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https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#1
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28814584/examining-self-reported-and-biological-stress-and-near-misses-among-emergency-medicine-residents-a-single-centre-cross-sectional-assessment-in-the-usa
#2
Bengt B Arnetz, Philip Lewalski, Judy Arnetz, Karen Breejen, Karin Przyklenk
OBJECTIVES: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. DESIGN: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. SETTING: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28795511/a-sequential-case-series-of-23-intubations-in-a-rural-emergency-department-in-new-zealand
#3
Eleanor Powell, Hatem Alkhouri, Sally McCarthy, John Mackenzie, Toby Fogg, John Vassiliadis, Chris Cresswell
OBJECTIVE: To describe the practice and procedure of emergency intubation in Whanganui Emergency Department, New Zealand and determine whether intubation can be carried out effectively in the rural setting. METHOD: A prospective observational study using the Australia and New Zealand Airway Registry proforma to collect data on the indication, lead intubator, first-pass success rate and peri-procedural complications. Data were also collected on whether a formal airway assessment was carried out and whether a checklist was used...
August 10, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28767318/the-gut-microbiome-and-mental-health-implications-for-anxiety-and-trauma-related-disorders
#4
Stefanie Malan-Muller, Mireia Valles-Colomer, Jeroen Raes, Christopher A Lowry, Soraya Seedat, Sian M J Hemmings
Biological psychiatry research has long focused on the brain in elucidating the neurobiological mechanisms of anxiety- and trauma-related disorders. This review challenges this assumption and suggests that the gut microbiome and its interactome also deserve attention to understand brain disorders and develop innovative treatments and diagnostics in the 21st century. The recent, in-depth characterization of the human microbiome spurred a paradigm shift in human health and disease. Animal models strongly suggest a role for the gut microbiome in anxiety- and trauma-related disorders...
August 2, 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28745856/severe-traumatic-brain-injury-in-children-an-evidence-based-review-of-emergency-department-management-digest
#5
Kirsten Morrissey, Hilary Fairbrother, Michelle N Vazquez
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#6
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745851/maxillofacial-trauma-managing-potentially-dangerous-and-disfiguring-complex-injuries-digest
#7
Devjani Das, Lea Salazar, Milana Zaurova
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face...
April 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28716551/application-of-human-induced-pluripotent-stem-cells-to-model-fibrodysplasia-ossificans-progressiva
#8
Emilie Barruet, Edward C Hsiao
Fibrodysplasia ossificans progressiva (FOP) is a genetic condition characterized by massive heterotopic ossification. FOP patients with mutations in the Activin A type I receptor (ACVR1), a bone morphogenetic protein (BMP) receptor. FOP is a progressive and debilitating disease characterized by bone formation flares that often occur after trauma. Since it is often difficult or impossible to obtain large amounts of tissue from human donors due to the risks of inciting more heterotopic bone formation, human induced pluripotent stem cells (hiPSCs) provide an attractive source for establishing in vitro disease models and for applications in drug screening...
July 14, 2017: Bone
https://www.readbyqxmd.com/read/28712923/key-players-in-the-immune-response-to-biomaterial-scaffolds-for-regenerative-medicine
#9
Liam Chung, David R Maestas, Franck Housseau, Jennifer H Elisseeff
The compatibility of biomaterials is critical to their structural and biological function in medical applications. The immune system is the first responder to tissue trauma and to a biomaterial implant. The innate immune effector cells, most notably the macrophage, play a significant role in the defense against foreign bodies and formation of a fibrous capsule around synthetic implants. Alternatively, macrophages participate in the pro-regenerative capacity of tissue-derived biological scaffolds. Research is now elucidating the role of the adaptive immune system, and T cells in particular, in directing macrophage response to synthetic and biological materials...
July 13, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28706765/trauma-and-hypothermia-in-antarctica-an-emergency-medicine-marine-simulation-scenario
#10
Chrystal Horwood, Kerry-Lynn Williams, Tate Skinner, Robert Brown, Tia Renouf, Adam Dubrowski
Simulation has been shown to improve both learner knowledge and patient outcomes. Many emergency medicine training programs incorporate simulation into their curricula to provide learners with experiences that are rare to encounter in practice, yet performance with a high degree of competence is critical. One rare encounter, which is depicted in the report, is the management of a trauma patient who was hypothermic after falling from an expedition vessel into the cold Southern Ocean. The unique scenario presented in this technical report incorporates CanMEDS learning objectives including the communicator, health advocate, and collaborator roles...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28701849/blunt-trauma-neck-with-complete-tracheal-transection-a-diagnostic-and-therapeutic-challenge-to-the-trauma-team
#11
K N J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict "difficult airway" and recognize "failed airway" very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28698750/the-relationship-between-risk-factors-of-head-trauma-with-ct-scan-findings-in-children-with-minor-head-trauma-admitted-to-hospital
#12
Babak Masoumi, Farhad Heydari, Hamidreza Hatamabadi, Reza Azizkhani, Zahra Yoosefian, Majid Zamani
BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan. AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional. METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#13
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire O'Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697164/the-use-safety-and-efficacy-of-olanzapine-in-a-level-i-pediatric-trauma-center-emergency-department-over-a-10-year-period
#14
Jon B Cole, Lauren R Klein, Ashley M Strobel, Stephane R Blanchard, Rebecca Nahum, Marc L Martel
OBJECTIVES: Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients. METHODS: A structured chart review was performed of patients 18 years old or younger receiving olanzapine from 2007 to 2016 in the emergency department of a pediatric level I trauma center. RESULTS: A total of 285 children received olanzapine...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28667524/low-evaluation-rate-for-osteoporosis-among-patients-presenting-with-a-rib-fracture
#15
Whang Kim, Hyun Sik Gong, Seung Hoo Lee, Jin Woo Park, Kahyun Kim, Goo Hyun Baek
This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. INTRODUCTION: Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28657831/case-report-life-saving-application-of-commercial-tourniquet-in-pediatric-extremity-hemorrhage
#16
David W Callaway, Andrew Puciaty, Josh Robertson, Tony Hannon, Sarah E Fabiano
Hemorrhage is the leading preventable cause of death in civilian and military trauma. Recent data from the ongoing conflicts in Iraq and Afghanistan suggest that early and aggressive tourniquet utilization is a safe and effective way to dramatically reduce mortality from extremity hemorrhage. As a result, prehospital tourniquet use is now endorsed by a majority of professional emergency medicine, emergency medical service and trauma professional societies. However, there currently exists scant evidence supporting the efficacy of commercially available tourniquets in controlling extremity hemorrhage in pediatric trauma patients...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28653261/future-enhanced-clinical-role-of-pharmacists-in-emergency-departments-in-england-multi-site-observational-evaluation
#17
Elizabeth Hughes, David Terry, Chi Huynh, Konstantinos Petridis, Matthew Aiello, Louis Mazard, Hirminder Ubhi, Alex Terry, Keith Wilson, Anthony Sinclair
Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage)...
August 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#18
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28619303/effect-of-light-pressure-stroking-massage-with-sesame-sesamum-indicum-l-oil-on-alleviating-acute-traumatic-limbs-pain-a-triple-blind-controlled-trial-in-emergency-department
#19
RANDOMIZED CONTROLLED TRIAL
Morteza Nasiri, Zahra Farsi
OBJECTIVES: Due to adverse effects of common medications used for traumatic pain management, it is crucial to use complementary methods to alleviate this pain. Present study aimed to assess the effect of light pressure stroking massage with topical sesame oil on pain severity of patients with limbs trauma. METHODS: This triple-blinded randomized trial was conducted on 40 patients with upper or lower extremities trauma in emergency department of Busheher Amir Al-Momenian Hospital, Busheher, Iran, in 2015-2016...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28615044/comparison-of-transportation-related-injury-mechanisms-and-outcome-of-young-road-users-and-adult-road-users-a-retrospective-analysis-on-24-373-patients-derived-from-the-traumaregister-dgu-%C3%A2
#20
Thomas Brockamp, Uli Schmucker, Rolf Lefering, Manuel Mutschler, Arne Driessen, Christian Probst, Bertil Bouillon, Paola Koenen
BACKGROUND: Most young people killed in road crashes are known as vulnerable road users. A combination of physical and developmental immaturity as well as inexperience increases the risk of road traffic accidents with a high injury severity rate. Understanding injury mechanism and pattern in a group of young road users may reduce morbidity and mortality. This study analyzes injury patterns and outcomes of young road users compared to adult road users. The comparison takes into account different transportation related injury mechanisms...
June 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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