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https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#1
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29018630/a-versatile-ultrasound-simulation-system-for-education-and-training-in-high-fidelity-emergency-scenarios
#2
Saverio Farsoni, Luca Astolfi, Marcello Bonfe, Savino Spadaro, Carlo Alberto Volta
Point of care ultrasonography and the related focused assessment with sonography for trauma protocol, if performed by experienced physicians, is a highly sensitive examination, and specific for the detection of free fluids. Different systems and methods have been proposed for training, including simulation as one of the most efficient. This paper presents an ultrasound training system, specifically designed to be used during bedside high fidelity simulation scenarios, that could facilitate the learning process...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/28994720/augmented-reality-as-a-telemedicine-platform-for-remote-procedural-training
#3
Shiyao Wang, Michael Parsons, Jordan Stone-McLean, Peter Rogers, Sarah Boyd, Kristopher Hoover, Oscar Meruvia-Pastor, Minglun Gong, Andrew Smith
Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training...
October 10, 2017: Sensors
https://www.readbyqxmd.com/read/28985089/examining-participant-perceptions-of-an-interprofessional-simulation-based-trauma-team-training-for-medical-and-nursing-students
#4
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/28974313/disparate-effects-of-catecholamines-under-stress-conditions-on-endothelial-glycocalyx-injury-an-in%C3%A2-vitro-model
#5
Jonathan V Martin, David M Liberati, Lawrence N Diebel
BACKGROUND: Geriatric trauma patients have high circulating norepinephrine (NE) levels but attenuated release of epinephrine (Epi) in response to increasing severity of injury. We hypothesized that NE and Epi have different effects on the endothelial and glycocalyx components of the vascular barrier following shock. METHODS: Human umbilical vein endothelial cells (HUVEC) were treated with varying concentrations of NE or Epi and exposed to simulated shock conditions (HR)...
September 22, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28962714/training-in-uniportal-video-assisted-thoracic-surgery
#6
REVIEW
Alberto Sandri, Alan D L Sihoe, Michele Salati, Diego Gonzalez-Rivas, Alessandro Brunelli
Interest in uniportal video-assisted thoracic surgery (VATS) is rapidly growing worldwide because it represents the surgical approach to the lung with the least possible trauma. Specific training in this surgical approach is crucial due to its technical implications, to perform it safely while upholding the required therapeutic radicality. Novel strategies, such as interactive learning technologies, simulators, high-volume preceptorships, and targeted proctorships, play important roles in the training for uniportal VATS which, ideally, should be standardized, governed, and credentialed by national and international surgical societies to ensure patient safety and academic responsibility...
November 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28957576/a-calming-cushion-as-a-therapeutic-wellness-tool-for-youths-with-disabilities-and-history-of-trauma
#7
Reizel Polak, Dori Hutchinson, Louise Perryman, Stephanie Brueck
Seclusion and restraint are commonly used by residential staff to control unsafe behaviors of youths with disabilities and complex trauma histories. This pilot study examined the effect of a nonrestraining cushion as a calming device and wellness tool in a setting that prohibits supportive physical contact, to see to what extent the cushion might help these youths to better regulate their emotional distress and unwanted behaviors. Volunteers used the cushion for 15 minutes over 24 sessions. Nine students completed the study and reported reduction in anxiety and agitation, and a soothing feeling with residual effects to their daily routines...
October 1, 2017: Social Work
https://www.readbyqxmd.com/read/28941740/fetal-radiation-dose-in-three-common-ct-examinations-during-pregnancy-monte-carlo-study
#8
A Kelaranta, T Mäkelä, T Kaasalainen, M Kortesniemi
PURPOSE: To determine fetal doses in different stages of pregnancy in three common computed tomography (CT) examinations: pulmonary CT angiography, abdomino-pelvic and trauma scan with Monte Carlo (MC) simulations. METHODS: An adult female anthropomorphic phantom was scanned with a 64-slice CT using pulmonary angiography, abdomino-pelvic and trauma CT scan protocols. Three different sized gelatin boluses placed on the phantom's abdomen simulated different stages of pregnancy...
September 20, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28932923/dual-energy-bone-removal-computed-tomography-brct-preliminary-report-of-efficacy-of-acute-intracranial-hemorrhage-detection
#9
Norihito Naruto, Hidenori Tannai, Kazuma Nishikawa, Kentaro Yamagishi, Masahiko Hashimoto, Hideto Kawabe, Yuichi Kamisaki, Hisashi Sumiya, Satoshi Kuroda, Kyo Noguchi
PURPOSE: One of the major applications of dual-energy computed tomography (DECT) is automated bone removal (BR). We hypothesized that the visualization of acute intracranial hemorrhage could be improved on BRCT by removing bone as it has the highest density tissue in the head. This preliminary study evaluated the efficacy of a DE BR algorithm for the head CT of trauma patients. METHODS: Sixteen patients with acute intracranial hemorrhage within 1 day after head trauma were enrolled in this study...
September 20, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28921846/improvement-of-polytrauma-management-quality-inspection-of-a-newly-introduced-course-concept
#10
Ingo Gräff, Shahab Ghamari, Sylvia Schacher, Procula Glien, Rolf Fimmers, Torsten Baehner, Se-Chan Kim
RATIONALE, AIMS, AND OBJECTIVES: A systematic literature search for training course concepts for care of severely injured and severely ill patients respecting improvement of process and outcome yielded little data. For several years, the University Hospital of Bonn has hosted a shock-room management course which, on the one hand, communicates human factor aspects and, on the other hand, pursues interdisciplinary and interprofessional team training. The Bonn shock-room management course (BSM-course®) differs from other courses in both format and principles...
September 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28920524/remotely-supported-prehospital-ultrasound-a-feasibility-study-of-real-time-image-transmission-and-expert-guidance-to-aid-diagnosis-in-remote-and-rural-communities
#11
Leila Eadie, John Mulhern, Luke Regan, Alasdair Mort, Helen Shannon, Ashish Macaden, Philip Wilson
Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28910470/a-comparison-of-ventilation-rates-between-a-standard-bag-valve-mask-and-a-new-design-in-a-prehospital-setting-during-training-simulations
#12
Joseph T Costello, Paul B Allen, Robert Levesque
BACKGROUND: Excessive ventilation of sick and injured patients is associated with increased morbidity and mortality. Combat Medical Systems® (CMS) is developing a new bag-valve-mask (BVM) designed to limit ventilation rates. The purpose of this study was to compare ventilation rates between a standard BVM device and the CMS device. METHODS: This was a prospective, observational, semirandomized, crossover study using Army Medics. Data were collected during Brigade Combat Team Trauma Training classes at Camp Bullis, Texas...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910465/combat-trousers-as-effective-improvised-pelvic-binders-a-comparative-cadaveric-study
#13
Andrew Loftus, Rhys Morris, Yasmin Friedmann, Ian Pallister, Paul Parker
BACKGROUND: Improvised explosive devices and landmines can cause pelvic fractures, which, in turn, can produce catastrophic hemorrhage. This cadaveric study compared the intrapelvic pressure changes that occurred with the application of an improvised pelvic binder adapted from the combat trousers worn by British military personnel with the commercially available trauma pelvic orthotic device (TPOD). METHODS: Six unembalmed cadavers (three male, three female) were used to simulate an unstable pelvic fracture with complete disruption of the posterior arch (AO/OTA 61-C1) by dividing the pelvic ring anteriorly and posteriorly...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28905356/impact-of-shoulder-dystocia-stratified-by-type-of-manoeuvre-on-severe-neonatal-outcome-and-maternal-morbidity
#14
Flurina Michelotti, Christopher Flatley, Sailesh Kumar
BACKGROUND: Shoulder dystocia is an uncommon and unpredictable obstetric emergency. It is associated with significant neonatal, maternal and medico-legal consequences. AIM: To ascertain the impact shoulder dystocia has on severe neonatal and maternal outcomes specific to the type of manoeuvre. MATERIALS AND METHODS: This was a retrospective study of 48 021 term singleton vaginal deliveries the Mater Mothers' Hospital in Brisbane between 2007 and 2015...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28893142/a-simulation-and-video-based-training-program-to-address-adverse-childhood-experiences
#15
Frances K Wen, Julie E Miller-Cribbs, Kim A Coon, Martina J Jelley, Kristin A Foulks-Rodriguez
Adverse childhood experiences (ACEs) are 10 categories of childhood abuse and maltreatment, which have a dose-response relationship with common adult health concerns seen in primary care including health risk behaviors, chronic disease, and mental illness. Many of the ACEs-associated biopsychosocial risk factors are modifiable. However, physicians may not address these issues for fear of opening "Pandora's Box", that is, a source of extensive problems for which they are not sufficiently prepared with training, resources, or time...
January 1, 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28885944/the-value-of-live-tissue-training-for-combat-casualty-care-a-survey-of-canadian-combat-medics-with-battlefield-experience-in-afghanistan
#16
Michael Kim, Ian Torrie, Robert Poisson, Nicholas Withers, Stephen Bjarnason, Luis Teodoro DaLuz, Dylan Pannell, Andrew Beckett, Homer C Tien
INTRODUCTION: The optimum method for training military personnel for combat casualty care is unknown. In particular, there is debate regarding the incremental benefit of live animal tissue training (LTT) over inanimate human patient simulators (HPSs). Although both LTT and HPS are currently used for predeployment training, the efficacy of these models has not been established. MATERIALS AND METHODS: Canadian Armed Forces combat medics, deployed to Afghanistan between 2006 and 2011, were surveyed retrospectively regarding their experience with combat casualty care and predeployment training...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885943/systematic-review-of-live-tissue-versus-simulation-education-for-prehospital-trauma-providers
#17
Craig Goolsby, Andrew Branting, Jason Ausman, David Williams, Chelsea Ausman, Jason David, Rhonda Allard
BACKGROUND: Advanced simulation capabilities have provided medical educators novel approaches for learners. Simulation has successfully replaced many aspects of medical education that previously used animal live-tissue training (LTT) for physician education. However, prehospital trauma providers, such as combat medics, currently used LTT to prepare for patient care. This use of LTT has sparked a debate about the optimal educational modality for this unique learner population. At this time, there is no clear evidence-based recommendation available to recommend either LTT or simulation as a superior modality...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885519/preparing-global-trauma-nurses-for-leadership-roles-in-global-trauma-systems
#18
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/28882905/cost-comparison-of-orthopaedic-fracture-pathways-using-discrete-event-simulation-in-a-glasgow-hospital
#19
Gillian H Anderson, Paul J Jenkins, David A McDonald, Robert Van Der Meer, Alec Morton, Margaret Nugent, Lech A Rymaszewski
OBJECTIVE: Healthcare faces the continual challenge of improving outcome while aiming to reduce cost. The aim of this study was to determine the micro cost differences of the Glasgow non-operative trauma virtual pathway in comparison to a traditional pathway. DESIGN: Discrete event simulation was used to model and analyse cost and resource utilisation with an activity-based costing approach. Data for a full comparison before the process change was unavailable so we used a modelling approach, comparing a virtual fracture clinic (VFC) with a simulated traditional fracture clinic (TFC)...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28882373/a-paradigm-shift-in-surgical-planning-and-simulation-using-3dgraphy-experience-of-first-50-surgeries-done-using-3d-printed-biomodels
#20
Vaibhav Bagaria, Kshitij Chaudhary
INTRODUCTION: Preoperative planning is an important aspect of any orthopedic surgery. Traditionally, surgeons mentally rehearse the operation and anticipate problems based on data available from "radiography" like MRI and CT. 3D printed bio-models and tools, or "3Dgraphy" can simplify this mental exercise and provide a realistic and user-friendly portrayal of this radiographic data. METHODS: Five surgeons participated in this multicenter study. 3D printed biomodels were obtained for 50 surgical cases that included periarticular trauma (24), pelvic trauma (11), complex primary (7), and revision arthroplasty (8)...
September 1, 2017: Injury
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