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https://www.readbyqxmd.com/read/28108319/how-the-changes-in-the-system-affect-trauma-care-provision-the-assessment-of-and-implications-for-lithuanian-trauma-service-performance-in-2007-2012
#1
Žilvinas Dambrauskas, Vytautas Aukštakalnis, Aurika Karbonskienė, Dmitrijus Kačiurinas, Jolanta Vokietienė, Robertas Lapka, Algimantas Pamerneckas, Narūnas Porvaneckas, Kęstutis Stašaitis, Nedas Jasinskas, Paulius Dobožinskas, Dinas Vaitkaitis, Raimundas Lunevičius
OBJECTIVE: The aim of this study was to identify and assess the effects of changes in the Lithuanian trauma service from 2007 to 2012. We postulate that the implications derived from this study will be of importance to trauma policy planners and makers in Lithuania and throughout other countries of Eastern and Central Europe. MATERIALS AND METHODS: Out of 10,390 trauma admissions to four trauma centers in 2007, 294 patients (2.8%) were randomly selected for the first arm of a representative study sample...
January 6, 2017: Medicina
https://www.readbyqxmd.com/read/28108218/chest-trauma-first-48hours-management
#2
Pierre Bouzat, Mathieu Raux, Jean Stéphane David, Karim Tazarourte, Michel Galinski, Thibault Desmettre, Delphine Garrigue, Laurent Ducros, Pierre Michelet
Chest Trauma remains an issue for health services for both severe and apparently mild trauma management. Severe chest trauma is associated with high mortality and is considered liable for 25% of mortality in multiple traumas. Moreover, mild trauma is also associated with significant morbidity especially in patients with preexisting conditions. Thus, whatever the severity, a fast-acting strategy must be organized. At this time there are no guidelines available from scientific societies. These expert recommendations aim to establish guidelines for chest trauma management in both pre hospital an in hospital settings, for the first 48hours...
January 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28107394/quality-of-documentation-as-a-surrogate-marker-for-awareness-and-training-effectiveness-of-phtls-courses-part-of-the-prospective-longitudinal-mixed-methods-epptc-trial
#3
David Häske, Stefan K Beckers, Marzellus Hofmann, Rolf Lefering, Bernhard Gliwitzky, Christoph C Wölfl, Paul Grützner, Ulrich Stöckle, Marc Dieroff, Matthias Münzberg
OBJECTIVE: Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness...
2017: PloS One
https://www.readbyqxmd.com/read/28099387/use-of-an-evidence-based-algorithm-for-patients-with-traumatic-hemothorax-reduces-need-for-additional-interventions
#4
Bradley M Dennis, Stephen P Gondek, Richard A Guyer, Susan E Hamblin, Oliver L Gunter, Oscar D Guillamondegui
BACKGROUND: Concerted management of the traumatic hemothorax is ill-defined. Surgical management of specific hemothoraces may be beneficial. A comprehensive strategy to delineate appropriate patients for additional procedures does not exist. We developed an evidence-based algorithm for hemothorax management. We hypothesize the use of this algorithm will decrease additional interventions. METHODS: A pre/post study was performed on all patients admitted to our trauma service with traumatic hemothorax from August 2010 to September 2013...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#5
Paul R Lewis, Casey E Dunne, James D Wallace, Jason B Brill, Richard Y Calvo, Jayraan Badiee, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: The Brain Trauma Foundation guidelines provide indications for neurosurgical intervention in traumatic brain injury (TBI) with moderate or severe intracranial hemorrhage (ICH). In TBI patients with less severe ICH, the utility of neurosurgical consultation remains unclear. We sought to determine if routine neurosurgical consultation is necessary for mild blunt TBI patients with ICH. METHODS: A retrospective cohort study was conducted on 500 consecutive blunt TBI patients aged 15 years or older with Glasgow Coma Scale score ≥13 and ICH on initial head computed tomography (CT) admitted to a Level 1 trauma center over 28 months...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28096063/formalized-expert-recommendations-chest-trauma-first-48hours-management
#6
Pierre Bouzat, Mathieu Raux, Jean Stéphane David, Karim Tazarourte, Michel Galinski, Thibault Desmettre, Delphine Garrigue, Laurent Ducros, Pierre Michelet
Chest Trauma remains an issue for health services for both severe and apparently mild trauma management. Severe chest trauma is associated with high mortality and is considered liable for 25% of mortality in multiple traumas. Moreover, mild trauma is also associated with significant morbidity especially in patients with preexisting conditions. Thus, whatever the severity, a fast-acting strategy must be organized. At this time there are no guidelines available from scientific societies. These expert recommendations aim to establish guidelines for chest trauma management in both pre hospital an in hospital settings, for the first 48hours...
January 13, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28076488/use-of-tranexamic-acid-in-trauma-patients-an-analysis-of-cost-effectiveness-for-use-in-brazil
#7
Marcelo A Pinto, Jair G da Silva, Aljamir D Chedid, Marcio F Chedid
Introduction: Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Objective: Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#8
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28068945/why-women-bleed-and-how-they-are-saved-a-cross-sectional-study-of-caesarean-section-near-miss-morbidity
#9
S Maswime, E J Buchmann
BACKGROUND: Maternal deaths from 'bleeding during and after caesarean section' (BDACS) have increased in South Africa, and have now become the largest sub-cause of deaths from obstetric haemorrhage. The aim of this study was to describe risk factors and causes of near-miss related to BDACS and interventions used to arrest haemorrhage and treat its effects. METHODS: Cross-sectional prospective study in 13 urban public hospitals in South Africa, from July to December 2014...
January 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28063676/early-predictors-for-massive-transfusion-in-older-adult-severe-trauma-patients
#10
Takao Ohmori, Taisuke Kitamura, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, Ryu Tamura, Kentaro Muranishi, Toshiyuki Matsumoto, Takamitsu Tokioka
BACKGROUND: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#11
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28057029/the-norwegian-guidelines-for-the-prehospital-management-of-adult-trauma-patients-with-potential-spinal-injury
#12
REVIEW
Daniel K Kornhall, Jørgen Joakim Jørgensen, Tor Brommeland, Per Kristian Hyldmo, Helge Asbjørnsen, Thomas Dolven, Thomas Hansen, Elisabeth Jeppesen
The traditional prehospital management of trauma victims with potential spinal injury has become increasingly questioned as authors and clinicians have raised concerns about over-triage and harm. In order to address these concerns, the Norwegian National Competence Service for Traumatology commissioned a faculty to provide a national guideline for pre-hospital spinal stabilisation. This work is based on a systematic review of available literature and a standardised consensus process. The faculty recommends a selective approach to spinal stabilisation as well as the implementation of triaging tools based on clinical findings...
January 5, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28050814/what-orthopaedic-operating-room-surfaces-are-contaminated-with-bioburden-a-study-using-the-atp-bioluminescence-assay
#13
Raveesh Daniel Richard, Thomas R Bowen
BACKGROUND: Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050455/outcomes-of-short-segment-posterior-instrumentation-in-unstable-thoracolumbar-fractures
#14
Sharvil H Gajjar, Hari J Menon, Nitin Chaudhari, Vipul Chaudhari
INTRODUCTION: The spinal traumas are common and leading problem in orthopaedics practice. The individuals are at a risk of high energy trauma in modern era. Unstable thoracolumbar burst fractures are serious injuries of concern, if left untreated may result in marked morbidity and disability to the patient. Thoracolumbar is the second most common segment involved in the spinal cord following spinal injuries followed by cervical segment. The goal of treatment of any spinal injury is restoration of the patient to maximum possible function with disability free life...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28039683/injury-epidemiology-in-iran-a-systematic-review
#15
Saber Azami-Aghdash, Homayoun Sadeghi-Bazargani, Hosein Shabaninejad, Hassan Abolghasem Gorji
BACKGROUND: Injuries are the second greatest cause of mortality in Iran. Information about the epidemiological pattern of injuries is effective in decision-making. In this regard, the aim of the current study is to elaborate on the epidemiology of injuries in Iran through a systematic review. METHODS: Required data were collected searching the following key words and their Persian equivalents; trauma, injury, accident, epidemiology, prevalence, pattern, etiology, risk factors and Iran...
January 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28030503/prophylaxis-against-venous-thromboembolism-in-pediatric-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-and-the-pediatric-trauma-society
#16
Arash Mahajerin, John K Petty, Sheila J Hanson, A Jill Thompson, Sarah H OʼBrien, Christian J Streck, Toni M Petrillo, E Vincent S Faustino
BACKGROUND: Despite the increasing incidence of venous thromboembolism (VTE) in hospitalized children, the risks and benefits of VTE prophylaxis, particularly for those hospitalized after trauma, are unclear. The Pediatric Trauma Society and the Eastern Association for the Surgery of Trauma convened a writing group to develop a practice management guideline on VTE prophylaxis for this cohort of children using the Grading of Recommendations Assessment, Development and Evaluation framework...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28013104/the-impact-of-nursing-delirium-preventive-innterventions-in-the-intensive-care-unit-underpin-icu-a-study-protocol-for-a-multi-centre-stepped-wedge-randomized-controlled-trial
#17
Annelies Wassenaar, Paul Rood, Lisette Schoonhoven, Steven Teerenstra, Marieke Zegers, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Delirium is a common disorder in Intensive Care Unit (ICU) patients and is associated with serious short- and long-term consequences, including re-intubations, ICU readmissions, prolonged ICU and hospital stay, persistent cognitive problems, and higher mortality rates. Considering the high incidence of delirium and its consequences, prevention of delirium is imperative. This study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the ICU, called UNDERPIN-ICU (nUrsiNg DEliRium Preventive INterventions in the ICU)...
December 8, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28011374/robust-cranial-cavity-segmentation-in-ct-and-ct-perfusion-images-of-trauma-and-suspected-stroke-patients
#18
Ajay Patel, Bram van Ginneken, Frederick J A Meijer, Ewoud J van Dijk, Mathias Prokop, Rashindra Manniesing
A robust and accurate method is presented for the segmentation of the cranial cavity in computed tomography (CT) and CT perfusion (CTP) images. The method consists of multi-atlas registration with label fusion followed by a geodesic active contour levelset refinement of the segmentation. Pre-registration atlas selection based on differences in anterior skull anatomy reduces computation time whilst optimising performance. The method was evaluated on a large clinical dataset of 573 acute stroke and trauma patients that received a CT or CTP in our hospital in the period February 2015-December 2015...
December 13, 2016: Medical Image Analysis
https://www.readbyqxmd.com/read/28005711/trauma-system-regionalization-improves-mortality-in-patients-requiring-trauma-laparotomy
#19
David Schechtman, Jack C He, Brenda M Zosa, Debra Allen, Jeffrey A Claridge
INTRODUCTION: This study evaluates the impact of a regional trauma network (RTN) on patient survival, intensive care unit (ICU) length of stay, and hospital length of stay in patients who required trauma laparotomy. METHODS: Patients who required trauma laparotomy from January 2008 to December 2013 were analyzed. Patients admitted during 2008-2009 and 2011-2013 were designated as pre-RTN and RTN groups, respectively. The primary outcome was mortality. RESULTS: A total of 569 patients were analyzed, 231 patients were pre-RTN, and 338 were in the RTN group...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27982326/analysis-of-the-revised-trauma-score-rts-in-200-victims-of-different-trauma-mechanisms
#20
Bruno Durante Alvarez, Danilo Mardegam Razente, Daniel Augusto Mauad Lacerda, Nicole Silveira Lother, Luiz Carlos VON-Bahten, Carla Martinez Menini Stahlschmidt
Objective: to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. Methods: we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
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