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https://www.readbyqxmd.com/read/29906381/points-pearls-management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#1
Andria Tatem, Rupa Kapoor, Bryan Wilson
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29889745/simulation-in-obstetrics
#2
Andrew J Satin
Simulation in obstetrics is a widely accepted and valuable tool that benefits all levels of learners from medical students to maternal-fetal medicine subspecialists. What began as an adjunct to medical education now has a rapidly expanding role in acquisition of new and innovative procedures, team and unit training, and safety and quality initiatives. The number of obstetric simulation peer-reviewed reports has increased exponentially in recent years, yet only a small percentage of reports primarily addresses clinical outcomes...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29888875/ketamine-use-for-rapid-sequence-intubation-in-australian-and-new-zealand-emergency-departments-from-2010-to-2015-a-registry-study
#3
Ian Ferguson, Hatem Alkhouri, Toby Fogg, Anders Aneman
OBJECTIVE: This study aimed to quantify the proportion of patients undergoing rapid sequence intubation using ketamine in Australian and New Zealand EDs between 2010 and 2015. METHODS: The Australian and New Zealand Emergency Department Airway Registry is a multicentre airway registry prospectively capturing data from 43 sites. Data on demographics and physiology, the attending staff and indication for intubation were recorded. The primary outcome was the annual percentage of patients intubated with ketamine...
June 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29860585/a-review-of-the-burden-of-trauma-pain-in-emergency-settings-in-europe
#4
REVIEW
Patrick D Dißmann, Maxime Maignan, Paul D Cloves, Blanca Gutierrez Parres, Sara Dickerson, Alice Eberhardt
Trauma pain represents a large proportion of admissions to emergency departments across Europe. There is currently an unmet need in the treatment of trauma pain extending throughout the patient journey in emergency settings. This review aims to explore these unmet needs and describe barriers to the delivery of effective analgesia for trauma pain in emergency settings. A comprehensive, qualitative review of the literature was conducted using a structured search strategy (Medline, Embase and Evidence Based Medicine Reviews) along with additional Internet-based sources to identify relevant human studies published in the prior 11 years (January 2006-December 2017)...
June 2, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29807546/surgical-plate-fixation-of-multiple-rib-fractures-a-case-report
#5
Konstantin Mitev, Dashurie Neziri, Emil Stoicovski, Zan Mitrev
BACKGROUND: The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit...
May 29, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29804723/outlook-and-future-of-inner-ear-therapy
#6
REVIEW
Jenna Devare, Samuel Gubbels, Yehoash Raphael
Drug delivery to the inner ear is an ideal method to treat a wide variety of otologic conditions. A broad range of potential applications is just beginning to be explored. New approaches combine principles of inner ear pharmacokinetics with emerging technologies of drug delivery including novel delivery systems, drug-device combinations, and new categories of drugs. Strategies include cell-specific targeting, manipulation of gene expression, local activation following systemic delivery, and use of stem cells, viral vectors, and gene editing systems...
May 17, 2018: Hearing Research
https://www.readbyqxmd.com/read/29802113/roles-of-the-emergency-medicine-pharmacist-a-systematic-review
#7
Cristina Roman, Gail Edwards, Michael Dooley, Biswadev Mitra
PURPOSE: Results of a systematic literature review to identify roles for emergency medicine (EM) pharmacists beyond traditionally reported activities and to quantify the benefits of these roles in terms of patient outcomes are reported. SUMMARY: Emergency department (ED)-based clinical pharmacy is a rapidly growing practice area that has gained support in a number of countries globally, particularly over the last 5-10 years. A systematic literature search covering the period 1995-2016 was conducted to characterize emerging EM pharmacist roles and the impact on patient outcomes...
June 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29799611/tourniquet-use-in-the-prehospital-setting-are-they-being-used-appropriately
#8
Kevin M Duignan, Laura C Lamb, Monica M DiFiori, John Quinlavin, James M Feeney
OBJECTIVE: The objective of this study was to evaluate tourniquet use in the Hartford prehospital setting during a 34-month period after the Hartford Consensus was published, which encouraged increasing tourniquet use in light of military research. DESIGN: This was a retrospective review of patients with bleeding from a serious extremity injury to determine appropriateness of tourniquet use or omission. SETTING: Level II trauma center between April 2014 and January 2017...
January 2018: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/29791967/global-emergency-medicine-a-review-of-the-literature-from-2017
#9
Torben K Becker, Indi Trehan, Alison Schroth Hayward, Braden J Hexom, Sean M Kivlehan, Kevin M Lunney, Payal Modi, Maxwell Osei-Ampofo, Amelia Pousson, Daniel K Cho, Adam C Levine
OBJECTIVES: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS: This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM...
May 23, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#10
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29776836/analysis-of-incidence-of-traumatic-brain-injury-in-blunt-trauma-patients-with-glasgow-coma-scale-of-12-or-less
#11
Alexander Becker, Kobi Peleg, Oded Olsha, Adi Givon, Boris Kessel
PURPOSE: Early diagnosis of traumatic brain injury (TBI) is important for improving survival and neurologic outcome in trauma victims. The purpose of this study was to assess whether Glasgow Coma Scale (GCS) of 12 or less can predict the presence of TBI and the severity of associated injuries in blunt trauma patients. METHODS: A retrospective cohort study including 303,435 blunt trauma patients who were transferred from the scene to hospital from 1998 to 2013. The data was obtained from the records of the National Trauma Registry maintained by Israel's National Center for Trauma and Emergency Medicine Research, in the Gertner Institute for Epidemiology and Health Policy Research...
April 16, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29774192/efficacy-of-the-all-in-one-therapeutic-strategy-for-severe-traumatic-brain-injury-preliminary-outcome-and-limitation
#12
Young-Soo Park, Yohei Kogeichi, Yoichi Shida, Hiroyuki Nakase
Objective: Despite recent advances in medicine, no significant improvement has been achieved in therapeutic outcomes for severe traumatic brain injury (TBI). In the treatment of severe multiple traumas, accurate judgment and prompt action corresponding to rapid pathophysiological changes are required. Therefore, we developed the "All-in-One" therapeutic strategy for severe TBI. In this report, we present the therapeutic concept and discuss its efficacy and limitations. Methods: From April 2007 to December 2015, 439 patients diagnosed as having traumatic intracranial injuries were treated at our institution...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29774048/the-complications-associated-with-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#13
REVIEW
Marcelo A F Ribeiro Junior, Celia Y D Feng, Alexander T M Nguyen, Vinicius C Rodrigues, Giovana E K Bechara, Raíssa Reis de-Moura, Megan Brenner
Non-compressible torso hemorrhage (NCTH) remains a significant cause of morbidity and mortality in the field of trauma and emergency medicine. In recent times, there has been a resurgence in the adoption of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for patients who present with NCTH. Like all medical procedures, there are benefits and risks associated with the REBOA technique. However, in the case of REBOA, these complications are not unanimously agreed upon with varying viewpoints and studies...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29760853/emergency-physicians-at-war
#14
REVIEW
Andrew E Muck, Melissa Givens, Vikhyat S Bebarta, Phillip E Mason, Craig Goolsby
Operation Enduring Freedom (OEF-A) in Afghanistan and Operation Iraqi Freedom (OIF) represent the first major, sustained wars in which emergency physicians (EPs) fully participated as an integrated part of the military's health system. EPs proved invaluable in the deployments, and they frequently used the full spectrum of trauma and medical care skills. The roles EPs served expanded over the years of the conflicts and demonstrated the unique skill set of emergency medicine (EM) training. EPs supported elite special operations units, served in medical command positions, and developed and staffed flying intensive care units...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29753518/application-of-the-canadian-computed-tomography-head-rule-to-patients-with-minimal-head-injury
#15
Kevin Davey, Turandot Saul, Geoffrey Russel, Jonathan Wassermann, Joshua Quaas
STUDY OBJECTIVE: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29740831/do-emergency-physicians-rely-on-point-of-care-ultrasound-for-clinical-decision-making-without-additional-confirmatory-testing
#16
Mohamad Moussa, Julie M Stausmire
PURPOSE: It is unknown if Emergency Physicians (EPs) rely solely on Emergency Medicine performed Point-Of-Care Ultrasound (EM-POCUS) for clinical decision making or if they proceed to subsequent "gold standard" studies for confirmatory diagnosis. METHODS: After Institutional Review Board approval, an online survey was distributed by the Ohio Chapter of the American College of Emergency Physicians to its members. RESULTS: The most common EM-POCUS procedures used without confirmatory testing were: determination of cardiac activity during cardiac arrest (81...
May 8, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#17
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29698348/accuracy-of-bedside-ultrasound-for-the-diagnosis-of-skull-fractures-in-children-aged-0-to-4-years
#18
Jea Yeon Choi, Yong Su Lim, Jae Ho Jang, Won Bin Park, Soung Youl Hyun, Jin Seong Cho
OBJECTIVES: The aim of this study was to investigate the accuracy of bedside ultrasound (US) performed by emergency physicians for diagnosing skull fractures in children 0 to 4 years old compared with the accuracy of head computed tomography (CT). We also sought to investigate characteristics and precautions associated with US. METHODS: This single-center prospective study involved children 0 to 4 years old who had a history of head trauma. Bedside US was performed by emergency medicine physicians, and the results were compared with CT scan interpretations provided by attending radiologists...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29698338/physician-confidence-in-dental-trauma-treatment-and-the-introduction-of-a-dental-trauma-decision-making-pathway-for-the-pediatric-emergency-department
#19
Matthew Cully, Jennifer Cully, Paul J Nietert, M Olivia Titus
OBJECTIVES: The objectives of this study were to (1) survey and report the awareness and confidence of pediatric emergency medicine physicians in the management of dental trauma and (2) determine the prevalence of dental trauma decision-making pathway utilization in the pediatric emergency department. METHODS: A survey was distributed through e-mail to the pediatric emergency medicine discussion list via Brown University LISTSERV. The survey study included 10 questions and was multiple-choice...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29696020/extracellular-vesicles-packages-sent-with-complement
#20
REVIEW
Ebru Karasu, Steffen U Eisenhardt, Julia Harant, Markus Huber-Lang
Cells communicate with other cells in their microenvironment by transferring lipids, peptides, RNA, and sugars in extracellular vesicles (EVs), thereby also influencing recipient cell functions. Several studies indicate that these vesicles are involved in a variety of critical cellular processes including immune, metabolic, and coagulatory responses and are thereby associated with several inflammatory diseases. Furthermore, EVs also possess anti-inflammatory properties and contribute to immune regulation, thus encouraging an emerging interest in investigating and clarifying mechanistic links between EVs and innate immunity...
2018: Frontiers in Immunology
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