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https://www.readbyqxmd.com/read/29777581/in-vivo-performance-of-a-visible-wavelength-optical-sensor-for-monitoring-intestinal-perfusion-and-oxygenation
#1
Mitchell B Robinson, Anna M Wisniowiecki, Ryan J Butcher, Mark A Wilson, M Nance Ericson, Gerard L Cote
Traumatic injury resulting in hemorrhage is a prevalent cause of death worldwide. The current standard of care for trauma patients is to restore hemostasis by controlling bleeding and administering intravenous volume resuscitation. Adequate resuscitation to restore tissue blood flow and oxygenation is critical within the first hours following admission to assess severity and avoid complications. However, current clinical methods for guiding resuscitation are not sensitive or specific enough to adequately understand the patient condition...
May 2018: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29776837/evaluation-of-massive-transfusion-protocol-practices-by-type-of-trauma-at-a-level-i-trauma-center
#2
Roshan Givergis, Swapna Munnangi, Katayoun Fayaz M Fomani, Anthony Boutin, Luis Carlos Zapata, Ld George Angus
PURPOSE: To evaluate massive transfusion protocol practices by trauma type at a level I trauma center. METHODS: A retrospective analysis was performed on a sample of 76 trauma patients with MTP activation between March 2010 and January 2015 at a regional trauma center. Patient demographics, transfusion practices, and clinical outcomes were compared by type of trauma sustained. RESULTS: Penetrating trauma patients who required MTP activation were significantly younger, had lower injury severity score (ISS), higher probability of survival (POS), decreased mortality, and higher Glasgow Coma scale (GCS) compared to blunt trauma patients...
April 18, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29776526/access-to-trauma-centers-for-road-crashes-in-the-united-states
#3
Wei Hu, Qiao Dong, Chunjiao Dong, Jun Yang, Baoshan Huang
INTRODUCTION: Existing research indicates that around 90% of all U.S. residents have access to at least one level I or II trauma center within 60min. However, a limitation of these estimates lies in that they are based on where people live and not where people are injured, which may overestimate the access to trauma centers for seriously injured patients in fatal crashes. METHOD: In this study, the Fatality Analysis Reporting System (FARS) data between 2013 and 2014 were collected and analyzed to quantify the access of injured patients to trauma centers for fatal crashes across states...
June 2018: Journal of Safety Research
https://www.readbyqxmd.com/read/29765226/whole-body-computed-tomography-in-trauma-patients-optimization-of-the-patient-scanning-position-significantly-shortens-examination-time-while-maintaining-diagnostic-image-quality
#4
Tilman Hickethier, Kamal Mammadov, Bettina Baeßler, Thorsten Lichtenstein, Jochen Hinkelbein, Lucy Smith, Patrick Sven Plum, Seung-Hun Chon, David Maintz, De-Hua Chang
Background: The study was conducted to compare examination time and artifact vulnerability of whole-body computed tomographies (wbCTs) for trauma patients using conventional or optimized patient positioning. Patients and methods: Examination time was measured in 100 patients scanned with conventional protocol (Group A: arms positioned alongside the body for head and neck imaging and over the head for trunk imaging) and 100 patients scanned with optimized protocol (Group B: arms flexed on a chest pillow without repositioning)...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29763388/how-should-trauma-patients-informed-consent-or-refusal-be-regarded-in-a-trauma-bay-or-other-emergency-settings
#5
Ashley Suah, Peter Angelos
The precipitous and unexpected nature of trauma requires training health care practitioners to think and act quickly, according to the best medical interest of the patient. The urgency of treatment for trauma patients, who frequently have temporary alterations in their abilities to make autonomous and competent decisions, often results in presumed consent for medically necessary treatment. Academic trauma centers use protocol-based management of injuries to facilitate their simultaneous evaluation by multiple clinicians and to avoid delays in treatment, ensuring that trauma patients receive the best possible care...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#6
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29760852/altered-mental-status-current-evidence-based-recommendations-for-prehospital-care
#7
REVIEW
Ashley Sanello, Marianne Gausche-Hill, William Mulkerin, Karl A Sporer, John F Brown, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci, Gregory H Gilbert
Introduction: In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29751949/platelet-storage-lesions-what-more-do-we-know-now
#8
REVIEW
Monica Suet Ying Ng, John-Paul Tung, John Francis Fraser
Platelet concentrate (PC) transfusions are a lifesaving adjunct to control and prevent bleeding in cancer, hematologic, surgical, and trauma patients. Platelet concentrate availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. Platelet storage lesions are a series of biochemical, structural, and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage...
April 17, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29745761/diagnostic-reliability-of-low-dose-multidetector-computed-tomography-and-cone-beam-computed-tomography-in-maxillofacial-trauma-an-experimental-blinded-and-randomized-study
#9
Romke Rozema, Michiel Hj Doff, Peter Ma van Ooijen, Douwe Postmus, Henriëtte E Westerlaan, Martijn F Boomsma, Baucke van Minnen
OBJECTIVE: To assess the diagnostic reliability of low dose Multidetector Computed Tomography (MDCT) and Cone Beam Computed Tomography (CBCT) for zygomaticomaxillary fracture diagnosis. METHODS: Unilateral zygomaticomaxillary fractures were inflicted on four out of six fresh frozen human cadaver head specimens. All specimens were scanned using four MDCT and two CBCT imaging protocols of which the radiation exposure was systematically reduced. A blinded diagnostic routine was simulated at which 16 radiologists and 8 oral and maxillofacial (OMF) surgeons performed randomized image assessments...
May 10, 2018: Dento Maxillo Facial Radiology
https://www.readbyqxmd.com/read/29745298/impact-of-a-prehospital-discrimination-between-trauma-patients-with-or-without-early-acute-coagulopathy-of-trauma-and-the-need-for-damage-control-resuscitation-rationale-and-design-of-a-multicenter-randomized-phase-ii-trial
#10
Martin Tonglet, Frédéric Swerts, Vincenzo D'Orio, Didier Moens, François-Xavier Lens, Jérémy Alves, Maximilien Thoma, Bernard Kreps, Pierre Youata Towo, Romain Betz, Gerard Decoster B, Michèle Guillaume, Eddy Husson, Anne Françoise Donneau, Jean Louis Poplavsky, Jean Marc Minon, Alexandre Guysen
BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be evaluated. The primary objective of this study is to evaluate the impact on mortality of a prehospital discrimination between trauma patients with or without a potential need for damage control resuscitation. METHODS: The trial will be designed as randomized phase II clinical trial with comparison of the experimental protocol against the standard of care...
May 10, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29743331/what-is-the-quality-of-reporting-on-guideline-protocol-or-algorithm-implementation-in-adult-trauma-centres-protocol-for-a-systematic-review
#11
Lesley Gotlib Conn, Avery B Nathens, Laure Perrier, Barbara Haas, Aaron Watamaniuk, Diego Daniel Pereira, Ashley Zwaiman, Luis Teodoro da Luz
INTRODUCTION: Quality improvement (QI) is mandatory in trauma centres but there is no prescription for doing successful QI. Considerable variation in implementation strategies and inconsistent use of evidence-based protocols therefore exist across centres. The quality of reporting on these strategies may limit the transferability of successful initiatives across centres. This systematic review will assess the quality of reporting on guideline, protocol or algorithm implementation within a trauma centre in terms of the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2...
May 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29742637/high-intensity-bowel-protocol-for-trauma-patients
#12
Anita Smith, Christopher Stimson, Penelope Stevens
BACKGROUND: Internal performance improvement data showed extended length of stay (LOS) in addition to an increased number of patients with constipation. This study was designed to evaluate the number of hospital days a trauma patient with opioid use had a bowel movement (BM) utilizing a high-intensity bowel protocol compared with the standard hospital bowel protocol. METHODS: This was a retrospective analysis of the trauma registry at a Level I trauma center from 2 different time periods to assess the number of hospital days that patients had a BM...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742634/successful-implementation-of-an-alcohol-screening-brief-intervention-and-referral-to-treatment-program
#13
Eric Zimmermann, Jason M Sample, Mary Ellen Zimmermann, Francesca Sullivan, Sarah Stankiewicz, Pierre Saldinger
Devastating effects of alcohol are well established in trauma. To address this, thve American College of Surgeons Committee on Trauma (ACS-COT) requires ACS-verified Level 1 trauma centers to have an active screening, brief intervention, and referral to treatment (SBIRT) program. In 2015, NewYork-Presbyterian/Queens successfully implemented an SBIRT program. Previous studies indicate difficulty in achieving a high level of SBIRT compliance. We explored the effects of a multidisciplinary approach in implementing a standardized screening protocol for every trauma-activated patient 15 years or older...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742626/delta-alert-expanding-gerotrauma-criteria-to-improve-patient-outcomes-a-2-year-study
#14
Lynn L Wiles, Mark D Day
BACKGROUND/SIGNIFICANCE: Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. PURPOSE: The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. METHODS: Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742577/surgical-management-of-the-recent-orbital-war-injury
#15
Safaa Riyadh, Saif Saadedeen Abdulrazaq, Ali Mhana Sabeeh Zirjawi
Maxillofacial trauma affects sensitive and essential functions for the human being such as smell, breathing, talking, and the most importantly the sight. Trauma to the orbit may cause a vision loss especially if this trauma yields a high kinetic energy like that encountered during wars. The purpose of the study was to evaluate the surgical outcomes of the orbital war trauma, enriching the literature with the experience of the authors in this field. A total of 16 patients were injured, evacuated, and managed, between June 2014 and June 2017, from the fight between the Iraqi army and the Islamic State of Iraq and Syria (ISIS) in different areas of Iraq...
May 8, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29738399/cost-determinants-in-the-90-day-management-of-isolated-ankle-fractures-at-a-large-urban-academic-hospital
#16
Matthew Varacallo, Patrick Mattern, Jonathan Acosta, Nader Toossi, Kevin Denehy, Susan Harding
OBJECTIVES: To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution. DESIGN: Retrospective cohort study SETTING:: Level I Trauma Center PATIENTS:: Two hundred ninety-nine patients undergoing open reduction internal fixation (ORIF) for the treatment of an acute, isolated ankle fracture between 2010 and 2015. INTERVENTION: none MAIN OUTCOME MEASUREMENTS:: Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29734225/evidenced-based-treatment-of-posttraumatic-stress-disorder-an-updated-review-of-validated-psychotherapeutic-and-pharmacological-approaches
#17
Meredith E Charney, Samantha N Hellberg, Eric Bui, Naomi M Simon
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Evaluate psychotherapeutic and pharmacologic approaches to treating patients with posttraumatic stress disorder. ABSTRACT: A strong evidence base exists for psychological and pharmacological interventions for the treatment of posttraumatic stress disorder (PTSD). The published literature investigating the effectiveness of these treatments in reducing the symptoms and impairments associated with PTSD has expanded substantially in recent years...
May 2018: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/29732587/clinical-contribution-of-wrist-and-hand-sonography-pilot-study
#18
Alberto Tagliafico, Bianca Bignotti, Federica Rossi, Maurizio Rubino, Alessandro Civani, Carlo Martinoli
OBJECTIVES: The purpose of this study was to evaluate the clinical contribution of wrist and hand sonography. METHODS: This study was performed in a tertiary academic medical center. Institutional review board approval was obtained. Data collection was done retrospectively from January 2012 to December 2016 and prospectively from January 2017 to July 2017. The study included 112 consecutive patients (52 men and 60 women; mean age, 47 ± 16 years; range, 15-87 years)...
May 6, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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
#19
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/29726299/in-vivo-immunogenicity-of-bovine-bone-removed-by-a-novel-decellularization-protocol-based-on-supercritical-carbon-dioxide
#20
Ling You, Xu Weikang, Yang Lifeng, Liang Changyan, Lin Yongliang, Wei Xiaohui, Xu Bin
Trauma or infections associated critical bone defects lead to a huge economic burden in the healthcare system worldwide. Recent advances in tissue engineering have led to potential new strategies for the repair, replacement, and regeneration of bone defects, especially in biomaterials and decellularization protocols from xenogenic tissues. However, the complexity in bone structure and mechanical environment limits the synthesis of artificial bone with biomaterials. Thus, the purpose of our study is to develop a natural bone scaffold with great immunocompatibility...
May 4, 2018: Artificial Cells, Nanomedicine, and Biotechnology
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