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Trauma, emergency medicine

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https://www.readbyqxmd.com/read/29017409/acute-clinical-predictors-of-symptom-recovery-in-emergency-department-patients-with-uncomplicated-mild-traumatic-brain-injury-mtbi-or-non-tbi-injuries
#1
Lindsay D Nelson, Robyn E Furger, Jana Ranson, Sergey Tarima, Thomas A Hammeke, Christopher Randolph, William B Barr, Kevin K Guskiewicz, Christopher M Olsen, E Brooke Lerner, Michael McCrea
There is a subset of patients with mild traumatic brain injury (mTBI) that report persistent symptoms that impair their functioning and quality of life. Being able to predict which patients will experience prolonged symptom recovery would help clinicians target resources for clinical follow-up to those most in need and would facilitate research to develop precision medicine treatments for mTBI. The purpose of this study was to investigate the predictors of symptom recovery in a prospective sample of emergency department trauma patients with either mTBI or non-mTBI injuries...
October 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28985089/examining-participant-perceptions-of-an-interprofessional-simulation-based-trauma-team-training-for-medical-and-nursing-students
#2
Rune Bruhn Jakobsen, Sarah Frandsen Gran, Bergsvein Grimsmo, Kari Arntzen, Erik Fosse, Jan C Frich, Per Hjortdahl
High quality care relies on interprofessional teamwork. We developed a short simulation-based course for final year medical, nursing and nursing anaesthesia students, using scenarios from emergency medicine. The aim of this paper is to describe the adaptation of an interprofessional simulation course in an undergraduate setting and to report participants' experiences with the course and students' learning outcomes. We evaluated the course collecting responses from students through questionnaires with both closed-ended and open-ended questions, supplemented by the facilitators' assessment of students' performance...
October 6, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28984431/what-do-we-know-about-alara-is-our-knowledge-sufficient-about-radiation-safety
#3
Ibrahim B Atci, Hakan Yilmaz, Veysel Antar, Nuriye G Ozdemir, Oguz Baran, Sila Sadillioglu, Mehmet Ozel, Okan Turk, Mehmet Yaman, Hakan Topacoglu
BACKGROUND: The aim of this study was to determine the knowledge of neurosurgeons and emergency physicians about ALARA (as low as reasonably achievable) and to gain awareness to them about this topic. METHODS: A multiple-choice survey comprising 17 questions was performed to 30 neurosurgeons and 70 emergency room doctors. RESULTS: Emergency medicine doctors, neurosurgeons, emergency medicine residents, neurosurgery residents and general practitioners participated in the survey...
December 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28962566/-i-stayed-with-my-illness-a-grounded-theory-study-of-health-seeking-behaviour-and-treatment-pathways-of-patients-with-obstetric-fistula-in-kenya
#4
Anne M Khisa, Grace M Omoni, Isaac K Nyamongo, Rachel F Spitzer
BACKGROUND: Obstetric fistula classic symptoms of faecal and urinary incontinence cause women to live with social stigma, isolation, psychological trauma and lose their source of livelihoods. There is a paucity of studies on the health seeking behaviour trajectories of women with fistula illness although women live with the illness for decades before surgery. We set out to establish the complete picture of women's health seeking behaviour using qualitative research. We sought to answer the question: what patterns of health seeking do women with obstetric fistula display in their quest for healing? METHODS: We used grounded theory methodology to analyse data from narratives of women during inpatient stay after fistula surgery in 3 hospitals in Kenya...
September 29, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28941075/patient-perspectives-on-priorities-for-emergency-medicine-research-the-perspex-study
#5
Stuart Vb McLay, David McCutcheon, Glenn Arendts, Stephen Pj Macdonald, Daniel M Fatovich
OBJECTIVES: To determine the priorities for emergency medicine research of patients currently in an ED and to compare their priorities with those of ACEM researchers. METHODS: A survey of current patients in the EDs of Royal Perth Hospital and Armadale Health Service. Patients gave their reason for presentation, suggested three important research priorities for emergency medicine and ranked their top 5 choices from a pre-specified list published by the ACEM researchers...
September 21, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28932702/emergency-ct-of-blunt-abdominal-trauma-experience-from-a-large-urban-hospital-in-southern-china
#6
REVIEW
Jingshan Gong, Dongdong Mei, Minjie Yang, Jianmin Xu, Yangyang Zhou
Trauma is one of the leading causes of death for men and women under the age of 45 years old, and abdominal injuries contribute to a large number of these deaths. Prompt diagnosis is very important for treatment decision making and can be life-saving. CT has become an essential imaging modality in emergency medicine. In this pictorial review, we present our experience of CT in blunt abdominal trauma and describe CT findings of common injuries, including hemoperitoneum, solid viscera, hollow viscera, mesenteric and diaphragmatic injuries...
August 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28926480/postconcussive-symptoms-over-the-first-14-days-after-mild-traumatic-brain-injury-an-experience-sampling-study
#7
Maria Pacella, Arjun Prabhu, Julia Morley, Stephanie Huang, Brian Suffoletto
OBJECTIVE: This study examined changes in postconcussive symptoms (PCS) over the acute postinjury recovery period, focusing on how daily PCSs differ between mild traumatic brain injury (mTBI) and other injury types. SETTING: An urban emergency department (ED) in Western Pennsylvania. SUBJECTS: A total of 108 adult patients with trauma being discharged from the ED were recruited and grouped by injury type: mild TBI (mTBI; n = 39), head injury without mTBI (HI: n = 16), and non-head-injured trauma controls (TCs: n = 53)...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28887865/plasma-rich-plasma-the-ultimate-secret-for-youthful-skin-elixir-and-hair-growth-triggering
#8
REVIEW
Ebtisam Elghblawi
The clinical application of platelet-rich plasma (PRP) is based on the increase in the concentration of growth factors that are released from alpha-granule of the concentrated platelets and in the secretion of proteins which are able to capitalize on the healing process at the cellular level. It has been invented to restore the natural beauty by starting the natural rejuvenation process of the skin and aiming to make it function as a younger one and to keep the skin youthful and maintain it. Besides that, it is also emerged to include hairs as a new injectable procedure to enable stimulating hair growth locally and topically; preventing its fall; improving hair shaft, hair stem, and its caliber; increasing its shine, vitality, and pliability; and declining hair splitting and breakage...
September 8, 2017: Journal of Cosmetic Dermatology
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#9
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28885519/preparing-global-trauma-nurses-for-leadership-roles-in-global-trauma-systems
#10
Sol Angelica Muñiz, Richard W Lang, Lisa Falcon, Jasmine Garces-King, Suzanne Willard, Gregory L Peck
Trauma leads to 5.7 million annual deaths globally, accounting for 25%-33% of global unintentional deaths and 90% of the global trauma burden in low- and middle-income countries. The Lancet Commission on Global Surgery and the World Health Organization assert that emergent and essential surgical capacity building and trauma system improvement are essential to address the global burden of trauma. In response, the Rutgers Global Surgery program, the School of Nursing and Medicine, and the Robert Wood Johnson University Hospital faculty collaborated in the first Interprofessional Models in Global Injury Care and Education Symposium in June 2016...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28883195/mapping-equivalence-of-german-emergency-department-medical-record-concepts-with-snomed-ct-after-implementation-with-hl7-cda
#11
Dominik Brammen, Heike Dewenter, Kai U Heitmann, Volker Thiemann, Raphael W Majeed, Felix Walcher, Rainer Röhrig, Sylvia Thun
INTRODUCTION: The German Emergency Department Medical Record (GEDMR) was created by medical domain experts and healthcare providers providing a dataset as well as a form. The trauma module of GEDMR was syntactically standardized using HL7 CDA and semantically standardized using different terminologies including SNOMED CT, LOINC and proprietary coding systems. This study depicts the mapping accuracy with aforementioned syntactical and semantical standards in general and especially the content coverage of SNOMED CT...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28882376/a-novel-approach-to-improving-the-interpretation-of-ct-brain-in-trauma
#12
L R Evans, M C Fitzgerald, D Varma, B Mitra
BACKGROUND: Computed tomography of the brain (CTB) has a fundamental role in the diagnosis and management of traumatic brain injury (TBI). There may be substantial discordance between initial CTB interpretation by emergency clinicians and the final radiology report. This study aimed to assess the utility of a structured reporting template in improving the accuracy of CTB interpretation by emergency clinicians. METHOD: A prospective pre- and post-intervention cohort study was undertaken using a study population of emergency medicine trainees...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28836750/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update-digest
#13
Whitney K Bryant, Sanjay Shewakramani, Milana Zaurova
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#14
REVIEW
Carlton D Scharman, Debora Burger, 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 perioperative and intraoperative 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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