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https://www.readbyqxmd.com/read/28538641/prehospital-plasma-resuscitation-associated-with-improved-neurologic-outcomes-after-traumatic-brain-injury
#1
Matthew C Hernandez, Cornelius A Thiels, Johnathon M Aho, Elizabeth B Habermann, Martin D Zielinski, James A Stubbs, Donald H Jenkins, Scott P Zietlow
INTRODUCTION: Trauma related hypotension and coagulopathy worsen secondary brain injury in patients with traumatic brain injuries (TBI). Early damage control resuscitation with blood products may mitigate hypotension and coagulopathy. Preliminary data suggest resuscitation with plasma in large animals improve neurologic function after TBI; however, data in humans are lacking. METHODS: We retrospectively identified all poly-trauma patients age >15 years with head injuries undergoing prehospital resuscitation with blood products at a single level I trauma center from 01/2002 to 12/2013...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28533863/management-and-outcome-of-traumatic-brain-injury-patients-at-muhimbili-orthopaedic-institute-dar-es-salaam-tanzania
#2
Respicious Boniface, Edwin Rwebugisa Lugazia, Abel Mussa Ntungi, Othman Kiloloma
INTRODUCTION: Traumatic brain Injuries represents a significant cause of morbidity and mortality worldwide and road traffic crashes accounts for a significant proportion of these injuries. However, access to neurosurgical care is poor in low income countries like Tanzania. The aim of this study was to assess the management and outcome of Traumatic brain injury patients at a tertiary level health facility in Tanzania. METHODS: A retrospective observational study of Traumatic brain injury patients attended at Muhimbili Orthopedic Institute between January 2014 and June 2014...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#3
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28526897/the-impact-of-pre-injury-direct-oral-anticoagulants-compared-to-warfarin-in-geriatric-g-60-trauma-patients
#4
J F Barletta, S Hall, J F Sucher, J K Dzandu, M Haley, A J Mangram
PURPOSE: Pre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin. METHODS: All trauma patients, age ≥60 who were admitted to the hospital and taking an oral anticoagulant pre-injury were retrospectively identified. Patients were excluded if their reason for admission was a suicide attempt or penetrating extremity injury...
May 19, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28526053/pre-hospital-triage-performance-after-standardized-trauma-courses
#5
Maria Lampi, Johan Junker, Peter Berggren, Carl-Oscar Jonson, Tore Vikström
BACKGROUND: The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses. METHODS: A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation...
May 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28507998/effects-of-pre-injury-anti-platelet-agents-on-short-term-outcome-of-patients-with-mild-traumatic-brain-injury-a-cohort-study
#6
Davood Farsi, Parviz Karimi, Mani Mofidi, Babak Mahshidfar, Mahdi Rezai, Peyman Hafezimoghadam, Saeed Abbasi
OBJECTIVE: To determine the effects of pre-injury consumption of anti-platelet agents on the 30-day outcomes of patients with mild traumatic brain injury (TBI). METHODS: This prospective cohort study was conducted at three general hospitals in Tehran, Iran between July 2013 and July 2014. The study population included all patients with mild TBI aged over 18 years that medicated with aspirin or clopidogrel before occurring trauma. Within hospitalization, all patients were assessed with respect to in-hospital conditions especially complications and adverse events...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28499510/effect-of-policy-change-on-the-use-of-long-distance-transport-and-follow-up-care-for-patients-with-traumatic-finger-amputations
#7
Michael T Nolte, Melissa J Shauver, Kevin C Chung, Aviram M Giladi
PURPOSE: In January 2006, the American College of Emergency Physicians released updated guidelines for air transfer. Digit amputation and near-amputation were no longer an indication for this costly service. We analyzed the effect of this update on the use of air transport and associated care outcomes for finger amputation patients and examined factors involved in providing follow-up care for these patients. METHODS: A retrospective chart review identified all patients treated for traumatic finger amputation between 1995 and 2012 at a major hand trauma referral center...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28494484/is-high-quality-trauma-care-business-as-usual-in-new-zealand
#8
Ian Civil, Siobhan Isles
New Zealand is on the cusp of establishing a world-class trauma system. Many of the building blocks are in place with national and regional guidelines in both the pre-hospital and hospital phases of care established. A dedicated clinical workforce is available in all DHBs and national data available through the Major Trauma Registry. The greatest threat to achieving high-quality trauma care in New Zealand at this point is governance stability rather than clinical variability. Now is the time to lock the trauma system into a framework not subject to political or bureaucratic whims...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#9
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28467026/prehospital-notification-for-major-trauma-patients-requiring-emergency-hospital-transport-a-systematic-review
#10
Anneliese Synnot, Adrian Karlsson, Lisa Brichko, Melissa Chee, Mark Fitzgerald, Mahesh C Misra, Teresa Howard, Joseph Mathew, Thomas Rotter, Michelle Fiander, Russell L Gruen, Amit Gupta, Satish Dharap, Madonna Fahey, Michael Stephenson, Gerard O'Reilly, Peter Cameron, Biswadev Mitra
OBJECTIVE: This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (< 30 days) and early (< 24 hours) mortality, hospital reception and trauma team presence (or equivalent) on arrival, time to critical interventions and length of hospital stay. METHODS: Experimental and observational studies of pre-hospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included...
May 3, 2017: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/28466701/care-of-patients-with-dementia-in-an-acute-trauma-and-orthopaedics-unit
#11
Gillian McCorkell, Deirdre Harkin, Victoria McCrory, Mary Lafferty, Vivien Coates
Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium...
May 3, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28465003/the-modified-rapid-emergency-medicine-score-a-novel-trauma-triage-tool-to-predict-in-hospital-mortality
#12
Ross T Miller, Niaman Nazir, Tracy McDonald, Chad M Cannon
BACKGROUND: Trauma systems currently rely on imperfect and subjective tools to prioritize responses and resources, thus there is a critical need to develop a more accurate trauma severity score. Our objective was to modify the Rapid Emergency Medicine (REMS) Score for the trauma population and test its accuracy as a predictor of in-hospital mortality when compared to other currently used scores, including the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the "Mechanism, Glasgow Coma Scale, Age and Arterial Pressure" (MGAP) score, and the Shock Index (SI) score...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28464812/predictors-of-seeking-financial-compensation-following-motor-vehicle-trauma-inception-cohort-with-moderate-to-severe-musculoskeletal-injuries
#13
Darnel Murgatroyd, Ian A Harris, Jian Sheng Chen, Sam Adie, Rajat Mittal, Ian D Cameron
BACKGROUND: Compensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma...
May 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28459301/role-of-guideline-adherence-in-improving-field-triage
#14
Craig D Newgard, Rongwei Fu, E Brooke Lerner, Mohamud Daya, Jonathan Jui, Lynn Wittwer, Terri A Schmidt, Dana Zive, Eileen M Bulger, Ritu Sahni, Craig Warden, Nathan Kuppermann
OBJECTIVE: To compare the sensitivity of current field triage practices for identifying high-risk trauma patients to strict guideline adherence, including changes in triage specificity, ambulance transport patterns, and trauma center volumes. METHODS: This was a pre-planned secondary analysis of an out-of-hospital prospective cohort of injured children and adults transported by 44 EMS agencies to 28 trauma and non-trauma hospitals in 7 Northwest U.S. counties from January 1, 2011 through December 31, 2011...
May 1, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28458899/takotsubo-cardiomyopathy-in-amiodarone-induced-hyperthyroidism
#15
Ismael Capel, Elisabet Tasa-Vinyals, Albert Cano-Palomares, Irene Bergés-Raso, Lara Albert, Mercedes Rigla, Assumpta Caixàs
SUMMARY: Takotsubo cardiomyopathy (TC) is an atypical, severe but reversible form of acute heart insufficiency. It typically presents with left ventricular failure, transient apical and mid-segments hypokinesis, absence of significant coronary stenosis and new electrographic abnormalities and/or elevation in serum cardiac enzymes. Although TC ('broken heart syndrome') has classically been associated with emotional trauma, evidence suggests that other precipitants might exist, including iatrogenic and thyroid-mediated forms...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28457576/effect-of-concentrated-psychiatric-education-on-perceived-competence-to-care-for-behavioral-health-patients
#16
Elizabeth J Winokur, Jeannine Loucks, Dana N Rutledge
Increasing numbers of behavioral patients are presenting to emergency departments, where competency of staff to care for this group is unknown. METHODS: This pre-post study measured the effects of a 7-hour conference on perceived competency of nurses and allied health professionals to care for behavioral health (BH) patients, as measured by the 23-item Behavioral Health Care Competency (BHCC) survey. RESULTS: Of 102 participants, most were emergency nurses (72%), acute care nurses and case managers (20%), and allied health personnel (trauma technicians and paramedics) (8%)...
April 27, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28448166/changes-in-motorcycle-related-injuries-and-deaths-after-mandatory-motorcycle-helmet-law-in-a-district-of-vietnam
#17
Ninh Thi Ha, David Ederer, Van Anh Vo Ha, An Van Pham, Anthony Mounts, Leisha Nolen, David Sugerman
OBJECTIVE: Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City. METHODS: Hospital records for road traffic injuries (RTI) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorised using the Abbreviated Injury Score (AIS). Rate ratios (RR) were used to compare rates pre- and post-law (2005/06-2009/10)...
April 27, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28442203/patterns-of-health-care-use-of-injured-adults-a-population-based-matched-cohort-study
#18
Rebecca J Mitchell, Cate M Cameron, Rod McClure
BACKGROUND: Healthcare use by traumatically injured individuals prior to and subsequent to their injury are not often explored for different types of injuries. This study aims to describe health care use 12 months preceding and 12 months following a traumatic injury by injury type and injury severity. METHOD: Hospital and mortality data from three Australian states were linked in a population-based matched cohort study. Individuals ≥18 years who had an injury-related hospital admission in 2009 were identified as the injured cohort...
April 14, 2017: Injury
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#19
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430721/outcomes-of-reverse-total-shoulder-arthroplasty-for-proximal-humeral-fractures-primary-arthroplasty-versus-secondary-arthroplasty-following-failed-proximal-humeral-locking-plate-fixation
#20
Emilio Sebastia-Forcada, Alejandro Lizaur-Utrilla, Román Cebrian-Gomez, Francisco A Miralles-Muñoz, Fernando A Lopez-Prats
OBJECTIVE: To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures. DESIGN: Matched case-control study. SETTING: University hospital, level I trauma center. PATIENTS: 30 consecutive patients with fracture sequelae due to failed PHLP fixation (mean age 73) were age- and gender-matched to 30 patients with acute fracture (mean age 75)...
April 6, 2017: Journal of Orthopaedic Trauma
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