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https://www.readbyqxmd.com/read/29438134/better-compliance-with-triage-criteria-in-trauma-would-reduced-costs-with-maintained-patient-safety
#1
Fredrik Linder, Lina Holmberg, Hampus Eklöf, Martin Björck, Claes Juhlin, Kevin Mani
OBJECTIVE: To evaluate trauma triage criteria in terms of compliance, undertriage, and overtriage and identify risk factors for mistriage. METHODS: In a retrospective cohort study, all consecutive trauma patients at a University Hospital in Sweden in 2012 were included. Patients were stratified into three groups on the basis of trauma team activation (full trauma team, limited trauma team, and no trauma team). Case records were reviewed for mechanism of injury, vital signs, and injuries...
February 12, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29437639/soluble-gpvi-is-elevated-in-injured-patients-shedding-is-mediated-by-fibrin-activation-of-gpvi
#2
Samantha J Montague, Céline Delierneux, Christelle Lecut, Nathalie Layios, Robert J Dinsdale, Christine S-M Lee, Natalie S Poulter, Robert K Andrews, Peter Hampson, Christopher M Wearn, Nathalie Maes, Jonathan Bishop, Amy Bamford, Chris Gardiner, Woei Ming Lee, Tariq Iqbal, Naiem Moiemen, Steve P Watson, Cécile Oury, Paul Harrison, Elizabeth E Gardiner
Soluble glycoprotein VI (sGPVI) is shed from the platelet surface and is a marker of platelet activation in thrombotic conditions. We assessed sGPVI levels together with patient and clinical parameters in acute and chronic inflammatory conditions, including patients with thermal injury and inflammatory bowel disease and patients admitted to the intensive care unit (ICU) for elective cardiac surgery, trauma, acute brain injury, or prolonged ventilation. Plasma sGPVI was measured by enzyme-linked immunosorbent assay and was elevated on day 14 after thermal injury, and was higher in patients who developed sepsis...
February 13, 2018: Blood Advances
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#3
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29433071/applying-crash-data-to-injury-claims-an-investigation-of-determinant-factors-in-severe-motor-vehicle-accidents
#4
Darren Shannon, Finbarr Murphy, Martin Mullins, Julian Eggert
An extensive number of research studies have attempted to capture the factors that influence the severity of vehicle impacts. The high number of risks facing all traffic participants has led to a gradual increase in sophisticated data collection schemes linking crash characteristics to subsequent severity measures. This study serves as a departure from previous research by relating injuries suffered in road traffic accidents to expected trauma compensation payouts and deriving a quantitative cost function. Data from the National Highway Traffic Safety Administration's (NHTSA) Crash Injury Research (CIREN) database for the years 2005-2014 is combined with the Book of Quantum, an Irish governmental document that offers guidelines on the appropriate compensation to be awarded for injuries sustained in accidents...
February 9, 2018: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29428212/computed-tomography-window-blending-feasibility-in-thoracic-trauma
#5
Jacob C Mandell, Jeremy R Wortman, Tatiana C Rocha, Les R Folio, Katherine P Andriole, Bharti Khurana
RATIONALE AND OBJECTIVES: This study aims to demonstrate the feasibility of processing computed tomography (CT) images with a custom window blending algorithm that combines soft-tissue, bone, and lung window settings into a single image; to compare the time for interpretation of chest CT for thoracic trauma with window blending and conventional window settings; and to assess diagnostic performance of both techniques. MATERIALS AND METHODS: Adobe Photoshop was scripted to process axial DICOM images from retrospective contrast-enhanced chest CTs performed for trauma with a window-blending algorithm...
February 7, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29406384/reconstruction-of-defects-in-the-weight-bearing-plantar-area-using-the-innervated-free-medial-plantar-instep-flap
#6
Jonas Gustafsson Löfstrand, Chih-Hung Lin
BACKGROUND: Defects in the weight-bearing heel or forefoot are commonly derived from chronic wounds, acute trauma, or tumor excision. Reconstruction of such defects pose a significant challenge to provide a flap that is stable, durable, and sensate. Several flaps have been described for reconstruction of plantar defects, but recurrent ulcerations and/or the need of additional procedures are common. This article provides the approach and outcomes of innervated free medial plantar flap for weight-bearing plantar defects reconstruction...
March 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29405797/new-immobilization-guidelines-change-ems-critical-thinking-in-older-adults-with-spine-trauma
#7
Linda Underbrink, Alice Twink Dalton, Jan Leonard, Pamela W Bourg, Abigail Blackmore, Holly Valverde, Thomas Candlin, Lisa M Caputo, Christopher Duran, Sherrie Peckham, Jeff Beckman, Brandon Daruna, Krista Furie, Debra Hopgood
OBJECTIVE: The impact of immobilization techniques on older adult trauma patients with spinal injury has rarely been studied. Our advisory group implemented a change in the immobilization protocol used by emergency medical services (EMS) professionals across a region encompassing 9 trauma centers and 24 EMS agencies in a Rocky Mountain state using a decentralized process on July 1, 2014. We sought to determine whether implementing the protocol would alter immobilization methods and affect patient outcomes among adults ≥60 years with a cervical spine injury...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29404850/mabal-a-novel-deep-learning-architecture-for-machine-assisted-bone-age-labeling
#8
Simukayi Mutasa, Peter D Chang, Carrie Ruzal-Shapiro, Rama Ayyala
Bone age assessment (BAA) is a commonly performed diagnostic study in pediatric radiology to assess skeletal maturity. The most commonly utilized method for assessment of BAA is the Greulich and Pyle method (Pediatr Radiol 46.9:1269-1274, 2016; Arch Dis Child 81.2:172-173, 1999) atlas. The evaluation of BAA can be a tedious and time-consuming process for the radiologist. As such, several computer-assisted detection/diagnosis (CAD) methods have been proposed for automation of BAA. Classical CAD tools have traditionally relied on hard-coded algorithmic features for BAA which suffer from a variety of drawbacks...
February 5, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29398167/severity-scores-in-trauma-patients-admitted-to-icu-physiological-and-anatomic-models
#9
L Serviá, M Badia, N Montserrat, J Trujillano
INTRODUCTION: The goals of this project were to compare both the anatomic and physiologic severity scores in trauma patients admitted to intensive care unit (ICU), and to elaborate mixed statistical models to improve the precision of the scores. METHODS: A prospective study of cohorts. The combined medical/surgical ICU in a secondary university hospital. Seven hundred and eighty trauma patients admitted to ICU older than 16 years of age. Anatomic models (ISS and NISS) were compared and combined with physiological models (T-RTS, APACHE II [APII], and MPM II)...
February 2, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29395772/effectiveness-of-prehospital-trauma-triage-systems-in-selecting-severely-injured-patients-is-comparative-analysis-possible
#10
REVIEW
Eveline A J van Rein, Rogier van der Sluijs, R Marijn Houwert, Amy C Gunning, Rob A Lichtveld, Luke P H Leenen, Mark van Heijl
INTRODUCTION: In an optimal trauma system, prehospital trauma triage ensures transport of the right patient to the right hospital. Incorrect triage results in undertriage and overtriage. The aim of this systematic review is to evaluate and compare prehospital trauma triage system quality worldwide and determine effectiveness in terms of undertriage and overtriage for trauma patients. METHODS: A systematic search of Pubmed/MEDLINE, Embase, and Cochrane Library databases was performed, using "trauma", "trauma center," or "trauma system", combined with "triage", "undertriage," or "overtriage", as search terms...
January 27, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29390372/dynamic-paraspinal-muscle-impingement-causing-acute-hemiplegia-after-c1-posterior-arch-laminectomy-a-case-report
#11
Naoki Notani, Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Shozo Kanezaki, Hiroshi Tsumura
RATIONALE: Acute neurological deficits following spinal surgery commonly result from epidural hematoma, surgical trauma, vascular compromise, and graft or hardware impingement, with the cause identified by magnetic resonance imaging (MRI). We present a rare case of dynamic paraspinal muscle impingement after C1 posterior arch laminectomy, which was diagnosed by myelography, with no significant findings on MRI. PATIENT CONCERNS: An 81-year-old, severely obese male, was referred to our department for the treatment of vertebral disease of the lumbar spine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388855/comparative-analysis-of-state-trauma-triage-criteria-vs-paramedic-discretion
#12
Todd Husty, Marie Crandall, Alexander R Logsdon, J Bracken Burns, David J Chesire, David J Ebler
OBJECTIVE: The Florida Adult Trauma Triage Criteria (FATTC) define specific parameters concerning injury mechanism and physiologic data that prompt paramedics to initiate a trauma alert and necessitate transport to a trauma center. In the state of Florida, paramedics are also given discretion to bring patients to the trauma center who do not meet those criteria. Our aim was to compare the injury characteristics and outcomes of adult patients who were evaluated in our trauma center after activation due to FATTC criteria vs...
February 1, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29384419/procedural-sedation-and-analgesia-in-trauma-patients-in-an-out-of-hospital-emergency-setting-a-prospective-multicenter-observational-study
#13
Michel Galinski, Laure Hoffman, Delphine Bregeaud, Mounir Kamboua, François-Xavier Ageron, Catherine Rouanet, Jean-Christophe Hubert, Jacques Istria, Mirko Ruscev, Karim Tazarourte, Florence Pevirieri, Frédéric Lapostolle, Frédéric Adnet
BACKGROUND: The quality of procedural analgesia and sedation among trauma patients has not been studied much in the prehospital setting. The main objective of this study was to characterize the quality of procedural analgesia sedation practices in prehospital settings in trauma patients. METHODS: This was an open-label observational prospective multicenter study (January 01, 2012-December 31, 2013). We included all consecutive trauma victims undergoing a potentially painful procedure on the accident scene...
January 31, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29380069/emotion-regulation-difficulties-in-traumatized-youth-a-meta-analysis-and-conceptual-review
#14
L Villalta, P Smith, N Hickin, A Stringaris
This article provides a quantitative and conceptual review of emotion regulation difficulties in trauma-exposed young people, and informs future directions in the field. Despite long-standing interest in the influence of emotion regulation difficulties on different internalizing and externalizing psychiatric disorders in childhood, several questions remain unresolved with respect to children and adolescents with PTSD (post-traumatic stress disorder). Meta-analytic data from adult victims suggest that emotion regulation problems are associated with PTSD, but this has never been studied in children and young people...
January 27, 2018: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/29370063/fresh-whole-blood-resuscitation-does-not-exacerbate-skeletal-muscle-edema-and-long-term-functional-deficit-after-ischemic-injury-and-hemorrhagic-shock
#15
Amit Aurora, Janet L Roe, Nsini A Umoh, Michael Dubick, Joseph C Wenke, Thomas J Walters
BACKGROUND: Hemorrhagic shock due to extremity vascular injuries is common in combat injuries. Fluid resuscitation is the standard treatment for severe hemorrhage. Tourniquets (TK) used for hemorrhage control cause ischemia-reperfusion (I/R) injury that induces edema formation in the injured muscle. Resuscitation fluids affect edema formation; however, its effect on long-term functional response remains unknown. The objectives of this study are 1) compare acute muscle damage; 2) determine long-term functional recovery of ischemic muscle, and 3) compare local and systemic inflammatory response including the expression of junctional proteins following early resuscitation with Hextend (HEX) and Fresh Whole Blood (FWB) using a rodent model of combined hemorrhage and TK-induced limb I/R...
January 24, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29370059/avoiding-cribari-gridlock-the-standardized-triage-assessment-tool-improves-the-accuracy-of-the-cribari-matrix-method-in-identifying-potential-over-and-undertriage
#16
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
BACKGROUND: The Cribari matrix method (CMM) is the standard to identify potential over- and undertriage but requires case reviews to correct for the fact that Injury Severity Score does not account for physiology or comorbidities, nor is it well correlated with resource consumption. Further, the secondary reviews introduce undesirable subjectivity. This study assessed if the Standardized Triage Assessment Tool (STAT)-a combination of the CMM and the Need For Trauma Intervention-could more accurately determine over- and undertriage than the CMM alone...
January 24, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29368084/radiological-classification-of-retroperitoneal-hematoma-resulting-from-lumbar-vertebral-fracture
#17
Shota Nakao, Kazuo Ishikawa, Hidefumi Ono, Kenji Kusakabe, Ichiro Fujimura, Masato Ueno, Koji Idoguchi, Yasuaki Mizushima, Tetsuya Matsuoka
PURPOSE: Lumbar vertebral fracture (LVF) infrequently produces massive retroperitoneal hematoma (RPH). This study aimed to systematically review the clinical and radiographic characteristics of RPH resulting from LVF. METHODS: For 193 consecutive patients having LVF who underwent computed tomography (CT), demographic data, physiological conditions, and outcomes were reviewed from their medical records. Presence or absence of RPH, other bone fractures, or organ/vessel injury was evaluated in their CT images, and LVF or RPH, if present, was classified according to either the Orthopaedic Trauma Association classification or the concept of interfascial planes...
January 24, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29366876/less-invasive-surgical-approaches-for-lvad-implantation-state-of-the-art
#18
M Ricklefs, J S Hanke, G Dogan, L C Napp, C Feldmann, A Haverich, J D Schmitto
For several years, the standard implantation strategy of VADs has involved a full sternotomy approach. However, less invasive implantation techniques are now becoming increasingly popular as they are associated with reduction of trauma, blood loss and arrhythmogenic complications as well as a decreased duration of intensive care unit and in-hospital stay. Thus, due to miniaturization and increasing technical improvement of ventricular assist devices, less invasive strategies for implantation, explantation, exchange and concomitant cardiac procedures are on the rise...
January 20, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29366329/rationale-and-design-of-the-smart-trial-a-randomised-prospective-parallel-non-blinded-one-centre-trial-to-evaluate-the-use-of-magnetic-resonance-imaging-in-acute-setting-in-patients-presenting-with-suspected-scaphoid-fracture
#19
Tiago Rua, Sanjay Vijayanathan, David Parkin, Vicky Goh, Paul McCrone, Sam Gidwani
Background Wrist injury is a common presentation to the Emergency Department in the United Kingdom. Among these injuries, the scaphoid is the most common fractured carpal bone. However, given the limited ability of conventional radiography to accurately diagnose a suspected scaphoid fracture on presentation, its diagnosis and management remain challenging. Despite the vast clinical evidence supporting the superior accuracy of magnetic resonance imaging, there is little to no evidence around the real-world clinical and economic impact of immediate magnetic resonance imaging in the management of suspected scaphoid fractures...
December 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29358539/effectiveness-of-antimicrobial-therapy-after-extraction-of-impacted-mandibular-third-molar-a-randomized-clinical-trial
#20
A Rabi, Rahul Maheshwari, Bhuvaneshwari Srinivasan, Lata P Warad, C C Suvarna, Kartik S Tank
AIM: The present study was conducted with the aim of evaluating the effectiveness of antimicrobial therapy following extraction of an impacted mandibular third molar. MATERIALS AND METHODS: This randomized controlled trial was conducted on a total of 60 patients who were randomly assigned into three groups: Group I individuals were given 625 mg of combined amoxicillin and clavulanic acid tablet; 625 mg of combined amoxicillin and clavulanic acid tablet + 400 mg metronidazole tablet was given to group II individuals; whereas group III individuals were assigned no treatment...
January 1, 2018: Journal of Contemporary Dental Practice
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