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https://www.readbyqxmd.com/read/28780982/validation-of-the-criteria-for-early-critical-care-resource-use-in-assessing-the-effectiveness-of-field-triage
#1
Ki Ok Ahn, Sang Chul Kim, Ju Ok Park, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong
BACKGROUND: This study aimed to validate the criteria for early critical care resource (CCR) use as an outcome predictor for seriously injured patients triaged in the field by comparing the effectiveness of the criteria for early CCR use with that of criteria defined by an Injury Severity Score (ISS) >15. METHODS: We analysed data from seriously injured trauma patients who were triaged using a field triage protocol by emergency medical service providers (EMS-ST patients)...
July 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28765353/hemostatic-management-of-trauma-induced-coagulopathy
#2
Janise B Phillips, Phillip L Mohorn, Rebecca E Bookstaver, Tanya O Ezekiel, Christopher M Watson
Trauma-induced coagulopathy is a primary factor in many trauma-related fatalities. Management hinges upon rapid diagnosis of coagulation abnormalities and immediate administration of appropriate hemostatic agents. Use of crystalloids and packed red blood cells has traditionally been the core of trauma resuscitation, but current massive transfusion protocols include combination therapy with fresh frozen plasma and predefined ratios of platelets to packed red blood cells, limiting crystalloid administration. Hemostatic agents such as tranexamic acid, prothrombin complex concentrate, fibrinogen concentrate, and, in cases of refractory bleeding, recombinant activated factor VIIa may also be warranted...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28765125/sepsis-and-critical-illness-research-center-investigators-protocols-and-standard-operating-procedures-for-a-prospective-cohort-study-of-sepsis-in-critically-ill-surgical-patients
#3
Tyler J Loftus, Juan C Mira, Tezcan Ozrazgat-Baslanti, Gabriella L Ghita, Zhongkai Wang, Julie A Stortz, Babette A Brumback, Azra Bihorac, Mark S Segal, Stephen D Anton, Christiaan Leeuwenburgh, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
INTRODUCTION: Sepsis is a common, costly and morbid cause of critical illness in trauma and surgical patients. Ongoing advances in sepsis resuscitation and critical care support strategies have led to improved in-hospital mortality. However, these patients now survive to enter state of chronic critical illness (CCI), persistent low-grade organ dysfunction and poor long-term outcomes driven by the persistent inflammation, immunosuppression and catabolism syndrome (PICS). The Sepsis and Critical Illness Research Center (SCIRC) was created to provide a platform by which the prevalence and pathogenesis of CCI and PICS may be understood at a mechanistic level across multiple medical disciplines, leading to the development of novel management strategies and targeted therapies...
August 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28761940/management-of-ankylotic-root-resorption-following-dental-trauma-a-short-review-and-proposal-of-a-treatment-protocol
#4
Shaul Lin, Malka Ashkenazi, Munir Karawan, Sorin T Teich, Zvi Gutmacher
Ankylotic root resorption is a serious complication following traumatic dental injuries. The aetiology of root resorption includes acute injury to the cementum and periodontal ligament, and subsequent biological processes that propagate the harm. The aim of the present paper is to present a structured treatment protocol for teeth that have experienced trauma and are at risk of developing ankylotic root resorption, followed by a decoronation protocol for situations in which ankylotic root resorption developed...
July 31, 2017: Oral Health & Preventive Dentistry
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#5
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28733846/implementation-of-a-standardized-protocol-to-manage-elderly-patients-with-low-energy-pelvic-fractures-can-service-improvement-be-expected
#6
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
July 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#7
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#8
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#9
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28701848/metatarsal-fracture-leading-to-massive-pulmonary-embolism
#10
Vikas Rajpurohit, Prateek Tejvir, Neelam Meena, Kailash Mittal
Immobilization and bed rest after fracture and orthopedic surgery are routinely advised protocol. Period of bed rest usually depends on the type of injury and orthopedic procedure, ranging from few days to weeks. The trauma, surgery, and immobilization with other contributing factors can lead to deep vein thrombosis and pulmonary embolism (PE) in these patients. Although there is high incidence of PE in such patients, it is difficult to diagnose, primarily because of the variety of nonspecific signs and symptoms...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28701204/criteria-and-models-for-the-distribution-of-casualties-in-trauma-related-mass-casualty-incidents-a-systematic-literature-review-protocol
#11
Ali Ardalan, Mohammad Reza Khajehaminian, Sayed Mohsen Hosseini Boroujeni, Amir Nejati, Abbasali Keshtkar, Abbas Rahimi Foroushani, Omid Mahdi Ebadati E
BACKGROUND: One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents...
July 12, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#12
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire O'Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697349/styloid-process-fracture-associated-with-maxillofacial-trauma-incidence-distribution-and-management
#13
P K Tiwary, N K Sahoo, Ankur Thakral, Udayan Ranjan
PURPOSE: Fracture of the styloid process of the temporal bone has been infrequently reported. The present study evaluated the incidence, causes, distribution, and management of styloid process fracture in association with other maxillofacial fractures. MATERIALS AND METHODS: A prospective evaluation of patients with maxillofacial trauma over a period of 1 year was carried out and patients' characteristics, mode and distribution of injury, and length of styloid process were recorded...
June 23, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28697212/maxillary-implant-prosthodontic-treatment-using-digital-laboratory-protocol-for-a-patient-with-epidermolysis-bullosa-a-case-history-report
#14
Rubén Agustín-Panadero, Blanca Serra-Pastor, David Peñarrocha-Oltra, Miguel Peñarrocha-Diago
Epidermolysis bullosa belongs to a group of genetic diseases that present with skin disorders and is characterized by generalized blister formation in response to mechanical trauma. This article reports on the management of a recessive dystrophic epidermolytic patient with four remaining periodontally compromised maxillary teeth. Treatment involved placement of four maxillary implants and use of computer-aided design/computer-assisted manufacture techniques to fabricate a fixed full-arch implant-supported prosthesis...
July 2017: International Journal of Prosthodontics
https://www.readbyqxmd.com/read/28670409/traumatic-spinal-cord-injury-long-term-motor-sensory-and-urinary-outcomes
#15
Rouzbeh Motiei-Langroudi, Homa Sadeghian
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28660819/selective-non-operative-management-of-abdominal-stab-wounds-is-a-safe-and-cost-effective-strategy-a-south-african-experience
#16
Kss Dayananda, V Y Kong, J L Bruce, G V Oosthuizen, G L Laing, D L Clarke
INTRODUCTION Selective non-operative management (SNOM) of abdominal stab wounds is well established in South Africa. SNOM reduces the morbidity associated with negative laparotomies while being safe. Despite steady advances in technology (including laparoscopy, computed tomography [CT] and point-of-care sonography), our approach has remained clinically driven. Assessments of financial implications are limited in the literature. The aim of this study was to review isolated penetrating abdominal trauma and analyse associated incurred expenses...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28652226/a-hybrid-web-based-and-in-person-self-management-intervention-to-prevent-acute-to-chronic-pain-transition-after-major-lower-extremity-trauma-ipact-e-trauma-protocol-for-a-pilot-single-blind-randomized-controlled-trial
#17
Mélanie Bérubé, Céline Gélinas, Géraldine Martorella, José Côté, Nancy Feeley, George-Yves Laflamme, Dominique Rouleau, Manon Choinière
BACKGROUND: Acute pain frequently transitions to chronic pain after major lower extremity trauma (ET). Several modifiable psychological risk and protective factors have been found to contribute to, or prevent, chronic pain development. Some empirical evidence has shown that interventions, including cognitive and behavioral strategies that promote pain self-management, could prevent chronic pain. However, the efficacy of such interventions has never been demonstrated in ET patients. We have designed a self-management intervention to prevent acute to chronic pain transition after major lower extremity trauma (iPACT-E-Trauma)...
June 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28647046/assessment-of-emergency-general-surgery-care-based-on-formally-developed-quality-indicators
#18
Angela Ingraham, Avery Nathens, Andrew Peitzman, Allison Bode, Gina Dorlac, Warren Dorlac, Preston Miller, Mahsa Sadeghi, Deena D Wasserman, Karl Bilimoria
BACKGROUND: Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. METHODS: We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators...
August 2017: Surgery
https://www.readbyqxmd.com/read/28644101/safety-and-cost-efficiency-of-a-restrictive-transfusion-protocol-in-patients-with-traumatic-brain-injury
#19
Laura B Ngwenya, Catherine G Suen, Phiroz E Tarapore, Geoffrey T Manley, Michael C Huang
OBJECTIVE Blood loss and moderate anemia are common in patients with traumatic brain injury (TBI). However, despite evidence of the ill effects and expense of the transfusion of packed red blood cells, restrictive transfusion practices have not been universally adopted for patients with TBI. At a Level I trauma center, the authors compared patients with TBI who were managed with a restrictive (target hemoglobin level > 7 g/dl) versus a liberal (target hemoglobin level > 10 g/dl) transfusion protocol. This study evaluated the safety and cost-efficiency of a hospital-wide change to a restrictive transfusion protocol...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#20
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
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