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https://www.readbyqxmd.com/read/29787555/implementation-of-a-ct-scan-practice-guideline-for-pediatric-trauma-patients-reduces-unnecessary-scans-without-impacting-outcomes
#1
Patrick R McGrew, Paul J Chestovich, Jay D Fisher, Deborah A Kuhls, Douglas R Fraser, Purvi P Patel, Chad W Katona, Syed Saquib, John J Fildes
INTRODUCTION: Computed Tomography (CT) scans are useful in the evaluation of trauma patients, but are costly and pose risks from ionizing radiation in children. Recent literature has demonstrated the utility of CT scan guidelines in the management of pediatric trauma. This study objective is to review our treatment of pediatric blunt trauma patients and evaluate CT utilization before and after CT-guideline implementation. METHODS: Our Pediatric Level 2 Trauma Center (TC) implemented a CT scan practice guideline for pediatric trauma patients in March 2014...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787528/increased-trauma-activation-is-not-equally-beneficial-for-all-elderly-trauma-patients
#2
Bryan W Carr, Peter M Hammer, Lava Timsina, Grace Rozycki, David V Feliciano, Jamie J Coleman
BACKGROUND: Physiologic changes in the elderly lead to higher morbidity and mortality after injury. Increasing level of trauma activation has been proposed to improve geriatric outcomes; but, the increased cost to the patient and stress to the hospital system are significant downsides. The purpose of this study was to identify the age at which an increase in activation status is beneficial. METHODS: A retrospective review of trauma patients ≥ 70 years old from October 1, 2011, to October 1, 2016 was performed...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29773309/posttraumatic-stress-disorder-in-patients-who-rule-out-versus-rule-in-for-acute-coronary-syndrome
#3
Ian M Kronish, Donald Edmondson, Nathalie Moise, Bernard P Chang, Ying Wei, David Lopez Veneros, William Whang
OBJECTIVE: Many patients who present to the emergency department (ED) with acute coronary syndromes (ACS) develop posttraumatic stress disorder (PTSD) due to the experience. Less is known about risk for PTSD in patients who rule out for ACS. Our objective was to compare the risk of developing PTSD among patients who rule out versus rule in for ACS. METHODS: We enrolled a consecutive sample of 1000 patients presenting to an emergency department (ED) with symptoms of a probable ACS...
May 14, 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29764673/comparison-between-thromboelastography-and-conventional-coagulation-test-should-we-abandon-conventional-coagulation-tests-in-polytrauma-patients
#4
Jaume Tur Martínez, Patrizio Petrone, Alexander Axelrad, Corrado P Marini
INTRODUCTION: TEG provides an in-vivo assessment of viscoelastic clot strength in whole blood compared with CCT, which may not reflect the influence of platelets. The aim of this study was to compare TEG vs. CCT in trauma patients stratified by mechanism of injury (MOI) and pre-existing coagulation status. METHODS: A retrospective, observational study of 230 polytrauma patients admitted to a University Hospital Level 1 Trauma Center, with TEG and CCT on admission stratified by MOI: multiple trauma (MT), isolated traumatic brain injury (TBI) or MT+TBI...
May 12, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29759627/complications-and-health-care-costs-associated-with-transvenous-cardiac-pacemakers-in-a-nationwide-assessment
#5
Daniel J Cantillon, Derek V Exner, Nima Badie, Kevin Davis, Ning Yan Gu, Yelena Nabutovsky, Rahul Doshi
OBJECTIVES: The aim of this study was to retrospectively characterize transvenous pacemaker (TVP) complications and associated health care costs in a large-scale U.S. patient cohort. BACKGROUND: TVP complications have previously been shown to affect more than 1 in 10 patients but may be underestimated. Pacemakers are widely implanted across community and urban hospitals by operators of varying specialization and experience. METHODS: Truven Health MarketScan databases track U...
November 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29755271/clinical-radiological-and-histopathological-characteristics-of-surgically-removed-orbital-hematic-cysts-a-case-series
#6
Hind M Alkatan, Mohammad Al Otaibi, Azza M Y Maktabi, Hamad Aljaedi, Sahar M Elkhamary, Yasser Al-Faky, Adel H Alsuhaibani
Background: Hematic cyst is a rare orbital condition that has a wide range of clinical presentation and is characterized pathologically by lack of endothelial lining. Purpose: To correlate clinical and radiological features of hematic cysts, to tissue diagnosis, and investigate the possible etiology behind this condition, its relation to trauma and other interesting histopathological findings. Methods: Retrospective case series at King Khaled Eye Specialist Hospital (KKESH) and King Abdulaziz University Hospital (KAUH) of all orbital lesions with tissue findings supporting the clinical and/or radiological diagnosis of hematic cyst...
January 2018: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/29754593/comparison-of-health-literacy-in-privately-insured-and-public-hospital-orthopaedic-patients
#7
Filip Cosic, Tabitha Porter, Cameron Norsworthy, Rohan Price, Harvinder Bedi
Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post)...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29747938/mental-health-after-unintentional-injury-in-a-pediatric-managed-medicaid-population
#8
Kylie M Bushroe, Erinn M Hade, Tara A McCarthy, Jeffrey A Bridge, Julie C Leonard
OBJECTIVES: The purpose of this study was to compare the rates of mental health diagnoses and psychotropic prescriptions pre- and posthospitalization for injury in a managed-Medicaid population. We hypothesized that children have increased rates of mental health diagnoses and psychotropic prescriptions after injury. STUDY DESIGN: We investigated children (n = 2208) ≤18 years of age treated at a pediatric trauma center from 2005 to 2015 who were enrolled in a managed-Medicaid program at hospital admission and for at least 1 healthcare visit in the preceding year...
April 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29745733/anterior-cervical-approach-for-the-treatment-of-axial-or-high-thoracic-levels
#9
Ran Harel, Maya Nulman, Zvi R Cohen, Nachshon Knoller
PURPOSE: Application of the anterior sub-axial cervical approach to the axial spine or the high thoracic spine has been previously described. Evaluation methods to determine the feasibility of these approaches were also described but alternative method was utilized in the current study. We describe our experience expanding the boundaries of anterior cervical approach utilizing a novel algorithm for approach selection. MATERIALS AND METHODS: A retrospective analysis of patients' files and imaging data of all anterior cervical approach to treat pathologies above C2-3 disc space or below C7-D1 disc space...
May 10, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29731496/aeromedical-transport-operations-using-helicopters-during-the-2016-kumamoto-earthquake-in-japan
#10
Tomokazu Motomura, Atsushi Hirabayashi, Hisashi Matsumoto, Nobutaka Yamauchi, Mitsunobu Nakamura, Hiroshi Machida, Kenji Fujizuka, Naomi Otsuka, Tomoko Satoh, Hideaki Anan, Hisayoshi Kondo, Yuichi Koido
More than 6,000 people died in the Great Hanshin (Kobe) Earthquake in 1995, and it was later reported that there were around 500 preventable trauma deaths. In response, the Japanese government developed the helicopter emergency medical service in 2001, known in Japan as the "Doctor-Heli" (DH), which had 46 DHs and 2 private medical helicopters as of April 2016. DHs transport physicians and nurses to provide pre-hospital medical care at the scene of medical emergencies. Following lessons learned in the Great East Japan Earthquake in 2011, a research group in the Ministry of Health, Labour and Welfare developed a command and control system for the DH fleet as well as the Disaster Relief Aircraft Management System Network (D-NET), which uses a satellite communications network to monitor the location of the fleet and weather in real-time during disasters...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29729820/tachycardic-and-non-tachycardic-responses-in-trauma-patients-with-haemorrhagic-injuries
#11
Andrew T Reisner, Shwetha Edla, Jianbo Liu, Jiankun Liu, Maxim Y Khitrov, Jaques Reifman
BACKGROUND: Analyses of large databases have demonstrated that the association between heart rate (HR) and blood loss is weaker than what is taught by Advanced Trauma Life Support training. However, those studies had limited ability to generate a more descriptive paradigm, because they only examined a single HR value per patient. METHODS: In a comparative, retrospective analysis, we studied the temporal characteristics of HR through time in adult trauma patients with haemorrhage, based on documented injuries and transfusion of ≥3 units of red blood cells (RBCs)...
April 30, 2018: Injury
https://www.readbyqxmd.com/read/29729014/revision-cochlear-implant-surgery-in-children-surgical-and-audiological-outcomes
#12
Jeffrey Yeung, Amanda Griffin, Stephen Newton, Margaret Kenna, Greg R Licameli
OBJECTIVES/HYPOTHESIS: To determine the incidence of cochlear implant failure and to examine surgical and audiological outcomes. STUDY DESIGN: Retrospective review, case series. METHODS: This study sought indications for revision surgery, surgical findings, and outcomes, and audiological outcomes in pediatric cochlear implant patients. Pre- and postcochlear reimplantation word recognition performance was analyzed using a modified version of the Pediatric Ranked Order Speech Perception (PROSPER) score...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29728151/development-and-validation-of-a-pre-hospital-red-flag-alert-for-activation-of-intra-hospital-haemorrhage-control-response-in-blunt-trauma
#13
Sophie Rym Hamada, Anne Rosa, Tobias Gauss, Jean-Philippe Desclefs, Mathieu Raux, Anatole Harrois, Arnaud Follin, Fabrice Cook, Mathieu Boutonnet, Arie Attias, Sylvain Ausset, Mathieu Boutonnet, Gilles Dhonneur, Jacques Duranteau, Olivier Langeron, Catherine Paugam-Burtz, Romain Pirracchio, Guillaume de St Maurice, Bernard Vigué, Alexandra Rouquette, Jacques Duranteau
BACKGROUND: Haemorrhagic shock is the leading cause of early preventable death in severe trauma. Delayed treatment is a recognized prognostic factor that can be prevented by efficient organization of care. This study aimed to develop and validate Red Flag, a binary alert identifying blunt trauma patients with high risk of severe haemorrhage (SH), to be used by the pre-hospital trauma team in order to trigger an adequate intra-hospital standardized haemorrhage control response: massive transfusion protocol and/or immediate haemostatic procedures...
May 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29719846/epidemiology-of-road-traffic-injury-fatalities-among-car-users-a-study-based-on-forensic-medicine-data-in-east-azerbaijan-of-iran
#14
Homayoun Sadeghi-Bazargani, Bahram Samadirad, Nasrin Shahedifar, Mina Golestani
Objective: To study the epidemiology of car user road traffic fatalities (CURTFs) during eight years, in East Azerbaijan, Iran. Methods: A total of 3051 CURTFs registered in East Azerbaijan forensic medicine organization database, Iran, during 2006-2014, were analyzed using Stata 13 statistical software package. Descriptive statistics ( p <0.05) and inferential statistical methods such as Chi-squared test and multivariate logistic regression with p <0.1 were applied...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29716840/terrorist-attack-in-nice-the-experience-of-general-surgeons
#15
D Massalou, C Ichai, D Mariage, P Baqué
INTRODUCTION: After the attacks in Paris, France was again struck by terrorism in the city of Nice during the night of July 14, 2016. At 22:33 in the evening, a 19-ton truck drove into the crowd of holiday celebrators. The attack resulted in 458 wounded and 86 deaths. The purpose of this study was to describe the management of patients with abdominal trauma admitted alive in our institution, in the context of a massive influx of victims. MATERIAL AND METHODS: We performed a retrospective analysis of the management of adults with abdominal trauma arising from the terrorist attack in Nice...
April 28, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#16
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29687304/improved-outcomes-following-implementation-of-a-multidisciplinary-care-pathway-for-elderly-hip-fractures
#17
Raina Wallace, L D George Angus, Swapna Munnangi, Sally Shukry, Jody C DiGiacomo, Charles Ruotolo
BACKGROUND: Hip fractures in patients 65 years and older are associated with significant morbidity and mortality. With the steady increase in the elderly population, we implemented an evidence-based clinical practice guideline for the management of hip fractures to optimize patient care and surgical outcomes. AIMS: To evaluate the effects of a multidisciplinary hip fracture care pathway on patient outcomes in the care of elderly patients. METHODS: A retrospective analysis of the differences in outcomes prior to (January-October 2014) and after (November 2014-April 2016) implementation of a hip fracture care pathway at a regional Level I trauma center was performed...
April 23, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29675749/evaluation-of-severe-and-fatal-injuries-in-extreme-and-contact-sports-an-international-multicenter-analysis
#18
Christian D Weber, Klemens Horst, Anthony R Nguyen, Rolf Lefering, Hans-Christoph Pape, Frank Hildebrand
PURPOSE: The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. METHODS: We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®)...
April 19, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29665347/comparison-of-revised-trauma-score-based-on-intracranial-haemorrhage-volume-among-head-injury-patients
#19
Albert Tito, Sonny G R Saragih, Diana Natalia
Head injury is one of the leading causes of mortality and morbidity at all ages and may develop into intracranial haemorrhage and increasing intracranial pressure. Pre-assessment must be conducted to head injury patients to decide the treatment plan. The aim of this study was to compare Revised Trauma Score (RTS) based on intracranial haemorrhage volume among head injury patients. This study was an analytic study with cross-sectional design where 31 patients were studied. The admission RTS and patients' status data were obtained from medical records at Dr...
2018: Prague Medical Report
https://www.readbyqxmd.com/read/29664833/effect-of-pre-hospital-red-blood-cell-transfusion-on-mortality-and-time-of-death-in-civilian-trauma-patients
#20
Marius Rehn, Anne Weaver, Karim Brohi, Sarah Eshelby, Laura Green, Jo Røislien, David J Lockey
BACKGROUND: Current management principles of haemorrhagic shock after trauma emphasize earlier transfusion therapy to prevent dilution of clotting factors and correct coagulopathy. London's air ambulance (LAA) was the first UK civilian pre-hospital service to routinely offer pre-hospital red blood cell (RBC) transfusion (phRTx). We investigated the effect of phRTx on mortality. METHODS: Retrospective trauma database study comparing mortality before-implementation with after-implementation of phRTx in exsanguinating trauma patients...
April 16, 2018: Shock
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