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https://www.readbyqxmd.com/read/30338447/general-practitioner-attitudes-and-experiences-of-orthopaedic-services-in-the-irish-midlands
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/30268182/atraumatic-transition-from-a-pediatric-emergency-center-to-a-pediatric-trauma-center-a-fight-for-better-outcomes
#8
Marina Gorelik, Adel Elkbuli, Shaikh Hai, Ascension Torres, Mark McKenney
Opening a new pediatric trauma center (PTC) is a sizable undertaking. A pediatric trauma team of specialists must be assembled, appropriate equipment and facilities prepared, and staff educated. Our PTC opened in May 2016, before that we had a pediatric emergency center. This study aimed to evaluate initial performance, and compare practices and outcomes before and after becoming a PTC. A review of prospectively collected data using our hospital's Trauma Registry. We compared patient profiles and outcomes 4...
September 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/30242444/-optimization-of-criteria-for-activation-of-trauma-teams-avoidance-of-overtriage-and-undertriage
#9
REVIEW
D Bieler, H Trentzsch, M Baacke, L Becker, H Düsing, B Heindl, K O Jensen, R Lefering, C Mand, O Özkurtul, T Paffrath, U Schweigkofler, K Sprengel, B Wohlrath, C Waydhas
INTRODUCTION: Severely injured patients are supposed to be admitted to hospital via the trauma room. Appropriate criteria are contained in the S3 guidelines on the treatment of patients with severe/multiple injuries (S3-GL); however, some of these criteria require scarce hospital resources while the patients then often clinically present as uninjured. There are tendencies to streamline the trauma team activation criteria (TTAC); however, additional undertriage must be avoided. A study group of the emergency, intensive care medicine and treatment of the severely injured section (NIS) is in the process of optimizing the TTAC for the German trauma system...
September 21, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/30241992/the-preferred-attributes-of-a-trauma-team-leader-evidence-from-a-discrete-choice-experiment
#10
David Mo, Nathan N O'Hara, Ross Hengel, Alexander R Cheong, Ash Singhal
OBJECTIVE: Leaders of a pediatric trauma team are tasked with managing rapidly changing diagnostic and treatment challenges, while ensuring the entire team functions effectively to produce optimal patient outcomes. An effective trauma team leader is often thought to be self-evident, and there is little formal literature identifying the leadership characteristics and attributes associated with optimal trauma team performance. The purpose of this study was to elicit the trauma team leader traits and characteristics deemed of greatest utility by members of the pediatric trauma team...
September 18, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/30234164/morning-report-decreases-length-of-stay-in-trauma-patients
#11
John D Wolfe, James R Gardner, William C Beck, John R Taylor, Avi Bhavaraju, Ben Davis, Mary Katherine Kimbrough, Ronald D Robertson, Saleema A Karim, Kevin W Sexton
Background: Modern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center. Methods: The University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/30229338/contrast-induced-nephropathy-following-ct-scan-for-trauma-is-not-rare-and-is-associated-with-increased-mortality-in-south-african-trauma-patients
#12
Asma Abubaker Bashir, Victor Kong, David Skinner, John Bruce, Grant Laing, Petra Brysiewicz, Damian Clarke
PURPOSE: Acute trauma patients are at risk for the development of acute kidney injury (AKI). One potential nephrotoxic agent, which a trauma patient may be exposed to, is iodinated contrast media (ICM). We aim to review the incidence and outcome of contrast-induced nephropathy (CIN) in trauma patients in a busy trauma service, and to identify potentially modifiable risk factors. METHODS: During the period from December 2012 to April 2017, all patients who underwent a contrast-enhanced CT scan for trauma were included...
September 18, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30227087/invasive-pulmonary-aspergillosis-risks-for-acquisition-and-death-in-a-community-hospital
#13
Morgan Lane, Mary Anne Szymeczek, Robert Sherertz, Kylie Meurtos, Jason D Sciarretta, John M Davis
BACKGROUND: Recent cases of hospital-acquired (HA) aspergillosis on our Trauma Service raised the question of whether this represented an outbreak or just increased case identification. PATIENTS AND METHODS: After Institutional Review Board approval, we performed a retrospective analysis of all 117 patients with positive pulmonary Aspergillus cultures at Grand Strand Medical Center from 2010 through 2016. The diagnosis of community-acquired (CA) invasive pulmonary aspergillosis (IPA) was determined when patients were admitted with a pneumonia and the diagnosis was made within the first week of hospitalization...
September 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/30225273/association-of-trauma-alert-response-charges-with-volume-and-hospital-ownership-type-in-florida
#14
Jessica L Ryan, Etienne E Pracht, Barbara Langland-Orban
Objective: The purpose was to analyze the association of trauma volume and hospital trauma center (TC) ownership type with trauma alert (TA) response charges, which are billed for activation of the trauma team to the emergency department (ED). Methods: All Florida ED and inpatients who were billed a TA charge from 2012 to 2014 were included (62 974 observations). Multiple linear regression, controlling for patient and hospital factors, was used to identify associations between TA charges and trauma volume and hospital ownership type...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30216752/craniofacial-trauma-is-associated-with-significant-psychosocial-morbidity-1-year-post-injury
#15
Kenleigh R McMinn, Monica Bennett, Mark B Powers, Michael L Foreman, Likith V Reddy, Ann Marie Warren
PURPOSE: The face and head play critical roles in one's sense of self and body image; as such, facial, head, and scalp injuries and potential associated disfigurement can lead to particular difficulties in coping. This study examined the psychosocial outcomes of patients with craniofacial (CF) trauma 1 year after injury and compared these outcomes with those of other traumatically injured patients who did not sustain such injuries. It was hypothesized that participants in the CF injury group would have worse outcomes than those without CF trauma...
August 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/30216263/a-tiered-approach-to-trauma-education-in-the-emergency-department
#16
Donna B Lee, Deb Battle
Although trauma centers are required to provide trauma education to nurses caring for trauma patients, there are no clearly defined standards for this education. In an effort to improve emergency department (ED) trauma nursing care, a tiered approach to ED trauma education (basic, intermediate, and advanced) was developed to provide specialized trauma education to a larger number of ED nurses at a Level II trauma center in Georgia. This tiered approach to ED trauma nurse education has resulted in the ability to quickly activate multiple trauma teams that work together competently and efficiently, leading to improved patient care and development of competent ED trauma nurses...
September 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/30216259/automated-postdischarge-trauma-patient-call-program
#17
Aaron Wright, Kelly Grady, Joseph Galante
Postdischarge phone calls have been shown to improve communications between patients and health care providers, potentially reducing readmission rates, medication errors, and emergency department (ED) visits. Given the complexity of social and medical issues associated with trauma, we studied the utility of an automated phone call system as a method of identifying gaps in trauma care. The Trauma Program and the Health Management and Education Department at a Level 1 academic trauma center engaged in a collaborative quality improvement effort using the CipherHealth LLC platform to provide automated phone calls to trauma patients 2-3 days after discharge...
September 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/30189060/radiology-imaging-trauma-patients-in-a-deployed-setting
#18
John Ritter, Seth O'Brien, Dennis Rivet, Ian Gibb, Jamie Grimes, Sidney Hinds, Robert Jessinger, Todd May, Michael Wirt, Stacy Shackelford, Octavian Adam, Gerald York, Brittany Ritchie, Rebecca Flores, Zsolt Stockinger
Medical imaging plays a critical role in the rapid diagnosis, effective triage, and management of complex poly-trauma patients. High-quality medical imaging can be accomplished successfully in a deployed or wartime setting. Due to advances in aggressive resuscitation techniques and the speed of the latest generation computed tomography scanners (64-detector and beyond), rapid trauma scans utilizing computed tomography and ultrasound imaging can routinely be performed prior to taking the patient to the operating room potentially providing the trauma team with lifesaving information...
September 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/30185300/being-narrow-minded-is-not-always-bad-focusing-on-emergent-interventions-in-undertriage-initiatives-improves-mortality-prediction
#19
Stephen Klepner, Adrian Ong, Anthony Martin, Tom Wasser, Alison L Muller, Adam Sigal, Forrest B Fernandez
The American College of Surgeons Committee on Trauma defines undertriage (UT) as any major trauma patient (injury severity score ≥ 16) not undergoing treatment at the highest level of trauma team activation. This methodology does not account for many important factors that may impact outcome. We performed a retrospective review of the Pennsylvania State Trauma Registry to determine the impact of treatment interventions on mortality. Patients were stratified by triage category as follows: UT, appropriate triage, and overtriage...
August 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/30179025/a-mixed-methods-exploratory-assessment-of-the-usefulness-of-baltimore-city-health-department-s-trauma-informed-care-training-intervention
#20
April Joy Damian, Tamar Mendelson, Janice Bowie, Joseph J Gallo
Youth exposure to trauma is a significant public health problem in the United States, particularly in urban areas. Although trauma-informed care (TIC) training of service providers to address this challenge is increasing nationwide, we lack empirical evidence regarding the feasibility and acceptability of cross-organizational TIC training, including perspectives of training participants. The purpose of our study was to evaluate participating service providers' self-reported changes in knowledge about trauma, attitudes toward traumatized individuals, and beliefs in their capacity to provide referrals to trauma services after completion of the TIC intervention...
September 3, 2018: American Journal of Orthopsychiatry
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