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"Trauma" OR "Blunt Trauma" OR "Penetrating Trauma" OR "Severe Trauma" OR "Trauma Centre" OR "Trauma Center" OR "Trauma Service" OR "Trauma Guidelines" OR "Head Trauma" OR "Facial Trauma" OR "Neck Trauma" OR "Airway Trauma" OR "Thoracic Trauma" OR "Chest T

Jenna Kroeker, Jay Keith, Hailey Carruthers, Cherry Hanna, Natasha Qureshi, Masa Calic, Meagan Kaye, Marissa Solow, James Coey, Sara Sulaiman
INTRODUCTION: Protocol advocates the use of rigid cervical collars (RCCs) in head trauma patients as they are at risk of concomitant cervical spine injury. Literature has shown RCCs to be a potential cause of venous outflow obstruction, changing internal jugular vein (IJV) cross-sectional area (CSA), and raising intracranial pressure (ICP). This study aims to investigate the effects of applying a RCC, for a period of four hours, on the dimensions of the IJV, in healthy participants. MATERIALS AND METHODS: Seventeen participants (nine male, eight female) took part in this study...
August 17, 2018: Clinical Anatomy
Pei Ing Ngam, Ching Ching Ong, Christopher Cy Koo, Poay Huan Loh, Lynette Ma Loo, Lynette Ls Teo
No abstract text is available yet for this article.
July 2018: Annals of the Academy of Medicine, Singapore
S Kolta, A Etcheto, J Fechtenbaum, A Feydy, C Roux, K Briot
Purpose/Introduction: Measurement of trabecular bone score (TBS® ) of the lumbar spine on dual energy X-ray absorptiometry (DXA) devices improves fracture risk prediction. We conducted a proof of concept study to assess the feasibility of TBS® measured on the low-dose imaging system EOS® . METHODS: TBS was assessed on both DXA and EOS® in 122 patients aged ≥ 50 yr, receiving no anti-osteoporotic treatment. The TBS® was computed on full-body EOS® images, focusing on the lumbar spine region...
July 4, 2018: Journal of Clinical Densitometry
Ambrose H Wong, R Andrew Taylor, Jessica M Ray, Steven L Bernstein
STUDY OBJECTIVE: The prevalence of agitation among emergency department (ED) patients is increasing. Physical restraints are routinely used to prevent self-harm and to protect staff, but are associated with serious safety risks. To date, characterization of physical restraint use in the emergency setting has been limited. We thus aim to describe restraint patterns in the general ED to guide future investigation in the management of behavioral disorders. METHODS: We conducted a cross-sectional study of adult patients presenting to 5 adult EDs within a large regional health system for 2013 to 2015, and with a physical restraint order during their visit...
August 14, 2018: Annals of Emergency Medicine
Quirine M J van der Vliet, Oscar E C van Maarseveen, Diederik P J Smeeing, Roderick M Houwert, Karlijn J P van Wessem, Rogier K J Simmermacher, Geertje A M Govaert, Mirjam B de Jong, Ivar G J de Bruin, Luke P H Leenen, Falco Hietbrink
INTRODUCTION: There is continuous drive to optimize healthcare for the most severely injured patients. Although still under debate, a possible measure is to provide 24/7 in-house (IH) coverage by trauma surgeons. The aim of this study was to compare process-related outcomes for severely injured patients before and after transition of attendance policy from an out-of-hospital (OH) on-call attending trauma surgeon to an in-house attending trauma surgeon. METHODS: Retrospective before-and-after study using prospectively gathered data in a Level 1 Trauma Center in the Netherlands...
August 10, 2018: Injury
Catherine Go, Youngjae J Chun, Jenna Kuhn, Yanfei Chen, Sung Kwon Cho, William C Clark, Bryan W Tillman
OBJECTIVE: Early hemorrhage control before the operating room is essential to reduce the significant mortality associated with traumatic injuries of the vena cava. Conventional approaches present logistical challenges on the battlefield or in the trauma bay. A retrievable stent graft would allow rapid hemorrhage control in the preoperative setting when endovascular expertise is not immediately available and without committing a patient to the limitations of current permanent stents. This study details a refined retrievable Rescue stent for percutaneous delivery that was examined in a porcine survival model of penetrating caval hemorrhage...
September 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Yeshambel Belyhun, Feleke Moges, Mengistu Endris, Banchamlak Asmare, Bemnet Amare, Damtew Bekele, Solomon Tesfaye, Martha Alemayehu, Fantahun Biadgelegne, Andargachew Mulu, Yared Assefa
OBJECTIVES: Empirical selections of antimicrobial therapy based on clinical observations are common clinical practices in Ethiopia. This study identified common external ocular infections and determined antibiotic susceptibility testing in northwest Ethiopia. RESULTS: Among 210 patients studied, conjunctivitis 32.9%(69), blepharitis 26.7%(56), dacryocystitis 14.8%(51), blepharoconjunctivitis 11.9%(25), and trauma 10.0%(21) were the most common external ocular infections...
August 17, 2018: BMC Research Notes
Edward Baker, Andreas Xyrichis, Christine Norton, Philip Hopkins, Geraldine Lee
BACKGROUND: Major Trauma remains a leading cause of mortality and morbidity worldwide. Blunt Thoracic Injury (BTI) accounts for > 15% of United Kingdom (UK) trauma admissions and is consistently associated with respiratory related complications that include pneumonia and respiratory failure. Despite this, it is unclear in current clinical practice how BTI impacts on the recovering trauma patients after discharge from hospital. This study aimed to investigate the state of knowledge on the impact of BTI on the long-term outcomes and health-related quality of life (HRQoL)...
August 17, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Aline B Maddux, Matthew Cox-Martin, Michael Dichiaro, Tellen D Bennett
OBJECTIVES: To determine the association between the Functional Status Scale and Pediatric Functional Independence Measure scores during the rehabilitation stay in children who survive traumatic brain injury. DESIGN: Secondary analysis of a prospective observational cohort study. SETTING: Tertiary care children's hospital with a level 1 trauma center and inpatient rehabilitation service. PATIENTS: Sixty-five children less than 18 years old admitted to an ICU with acute traumatic brain injury and subsequently transferred to the inpatient rehabilitation service...
August 16, 2018: Pediatric Critical Care Medicine
Elizabeth Y Killien, Brianna Mills, R Scott Watson, Monica S Vavilala, Frederick P Rivara
OBJECTIVES: To determine risk factors identifiable at hospital arrival associated with acute respiratory distress syndrome development among critically injured children. DESIGN: Retrospective cohort study. SETTING: Level I or II adult or pediatric trauma centers contributing to the National Trauma Data Bank from 2007 to 2016. PATIENTS: Patients less than 18 years admitted to an ICU with traumatic injury. INTERVENTIONS: None...
August 16, 2018: Critical Care Medicine
Holly A Swartz, Jill M Cyranowski, Yu Cheng, Marlissa Amole
OBJECTIVE: Treatment of maternal depression with psychotherapy has been shown to confer indirect benefits to school-age offspring with psychiatric disorders. The current study sought to understand mechanisms by which improvement in depressed mothers, with and without histories of trauma and treated with psychotherapy, produce changes in children who struggle with psychiatric illnesses themselves. We hypothesized that maternal history of childhood trauma would moderate the relationship between maternal and child outcomes and that increased positive and decreased negative parenting behaviors would mediate the relationship between maternal and child outcomes...
August 3, 2018: Comprehensive Psychiatry
Basil K Williams, Maura Di Nicola, Sandor Ferenczy, Jerry A Shields, Carol L Shields
PURPOSE: To describe the clinical and imaging findings and treatment options in a series of patients with iris microhemangiomatosis. DESIGN: Retrospective observational case series. METHODS: Setting: Single institution. STUDY POPULATION: Twenty-two eyes of 14 consecutive patients with iris microhemangiomatosis were reviewed. OBSERVATION PROCEDURES: Clinical examination and slit lamp photography were performed on every patient...
August 14, 2018: American Journal of Ophthalmology
Brian D Sumner, Emily A Grimsley, Niall H Cochrane, Ryan R Keane, Alexis B Sandler, Paul C Mullan, Karen J O'Connell
BACKGROUND: The National Association of EMS Physicians emphasizes the importance of high quality communication between emergency medical services (EMS) providers and emergency department (ED) staff for providing safe, effective care. The Joint Commission has identified ineffective handoff communication as a contributing factor in 80% of serious medical errors. The quality of handoff communication from EMS to ED teams for critically ill pediatric patients needs further exploration. OBJECTIVE: This study assessed the quality of handoff communication between EMS and ED staff during pediatric medical resuscitations...
August 17, 2018: Prehospital Emergency Care
Steven G Schauer, Jason F Naylor, Joseph K Maddry, Carmen Hinojosa-Laborde, Michael D April
BACKGROUND: Tactical Combat Casualty Care (TCCC) guidelines regarding prehospital analgesia agents have evolved. The guidelines stopped recommending intramuscular (IM) morphine in 1996, recommending only intravenous (IV) routes. In 2006, the guidelines recommended oral transmucosal fentanyl citrate (OTFC), and in 2012 it added ketamine via all routes. It remains unclear to what extent prehospital analgesia administered on the battlefield adheres to these guidelines. We seek to describe trends in analgesia administration patterns on the battlefield during 2007-2016...
August 17, 2018: Prehospital Emergency Care
Tracy Shamas, Sarah Gillespie-Heyman
One aspect of palliative medicine that has been underexplored is the perspective of veterans either facing critical life-limiting illness or at the end of life. The needs of veterans differ not only because military culture affects how veterans cope with their illness but also because exposure-related factors (combat and environmental) differ between military branches. In this paper, we describe two cases involving end-of-life care for veterans with combat trauma and describe individualized approaches to their care...
August 1, 2018: AMA Journal of Ethics
Tetyana Gorbachova, Yulia Melenevsky, Micah Cohen, Brett W Cerniglia
Several pathologic conditions may manifest as an osteochondral lesion of the knee that consists of a localized abnormality involving subchondral marrow, subchondral bone, and articular cartilage. Although understanding of these conditions has evolved substantially with the use of high-spatial-resolution MRI and histologic correlation, it is impeded by inconsistent terminology and ambiguous abbreviations. Common entities include acute traumatic osteochondral injuries, subchondral insufficiency fracture, so-called spontaneous osteonecrosis of the knee, avascular necrosis, osteochondritis dissecans, and localized osteochondral abnormalities in osteoarthritis...
August 17, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Charles-Henri Houzé-Cerfon, Vincent Bounes, Johanna Guemon, Thibault Le Gourrierec, Thomas Geeraerts
OBJECTIVE: In Trauma brain injury (TBI) patients, early detection and subsequent prompt treatment of elevated intracranial pressure (ICP) is a challenge in the pre-hospital setting, as physical examination is limited in comatose patients, and invasive device placement not possible. The aim of this study was to evaluate the quality and feasibility of Optic Nerve Sheath Diameter (ONSD) measurements obtained during the prehospital management of TBI patients. METHODS: Prospective, observational study of 23 moderate and severe TBI patients during pre-hospital medical care...
August 17, 2018: Prehospital Emergency Care
Samuel M Galvagno, Michael Massey, Pierre Bouzat, Roumen Vesselinov, Matthew J Levy, Michael G Millin, Deborah M Stein, Thomas M Scalea, Jon Mark Hirshon
STUDY OBJECTIVE: Prehospital triage of the seriously injured patient is fraught with challenges and trauma scoring systems in current triage guidelines warrant further investigation. The primary objective of this study was to assess the correlation of the physiologically based Revised Trauma Score (RTS) and MGAP score (mechanism of injury, Glasgow coma scale, age, blood pressure) with the anatomically based Injury Severity Score (ISS). The secondary objectives for this study were to compare the accuracy of the MGAP score and the RTS for the prediction of in-hospital mortality for trauma patients...
August 17, 2018: Prehospital Emergency Care
Philip H Schroeder, Nicholas J Napoli, William F Barnhardt, Laura E Barnes, Jeffrey S Young
OBJECTIVE: This study sought to address the disagreement in literature regarding the "golden hour" in trauma by using the Relative Mortality Analysis to overcome previous studies' limitations in accounting for acuity when evaluating the impact of prehospital time on mortality. METHODS: The previous studies that failed to support the "golden hour" suffered from limitations in their efforts to account for the confounding effects of patient acuity on the relationship between prehospital time and mortality in their trauma populations...
August 17, 2018: Prehospital Emergency Care
Angela M Groves, Jacqueline P Williams, Eric Hernady, Christina Reed, Bruce Fenton, Tanzy Love, Jacob N Finkelstein, Carl J Johnston
Biomarkers could play an essential role during triage in the aftermath of a radiological event, where exposure to radiation will be heterogeneous and complicated by concurrent trauma. Used alongside biodosimetry, biomarkers can identify victims in need of treatment for acute radiation effects, and might also provide valuable information on later developing consequences that need to be addressed as part of a treatment strategy. Indeed, because the lung is particularly sensitive to radiation and resultant late effects not only affect quality of life, but can also lead to morbidity, the risk of developing downstream pulmonary complications in exposed individuals requires assessment...
August 17, 2018: Radiation Research
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