of small-volume 7.5% NaCl adenosine, lidocaine, and Mg2+ (ALM) on fibrinolysis in the rat model of hemorrhagic shock. Methods: Rats were anesthetized and randomly assigned to one of four groups: (1) baseline, (2) shock, (3) 7.5% NaCl controls, and (4) 7.5% NaCl ALM. Animals were bled for 20 min (42% blood loss) and left in shock for 60 min before resuscitation with 0...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628663/distribution-of-laboratory-parameters-in-trauma-population
#12
Prashant Bhandarkar, Ranabir Pal, Ashok Munivenkatappa, Nobhojit Roy, Vineet Kumar, Amit Agrawal
Background: Biochemical laboratory investigations help plan optimum management and communication in short- as well as long-term outcome to trauma victims. Objective: To assess the status of real-time values of biochemical laboratory investigations of different trauma patients and their association with overall mortality. Materials and Methods: Data based on prospective, observational registry of "Towards Improved Trauma Care Outcomes" (TITCO) from four Indian city hospitals...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628662/prehospital-ultrasound-in-trauma-a-review-of-current-and-potential-future-clinical-applications
#13
REVIEW
Tharwat El Zahran, Mazen J El Sayed
Ultrasound (US) is an essential tool for evaluating trauma patients in the hospital setting. Many previous in-hospital studies have been extrapolated to out of hospital setting to improve diagnostic accuracy in prehospital and austere environments. This review article presents the role of prehospital US in blunt and penetrating trauma management with emphasis on its current clinical applications, challenges, and future implications of such use.
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628661/early-predictive-factors-of-hypofibrinogenemia-in-acute-trauma-patients
#14
Angeline Neetha Radjou
No abstract text is available yet for this article.
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628660/whats-new-in-emergencies-trauma-and-shock-computed-tomography-profile-and-its-utilization-in-traumatic-brain-injury
#15
EDITORIAL
Amit Agrawal, Luis Rafael Moscote-Salazar
No abstract text is available yet for this article.
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29097863/a-case-of-traumatic-vacuum-phenomenon-in-the-sleeve-of-a-nerve-root-due-to-nerve-root-avulsions
#16
Hiromichi Ohsaka, Chikato Hayashi, Kazuhiko Omori, Youichi Yanagawa
No abstract text is available yet for this article.
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29097862/isolated-traumatic-basal-ganglia-hematoma-in-children
#17
Sushanta K Sahoo, Sidharth Vankipuram, Chhitij Srivastava
No abstract text is available yet for this article.
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29097861/biliary-complications-after-hepatic-trauma-in-children
#18
Riccardo Guanà, Carbonaro Giulia, Andrea Brunati, Salvatore Garofalo, Jurgen Schleef
Aim of the Study: In pediatric patients with liver trauma and hemodynamic stability, conservative treatment is acknowledged as the gold standard. Patients and Methods: We conducted a retrospective analysis of 116 consecutive pediatric patients (<14-year-old) observed at our institution for closed abdominal trauma from January 2010 to January 2016. Among these, 16 patients (13%) had hepatic trauma Grade II or more, according to Moore liver trauma injury score...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29097860/necrotizing-fasciitis-how-reliable-are-the-cutaneous-signs
#19
REVIEW
Ho Jun Kiat, Yap Hui En Natalie, Lateef Fatimah
Necrotizing fasciitis (NF) is a surgical emergency. It is often aggressive and characterized by the rapidly progressive inflammatory infection of the fascia that causes extensive necrosis of the subcutaneous tissue and fascia, relatively sparing the muscle and skin tissue. As the disease progresses, thrombosis of the affected cutaneous perforators subsequently devascularizes the overlying skin. The course indeed can be a fulminant one. The diagnosis of NF, especially in the early stages, is extremely challenging, and it can be very close in presentation to other skin and subcutaneous tissue infections...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29097859/quantifying-burnout-among-emergency-medicine-professionals
#20
William Wilson, Jeffrey Pradeep Raj, Girish Narayan, Murtuza Ghiya, Shakuntala Murty, Bobby Joseph
Background: Burnout is a syndrome explained as serious emotional depletion with poor adaptation at work due to prolonged occupational stress. It has three principal components namely emotional exhaustion(EE), depersonalization(DP) and diminished feelings of personal accomplishment(PA). Thus, we aimed at measuring the degree of burnout in doctors and nurses working in emergency medicine department (EMD) of 4 select tertiary care teaching hospitals in South India. Methods: A cross sectional survey was conducted among EMD professionals using a 30-item standardized pilot tested questionnaire as well as the Maslach burnout inventory...
October 2017: Journal of Emergencies, Trauma, and Shock
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