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"Triage" AND "Trauma"

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
Cassie N Lux, William T N Culp, Matthew S Mellema, Desiree D Rosselli, Chad W Schmiedt, Ameet Singh, April Haynes, Laura E Selmic, Heidi Phillips, Milan Milovancev, Philipp D Mayhew, Dorothy C Brown
OBJECTIVE To determine the most common types of injuries in cats surgically treated for thoracic trauma, complications associated with surgical treatment, and factors associated with mortality rate and evaluate the effectiveness of the animal trauma triage (ATT) scoring system for predicting outcome. DESIGN Retrospective case series with nested observational study. ANIMALS 23 client-owned cats surgically treated for thoracic trauma at 7 veterinary teaching hospitals between 1990 and 2014. PROCEDURES Medical records were reviewed to collect data on signalment, medical history, clinical signs and physical examination findings at initial evaluation, clinicopathologic findings, initial emergency treatments and diagnostic tests performed, type of trauma sustained, imaging findings, surgery details, postoperative complications, duration of hospitalization, and cause of death, if applicable...
September 1, 2018: Journal of the American Veterinary Medical Association
Terje Nordgarden, Peter Odland, Anne Berit Guttormsen, Kristina Stølen Ugelvik
BACKGROUND: Studies show increased mortality among severely injured patients not met by trauma team. Proper triage is important to ensure that all severely injured patients receive vital trauma care. In 2017 a new national trauma plan was implemented in Norway, which recommended the use of a modified version of "Guidelines for Field Triage of Injured Patients" to identify severely injured patients. METHODS: A retrospective study of 30,444 patients admitted to Haukeland University Hospital in 2013, with ICD-10 injury codes upon discharge...
August 14, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Katharine D Harper, Courtney Quinn, Joshua Eccles, Frederick Ramsey, Saqib Rehman
BACKGROUND: Recent literature has demonstrated that emergent administration of antibiotics is perhaps more critical than even emergent debridement. Most recent studies recommend patients receive antibiotics no later than 1 hour after injury to prevent infection. The objective of this study is to evaluate the time to antibiotic administration after patients with open fractures arrive to a trauma center depending on triaging team. METHODS: A retrospective study at a level 1 Trauma center from January 2013 to March 2015 where 117 patients with open fractures were evaluated...
2018: PloS One
Jo-Annie Letendre, Robert Goggs
Trauma is common in dogs and causes significant morbidity and mortality, but it remains a challenge to assess prognosis in these patients. This study aimed to investigate the use of plasma cell-free DNA (cfDNA) and nucleosome concentrations as prognostic biomarkers in canine trauma. Using a prospective, observational case-control study design, 49 dogs with trauma were consecutively enrolled from 07/2015 to 10/2017 and followed to hospital discharge. Dogs with animal trauma triage (ATT) scores ≥3 at presentation were eligible for enrollment...
2018: Frontiers in Veterinary Science
Robert Goggs, Jo-Annie Letendre
Trauma is common in dogs and causes significant morbidity and mortality, but it remains challenging to predict the prognosis of dogs with traumatic injuries. This study aimed to quantify plasma high-mobility group box-1 (HMGB-1) and cytokine concentrations in dogs with moderate-to-severe trauma, and to evaluate the association between these biomarkers and the injury severity and survival to discharge. Using a prospective, observational case-control study design, 49 dogs with an animal trauma triage (ATT) score ≥3 were consecutively enrolled from 07/2015 to 10/2017 and followed to hospital discharge...
2018: Frontiers in Veterinary Science
Ole-Petter Vinjevoll, Oddvar Uleberg, Elaine Cole
BACKGROUND: Sensitive decision making tools should assist prehospital personnel in the triage of injured patients, identifying those who require immediate lifesaving interventions and safely reducing unnecessary under- and overtriage. In 2014 a new trauma team activation (TTA) tool was implemented in Central Norway. The overall objective of this study was to evaluate the ability of the new TTA tool to identify severe injury. METHODS: This was a multi-center observational cohort study with retrospective data analysis...
August 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Kevin Kei-Ching Hung, Janice H H Yeung, Catherine S K Cheung, Ling-Yan Leung, Raymond C H Cheng, N K Cheung, Colin A Graham
BACKGROUND: With the aging population, the number of older patients with multiple injuries is increasing. The aim of this study was to understand the patterns and outcomes of older patients admitted to a major trauma centre in Hong Kong from 2006 to 2015, and investigate the performance of the trauma team activation (TTA) criteria for these elderly patients. METHODS: This was a retrospective cohort study from a university hospital major trauma centre in Hong Kong from 2006 to 2015...
June 5, 2018: American Journal of Emergency Medicine
Melissa K James, Lavonne A Clarke, Rose M Simpson, Anthony J Noto, Joshua R Sclair, Geoffrey K Doughlin, Shi-Wen Lee
STUDY OBJECTIVE: The aim of this study is to determine the accuracy of pre-hospital trauma notifications and the effects of inaccurate information on trauma triage. METHODS: This study was conducted at a level-1 trauma center over a two-year period. Data was collected from pre-notification forms on trauma activations that arrived to the emergency department via ambulance. Trauma activations with pre-notification were compared to those without notification and pre-notification forms were assessed for accuracy and completeness...
June 27, 2018: American Journal of Emergency Medicine
Shaukat Ali Jawaid, Masood Jawaid
Authors under pressure to publish to meet some academic requirement are one of the most dangerous pressure group which the editors of good quality peer review biomedical journals have to face every day. Their failure to read and follow instructions for authors which are published on every journal website, lack of training facilities in research methodology, medical writing, and low computer literacy rate leads to increased trauma to their manuscripts. The authors must realize that from submission to final publication manuscripts go through various stages i...
May 2018: Pakistan Journal of Medical Sciences Quarterly
Linnéa Lagerstedt, Juan José Egea-Guerrero, Alejandro Bustamante, Ana Rodríguez-Rodríguez, Amir El Rahal, Manuel Quintana-Diaz, Roser García-Armengol, Carmen Melinda Prica, Elisabeth Andereggen, Lara Rinaldi, Asita Sarrafzadeh, Karl Schaller, Joan Montaner, Jean-Charles Sanchez
Mild traumatic brain injury (mTBI) patients may have trauma-induced brain lesions detectable using CT scans. However, most patients will be CT-negative. There is thus a need for an additional tool to detect patients at risk. Single blood biomarkers, such as S100B and GFAP, have been widely studied in mTBI patients, but to date, none seems to perform well enough. In many different diseases, combining several biomarkers into panels has become increasingly interesting for diagnoses and to enhance classification performance...
2018: PloS One
Jerome Manson, Kristen Burke, Catherine P Starnes, Kristin Long, Paul A Kearney, Andrew Bernard
Centers for disease control (CDC) Guidelines for Field Triage are effective when proper implementation by EMS personnel is paired with surgeon willingness to care for trauma victims. We hypothesized that in a state with an immature trauma system, a discrepancy exists between medic and surgeon perception of surgical readiness, coinciding with inconsistent implementation of protocols. Surveys were conducted among medics and general surgeons. Destination protocols, trauma center locations, surgeon readiness, and interest in trauma were assessed...
June 1, 2018: American Surgeon
Zhao-Wen Zong, Si-Xu Chen, Hao Qin, Hua-Ping Liang, Lei Yang, Yu-Feng Zhao
The characteristics and treatment of pelvic fractures vary between general conditions and modern war. An expert consensus has been reached based on pelvic injury epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. According to this consensus, first aid, emergency treatment and early treatment of pelvic fractures are introduced in three separate levels. In Level I facilities, simple triage and rapid treatment following the principles of advanced trauma life support are recommended to evaluate combat casualties during the first-aid stage...
June 30, 2018: Military Medical Research
S P Mackenzie, T H Carter, J G Jefferies, J B J Wilby, P Hall, A D Duckworth, J F Keating, T O White
Aims: The Edinburgh Trauma Triage Clinic (TTC) streamlines outpatient care through consultant-led 'virtual' triage of referrals and the direct discharge of minor fractures from the Emergency Department. We compared the patient outcomes for simple fractures of the radial head, little finger metacarpal, and fifth metatarsal before and after the implementation of the TTC. Patients and Methods: A total of 628 patients who had sustained these injuries over a one-year period were identified...
July 2018: Bone & Joint Journal
S P Mackenzie, T H Carter, J G Jefferies, J B J Wilby, P Hall, A D Duckworth, J F Keating, T O White
No abstract text is available yet for this article.
July 2018: Bone & Joint Journal
Paula T Ross, James T Fitzgerald, Divy Ravindranath, Paul N Pfeiffer, Mamta K Singh, Saul J Weiner, Deborah M Rooney, Stacie Buckler, Laurie Whitman, Brook Watts, Dorian Jones, Adam S Tremblay, Monica L Lypson
Background : Despite their placement in Veterans Health Administration centers nationwide, residents' training and assessment in veteran-centered care is variable and often insufficient. Objective : We assessed residents' ability to recognize and address mental health issues that affect US military veterans. Methods : Two unannounced standardized patient (SP) cases were used to assess internal medicine residents' veteran-centered care skills from September 2014 to March 2016...
June 2018: Journal of Graduate Medical Education
Benedetta Riva, Antonio Clavenna, Massimo Cartabia, Angela Bortolotti, Ida Fortino, Luca Merlino, Andrea Biondi, Maurizio Bonati
Objectives: To estimate the rate of paediatric attendance at emergency departments (EDs) in the Lombardy Region, Italy, and to determine the factors contributing to different patterns of use. Methods: By analysing healthcare administrative databases, ED attendance by 1.6 million youths <18 years old during 2012 in the Lombardy Region was assessed. The pattern of use was categorised based on the number of ED visits and level of emergency, defined by triage code and outcome of the visit...
2018: BMJ Paediatrics Open
Anette Lemström
AimsHelsinki University Hospital for Children and Adolescents treats 0-to 16-year old pediatric and surgical patients. The patients arrive to the emergency unit by ambulance, referral or by decision of the triage nurse. The most common reason for visit is pain. VAS pain scale should be used, but pain is not evaluated properly. The aim of this study was to review literature on evaluation and treatment of pain in pediatric emergency unit. MethodsA search from Cinahl and Finnish Medic-database covering last 10 years was performed using: pain, child, trauma, documentation, evaluation, emergency and assessment as keywords...
December 29, 2017: Scandinavian Journal of Pain
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