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https://www.readbyqxmd.com/read/30551800/evaluation-of-a-practice-improvement-protocol-for-patient-transfer-from-the-emergency-department-to-the-surgical-intensive-care-unit-after-a-level-i-trauma-activation
#1
Sarah Stankiewicz, Craig Larsen, Francesca Sullivan, Cristina Zullo, Suzanne C Pugh, Miroslav Kopp
BACKGROUND: ED boarding is a major issue in many hospitals. ED boarding occurs when there is insufficient hospital capacity to supply inpatient beds for admitted patients. ED boarding is not only a problem because of increased wait times for patients but also because it results in delays in administration of medication, higher rates of complications, and increased mortality. METHODS: In an attempt to improve patient flow and reduce time spent in the emergency department for patients requiring admission to the surgical intensive care unit (SICU), the emergency department, trauma service, and SICU collaborated on a guideline...
December 11, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/30535521/predictive-capability-of-the-injury-severity-score-versus-the-new-injury-severity-score-in-the-categorization-of-the-severity-of-trauma-patients-a-cross-sectional-observational-study
#2
Rebeca Abajas Bustillo, Francisco José Amo Setién, María Del Carmen Ortego Mate, María Seguí Gómez, María Jesús Durá Ros, César Leal Costa
PURPOSE: The AIS scale is a measurement tool for single injuries. The ISS is considered the gold standard for determining the severity of injured patients, and the NISS was developed to improve the ISS with respect to loss of information, as well as to facilitate its calculation. The aim of this study was to analyse what injury severity measure, calculated according to the Abbreviated Injury Scale (AIS), 1998 and 2005 (update 2008) versions, performs better with mortality, cost and hospital length of stay healthcare indicators...
December 8, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30505681/object-motion-detection-based-on-passive-uhf-rfid-tags-using-a-hidden-markov-model-based-classifier
#3
Young Ho Lee, Ivan Marsic
We present an object motion detection system using backscattered signal strength of passive UHF RFID tags as a sensor for providing information on the movement and identity of work objects-important cues for activity recognition. For using the signal strength for accurate detection of object movement we propose a novel Markov model with continuous observations, RSSI preprocessor, frame-based data segmentation, and motion-transition finder. We use the change of backscattered signal strength caused by tag's relocation to reliably detect movement of tagged objects...
November 2018: Sensing and Bio-Sensing Research
https://www.readbyqxmd.com/read/30503515/determining-the-impact-of-culture-on-venous-thromboembolism-prevention-in-trauma-patients-a-southwestern-surgical-congress-multicenter-trial
#4
Justin L Regner, Courtney N Shaver
INTRODUCTION: Venous thromboembolism (VTE) remains one of the principal causes of morbidity and death in trauma patients that survive the first 24 h. Recent literature on VTE prevention focuses on choice of chemoprophylaxis, specifically unfractionated heparin (UFH) versus low molecular weight heparin (LMWH). This singular focus on a multifactorial process may be inadequate to fully understand the optimal approach to VTE prevention. We hypothesized that variations in care between trauma centers could be used to identify key components of VTE prevention associated with better outcomes...
November 20, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/30498792/childhood-injuries-in-oman-retrospective-review-of-a-multicentre-trauma-registry-data
#5
Amber Mehmood, Priyanka Agrawal, Katharine A Allen, Ammar Al-Kashmiri, Ali Al-Busaidi, Adnan Ali Hyder
Objectives: Injuries are among the top causes of hospital-based mortality for adults in Oman. However, little is known about the distribution and risk of injuries among children. This paper describes the epidemiology and risk factors for childhood injuries (0-15 years of age), in two hospitals of Oman. Methods: Data were collected between November 2014 and April 2015 at Khoula and Nizwa Hospitals. All patients between 0 and 15 years with a diagnosis of injury/trauma admitted to the hospital, and those who had trauma team activation in the emergency department were included in the analysis...
2018: BMJ Paediatrics Open
https://www.readbyqxmd.com/read/30470686/patterns-of-moderate-and-severe-injury-in-children-after-the-introduction-of-major-trauma-networks
#6
Samantha Jones, Sarah Tyson, Michael Young, Matthew Gittins, Naomi Davis
OBJECTIVE: To describe the demographics, mechanisms, presentation, injury patterns and outcomes for children with traumatic injuries. SETTING: Data collected from the UK's Trauma and Audit Research Network. DESIGN AND PATIENTS: The demographics, mechanisms of injury and outcomes were described for children with moderate and severe injuries admitted to the Major Trauma Network in England between 2012 and 2017. RESULTS: Data regarding 9851 children were collected...
November 23, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/30463744/acute-kidney-injury-on-presentation-to-a-major-trauma-service-is-associated-with-poor-outcomes
#7
David Lee Skinner, Victor Y Kong, Kim de Vasconcellos, John L Bruce, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This study sought to describe the burden of disease of acute kidney injury (AKI) among adult South African trauma patients who presented to a tertiary level trauma service. METHODS: The trauma database was interrogated for the period from December 2012 to July 2017. All patients over the age of 18 y, who were admitted following trauma, were included. Outcome data were reviewed. This included in-hospital mortality, need for intensive care unit admission, and length of stay...
December 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/30429147/retrospective-analysis-of-alcohol-testing-in-trauma-team-activation-patients-at-a-canadian-tertiary-trauma-centre
#8
Mete Erdogan, Nelofar Kureshi, Saleema A Karim, John M Tallon, Mark Asbridge, Robert S Green
OBJECTIVES: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing...
November 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/30415875/complicated-mild-traumatic-brain-injury-at-a-level-i-pediatric-trauma-center-burden-of-care-and-imaging-findings
#9
Colby Hansen, Maya Battikha, Masaru Teramoto
OBJECTIVE: The aims of this study were: (1) to characterize mild traumatic brain injury (mTBI), mTBI with skull fracture, and complicated mTBI in school-aged children seen at a Level I pediatric trauma center and (2) to examine the nature of imaging findings seen in children with mTBI with skull fracture and those with complicated mTBI. METHODS: A total of 1777 pediatric patients (male: 1193 or 67.1%; age = 11.1 ± 3.5 years) sustaining mTBI who presented to the Emergency Department or directly to the trauma service in the years 2010 to 2013 were identified and classified into mTBI (n = 1,319 or 74...
October 6, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/30402561/mass-casualty-events-what-to-do-as-the-dust-settles
#10
Rachel M Russo, Joseph M Galante, John B Holcomb, Warren Dorlac, Jason Brocker, David R King, M Margaret Knudson, Thomas M Scalea, Michael L Cheatham, Raymond Fang
Care during mass casualty events (MCE) has improved during the last 15 years. Military and civilian collaboration has led to partnerships which augment the response to MCE. Much has been written about strategies to deliver care during an MCE, but there is little about how to transition back to normal operations after an event. A panel discussion entitled The Day(s) After: Lessons Learned from Trauma Team Management in the Aftermath of an Unexpected Mass Casualty Event at the 76th Annual American Association for the Surgery of Trauma meeting on September 13, 2017 brought together a cadre of military and civilian surgeons with experience in MCEs...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/30402557/evaluation-of-the-georgia-trauma-system-using-the-american-college-of-surgeons-needs-based-assessment-of-trauma-systems-tool
#11
Dennis W Ashley, Etienne E Pracht, Laura E Garlow, Regina S Medeiros, Elizabeth V Atkins, Tracy J Johns, Colville H Ferdinand, Christopher J Dente, James R Dunne, Jeffrey M Nicholas
Background: The American College of Surgeons Needs Based Assessment of Trauma Systems (NBATS) tool was developed to help determine the optimal regional distribution of designated trauma centers (DTC). The objectives of our current study were to compare the current distribution of DTCs in Georgia with the recommended allocation as calculated by the NBATS tool and to see if the NBATS tool identified similar areas of need as defined by our previous analysis using the International Classification of Diseases, Ninth Revision, Clinical Modification Injury Severity Score (ICISS)...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/30361932/-reduction-of-treatment-time-for-children-in-the-trauma-room-care-impact-of-implementation-of-an-interdisciplinary-trauma-room-concept-itrap-s
#12
M Lehner, F Hoffmann, B Kammer, M Heinrich, L Falkenthal, D Wendling-Keim, M Kurz
INTRODUCTION: In addition to infrastructural and conceptual planning, smooth interdisciplinary cooperation is crucial for trauma room care of severely injured children based on time-saving management and a clear set of priorities. The time to computed tomography (CT) is a well-accepted marker for the efficacy of trauma management. Up to now there are no guidelines in the literature for an adapted approach in pediatric trauma room care. METHODS: A step-by-step algorithm for pediatric trauma room care (Interdisciplinary Trauma Room Algorithm in Pediatric Surgery, iTRAPS ) was developed within the framework of an interdisciplinary team: pediatric surgeons, pediatric anaethesiologists, pediatric intensivists and pediatric radiologists...
October 25, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/30349902/designing-and-optimizing-digital-applications-for-medical-emergencies
#13
Alyssa Klein, Leah Kulp, Aleksandra Sarcevic
In this ongoing study, we aim to redesign an existing dynamic digital checklist application (app) for trauma resuscitations in a regional trauma center. The design followed an iterative, user-centered approach. Trauma team physician leaders and research coordinators at the center participated in a survey and usability study to provide feedback for improving the user interface. Proper optimization of the user experience is necessary for future adoption of the digital checklist. This study lays the groundwork for in situ use and evaluation of the checklist by trauma team members...
April 2018: Extended Abstracts on Human Factors in Computing Systems
https://www.readbyqxmd.com/read/30338447/general-practitioner-attitudes-and-experiences-of-orthopaedic-services-in-the-irish-midlands
#14
Marc F O'Reilly, Khalid M Mohamed, Eoin C Sheehan
INTRODUCTION: Disorders of the musculoskeletal system are the main cause of disability and lost working days worldwide, and osteoarthritis affects almost half a million people in Ireland. Appropriate access and resourcing of general practice and orthopaedics is a necessary measure for the provision of a safe and efficient health service. One area that remains particularly challenging in Ireland is that of outpatient waiting lists, and the purpose of this study was to assess the attitudes and experiences of general practitioners in the Irish midlands with regard to orthopaedic services and to evaluate these in the context of national strategies and international best practice...
October 18, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/30318283/the-performance-of-trauma-team-activation-criteria-at-an-australian-regional-hospital
#15
Mitchell Cameron, Kathleen M McDermott, Lewis Campbell
OBJECTIVE: It is common practice for hospitals to use a trauma team activation criteria (TTAC) to identify patients at risk of major trauma and to activate a multidisciplinary team to receive such patients on arrival to the ED. The aims of this study are to describe the frequency of individual criteria and the ability of one currently used system to predict major trauma, and to estimate the effect of simplified criteria on the prediction. DESIGN AND SETTING: A retrospective observational study of the entire cohort of adult patients who a) received trauma team activation or b) were included in the trauma registry of Royal Darwin Hospital in 2015...
October 5, 2018: Injury
https://www.readbyqxmd.com/read/30308539/simultaneous-damage-control-surgery-and-endovascular-procedures-for-patients-with-blunt-trauma-in-the-hybrid-emergency-room-system-hers-new-multidisciplinary-trauma-team-building
#16
Kaori Ito, Tsuyoshi Nagao, Kahoko Nakazawa, Akinori Kato, Hiroto Chiba, Hiroshi Kondo, Yasufumi Miyake, Tetsuya Sakamoto, Takashi Fujita
No abstract text is available yet for this article.
October 10, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30302552/experienced-trauma-team-leaders-save-the-lives-of-multiple-trauma-patients-with-severe-head-injuries
#17
Zhi-Jie Hong, Cheng-Jueng Chen, De-Chuan Chan, Teng-Wei Chen, Jyh-Cherng Yu, Sheng-Der Hsu
The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan. From January 2009 to December 2013, 284 patients were randomly assigned to one of two trauma team leaders (junior and senior leaders) on duty, irrespective of the seniority of the qualified trauma team leader...
October 9, 2018: Surgery Today
https://www.readbyqxmd.com/read/30286652/a-selective-non-operative-approach-to-thoracic-stab-wounds-is-safe-and-cost-effective-a-south-african-experience
#18
Kss Dayananda, V Y Kong, J L Bruce, G V Oosthuizen, G L Laing, P Brysiewicz, D L Clarke
INTRODUCTION: Penetrating thoracic trauma is common and costly. Injuries are frequently and selectively amenable to non-operative management. Our selective approach to penetrating thoracic trauma is reviewed and the effectiveness of our clinical algorithms confirmed. Additionally, a basic cost analysis was undertaken to evaluate the financial impact of a selective nonoperative management approach to penetrating thoracic trauma. MATERIALS AND METHODS: The Pietermaritzburg Metropolitan Trauma Services electronic regional trauma registry hybrid electronic medical records were reviewed, highlighted all penetrating thoracic traumas...
October 5, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/30274901/patient-experiences-of-initial-trauma-care
#19
Anna Granström, Lovisa Strömmer, Ann-Charlotte Falk, Anna Schandl
BACKGROUND: Correct initial treatment of trauma patients reduces mortality and morbidity. However, the initial examination may be perceived as traumatic because of the stressful situation, the unfamiliar setting and the shock of being seriously injured. To date, little is known about patient's experiences of initial trauma management. The aim of this study was to explore trauma patients' experiences of being exposed to initial full trauma team assessment at a Level 1 trauma centre. METHODS: Interviews with 16 patients who had been exposed to initial trauma care were conducted at a Level 1 trauma centre, at a Swedish University Hospital...
September 28, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/30274757/external-benchmarking-of-trauma-services-in-new-south-wales-risk-adjusted-mortality-after-moderate-to-severe-injury-from-2012-to-2016
#20
David Gomez, Pooria Sarrami, Hardeep Singh, Zsolt J Balogh, Michael Dinh, Jeremy Hsu
BACKGROUND: Trauma centres and systems have been associated with improved morbidity and mortality after injury. However, variability in outcomes across centres within a given system have been demonstrated. Performance improvement initiatives, that utilize external benchmarking as the backbone, have demonstrated system-wide improvements in outcomes. This data driven approach has been lacking in Australia to date. Recent improvement in local data quality may provide the opportunity to engage in data driven performance improvement...
September 23, 2018: Injury
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