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https://www.readbyqxmd.com/read/30106964/administration-of-intravenous-antibiotics-in-patients-with-open-fractures-is-dependent-on-emergency-room-triaging
#1
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
https://www.readbyqxmd.com/read/30106871/hypothermia-as-an-outcome-predictor-tool-in-pediatric-trauma-a-propensity-matched-analysis
#2
Thomas R McCarty, Thomas J Abramo, Robert T Maxson, Gregory Albert, Mallikarjuna R Rettiganti, Marie E Saylors, Jonathan W Orsborn, Amanda I Hollingsworth
OBJECTIVE: Hypothermia is an independent risk factor for mortality in adult trauma patients. Two small studies have shown similar results in pediatric trauma patients. Temperature is not included in any pediatric trauma assessment scores. This study sought to compare mortality and various descriptive outcomes between pediatric hypothermic and normothermic trauma patients. METHODS: Data were obtained from the National Trauma Database from 2009 to 2012. Patients meeting inclusion criteria were stratified by presence of isolated head injury, head injury with multiple trauma, and absence of head injury...
August 13, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30106868/a-randomized-single-blinded-simulation-based-trial-of-a-novel-method-for-fluid-administration-to-a-septic-infant
#3
Matthew Kline, Lauren Crispino, Ambika Bhatnagar, Rajavee A Panchal, Marc Auerbach
OBJECTIVES: For children presenting in shock, American College of Critical Care Medicine guidelines recommend 3 boluses of intravenous fluids during initial resuscitation, but these are often not met. This study aims to compare a novel device LifeFlow, to established manual methods for rapid fluid delivery in a simulated environment. METHOD: This single-blinded randomized trial was conducted in a level 1 pediatric trauma center emergency department. Fifty-four participants were paired and randomized to one of the following methods: push/pull, pressure bag, or LifeFlow...
August 13, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30105495/analysis-of-water-sports-injuries-admitted-to-a-pediatric-trauma-center-a-13-year-experience
#4
Thomas A Boyle, Kittu A Rao, Davis B Horkan, Marguerite L Bandeian, Juan E Sola, Charles A Karcutskie, Casey Allen, Eduardo A Perez, Edward B Lineen, Anthony R Hogan, Holly L Neville
BACKGROUND: Unintentional injury is the leading cause of death in children and adolescents. Injuries occurring during boating and recreational water sports are poorly described in the literature. Herein, we compare injuries from water sports to those resulting from motor vehicle collisions, which are better described in existing literature. METHODS: A retrospective review of 1935 consecutive pediatric trauma patients, as defined by age < 18 years, admitted to a single level-1 pediatric trauma center between January 2000 and August 2013 was performed...
August 13, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/30104927/set-it-and-forget-it-diaphyseal-fractures-of-the-humerus-undergo-minimal-change-in-angulation-after-functional-brace-application
#5
Alexander M Crespo, Sanjit R Konda, Kenneth A Egol
Objectives: To quantify radiographic changes observed in humeral shaft frctures throughout course of treatment with functional bracing. Design: Retrospective cohort study. Setting: Level 1 Trauma Center and affiliated Tertiary Care Center. Patients: 72 retrospectively identified patients with fracture of the humeral diaphysis. Intervention: Application of functional brace with radiographs obtained immediately after brace application and at 1 week, 2 weeks, 3 weeks, 6 weeks, 3 months, 6 months and 12 month follow-up...
2018: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/30104924/unintentional-firearm-injuries-remain-prevalent-over-a-12-year-experience-at-a-rural-midwestern-level-1-trauma-center
#6
Brian Guetschow, Michele Lilienthal, Michael Willey
Recently, firearm injuries in the United States have taken center stage in political debates and in the media. Much of the past epidemiological research on firearm injuries has focused primarily on the urban landscape. This study was undertaken to highlight the unique spectrum of firearm injuries seen at a rural level 1 trauma center to provide insight into prevalence, mechanism of injury, and seasonal variation. An IRB-approved retrospective study was performed of the trauma registry at a rural Level 1 hospital to identify all patients with firearm injuries from January 2002 to May 2014...
2018: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/30100678/managing-complex-trauma-injuries-in-the-elderly-a-case-report-of-a-free-flap-and-circular-frame-in-a-95-year-old-patient-with-an-open-iiib-tibial-fracture
#7
Charlotte Hammonds, Philippa C Jackson, Patrick Foster, Jonathan D Wiper
In an ageing population, increasing numbers of patients over the age of 70 are sustaining severe trauma. These patients require careful multidisciplinary team (MDT) management with careful consideration of existing co-morbidities, as such their treatment should be individually tailored. We present the case of a patient believed to be the oldest documented patient treated in a trauma setting with free flap and circular frame fixation to an open tibial fracture. A 95-year-old male presented to the Level 1 Major Trauma Centre (MTC) with multiple injuries after a pedestrian vs car incident...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/30100025/pulmonary-contusions-in-the-elderly-after-blunt-trauma-incidence-and-outcomes
#8
Amanda Bader, Uzma Rahman, Matthew Morris, Jane E McCormack, Emily C Huang, Marlene Zawin, James A Vosswinkel, Randeep S Jawa
BACKGROUND: In the general population with blunt chest trauma, pulmonary contusions (PCs) are commonly identified. However, there is limited research in the elderly. We sought to evaluate the incidence and outcomes of PCs in elderly blunt trauma admissions. METHODS: We retrospectively reviewed the trauma registry at a level I trauma center for all blunt thoracic trauma patients aged ≥65 y, who were admitted between 2007 and 2015. The medical records of PC patients were reviewed...
October 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/30098813/direct-oral-anticoagulants-do-not-worsen-traumatic-brain-injury-after-low-level-falls-in-the-elderly
#9
Madelyn Batey, Jason Hecht, Cherise Callahan, Wendy Wahl
BACKGROUND: Falls are now the leading cause of trauma and represent the most common type of trauma in the elderly. The use of anticoagulants is increasing in older patients, but there are little data on outcomes after traumatic brain injury while anticoagulated with direct oral anticoagulants compared with warfarin. We hypothesized that anticoagulated patients would have a greater mortality and complications than nonanticoagulated patients, and patients on direct oral anticoagulants would have more fatal outcomes after low-level falls because of lack of reversal agents...
August 8, 2018: Surgery
https://www.readbyqxmd.com/read/30097311/bilateral-low-dose-computed-tomography-assessment-for-post-operative-rotational-malalignment-after-intramedullary-nailing-for-tibial-shaft-fractures-reliability-of-a-practical-imaging-technique
#10
Nils Jan Bleeker, Megan Cain, Mariana Rego, Aimane Saarig, Andrew Chan, Inger Sierevelt, Job N Doornberg, Ruurd L Jaarsma
INTRODUCTION: The purpose of this study is to evaluate the intra- and inter-observer reliability of low-dose protocolled bilateral postoperative Computed Tomography (CT)-assessment of rotational malalignment after intramedullary nailing (IMN) of tibial shaft fractures. MATERIALS AND METHODS: 156 patients were prospectively included with tibial shaft fractures that were treated with IMN in a Level-I Trauma Centre. All patients underwent post-operative bilateral low-dose CT-assessment (effective dose of 0...
July 29, 2018: Injury
https://www.readbyqxmd.com/read/30095507/effectiveness-of-an-exercise-based-active-rehabilitation-intervention-for-youth-who-are-slow-to-recover-after-concussion
#11
Jérôme Gauvin-Lepage, Debbie Friedman, Lisa Grilli, Maria Sufrategui, Carol De Matteo, Grant L Iverson, Isabelle Gagnon
OBJECTIVE: (1) To determine the impact of providing participants aged 8 to 17 years who are slow to recover after a concussion with a well-developed active rehabilitation intervention (ARI), compared with receiving standard care alone, on postconcussion symptoms (PCS) at 2 and 6 weeks after the initiation of ARI; and (2) to investigate functional recovery 6 weeks after initiation of ARI. DESIGN: A multicenter prospective quasi-experimental control group design. SETTING: Tertiary care pediatric trauma center and community health care providers...
August 8, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/30093380/prevalence-of-anaphylaxis-among-adults-admitted-to-critical-care-for-severe-asthma-exacerbation
#12
Ayobami T Akenroye, Abayomi Ajala, Elham Azimi-Nekoo, Gabriele S de Vos
BACKGROUND: In asthmatics, making a diagnosis of anaphylaxis could be challenging as respiratory symptoms are a common feature of both conditions. Identifying anaphylaxis is important to providing appropriate care. A prior study showed that anaphylaxis is sometimes misdiagnosed as acute asthma in children. We sought to identify the percentage of adults admitted to the intensive care unit (ICU) with asthma exacerbations who met criteria for anaphylaxis. METHODS: Retrospective chart review of adults admitted with acute asthma to the ICU at Jacobi Medical Center, a Level 1 trauma centre in Bronx, New York...
August 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/30090816/massive-blood-transfusions-and-outcomes-in-trauma-patients-an-intention-to-treat-analysis
#13
Steven Liu, Quinn Fujii, Farris Serio, Andrew McCague
Objective: To determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility. Methods: A prospective cohort study was conducted on 131 patients who received massive blood transfusion (MBT), defined as 10 U or higher of PRBCs received in the initial 24 hours. Data collected from a Level II trauma center registry were used to analyze reports of adult patients from July 2014 to 2017. Cohorts were divided by amount of blood received - 0 to 9 U, 10-19 U, 20 to 29 U, 30-39 U, 40 U or higher - odds ratio for mortality and p-values for mean Injury Severity Score and overall hospital length of stay were calculated for each group...
July 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/30090144/bull-horn-head-injury-with-retained-horn-in-brain-a-rare-case-report
#14
Pavan Kumar, Vardan Kulshreshtha, Ashok Kumar, Gaurav Jaiswal, Tarun K Gupta
Pediatric head injuries are a commonly seen emergency in trauma centers worldwide. There are various modes of injury such as fall from height, road traffic accidents, objects hitting the head, assault, and battered baby. We report here a child who presented to us with a history of sustaining head injury by a stray bull on the road and a retained broken bull horn inside the brain and its subsequent management.
April 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/30090129/effect-of-positive-end-expiratory-pressure-on-optic-nerve-sheath-diameter-in-pediatric-patients-with-traumatic-brain-injury
#15
Ankur Khandelwal, Indu Kapoor, Charu Mahajan, Hemanshu Prabhakar
Background: The peak incidence of traumatic brain injury (TBI) has been reported in children and young adults. Intracranial pressure (ICP) as an important component can be measured with invasive technique, whereas noninvasive measurement of optic nerve sheath diameter (ONSD) is increasingly becoming popular. Positive end-expiratory pressure (PEEP) has been found to affect ICP. We aimed to compare the effect of different values of PEEP on ONSD and to obtain the correlation with ICP measurement...
April 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/30086443/radiographic-evaluation-of-the-pregnant-trauma-patient-what-are-we-willing-to-miss
#16
Emily S Herfel, Joshua H Hill, Michael Lieber
OBJECTIVE: Trauma is the leading cause of non-obstetrical causes of death in pregnant patients. The use of radiographic imaging for evaluation in the trauma bay is a controversial topic. However, in some cases the benefits of using radiographic imaging to ensure maternal survival outweigh the risks of radiation exposure to the fetus. This study explores whether sparing fetal exposure to radiation by minimizing use of ionizing radiographic imaging to the mother will put the mother at risk for a delayed diagnosis of injury...
June 28, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/30086071/effects-of-driving-distance-and-transport-time-on-mortality-among-level-i-and-ii-traumas-occurring-in-a-metropolitan-area
#17
Theodore G Karrison, L Philip Schumm, Masha Kocherginsky, Ronald Thisted, Douglas R Dirschl, Selwyn Rogers
BACKGROUND: The purpose of this study was to evaluate the effects of ambulance driving distance and transport time on mortality among trauma incidents occurring in the City of Chicago, a large metropolitan area. METHODS: We studied individuals >16 years old who suffered a Level I or II injury and were taken to a Level I trauma center. The outcome was in-hospital mortality, including those dead on arrival but excluding those deemed dead on scene. Driving distance was calculated from the scene of injury to the trauma center where the patient was taken...
August 6, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30086069/the-volume-outcome-relationship-in-severely-injured-patients-a-systematic-review-and-meta-analysis
#18
Charlie A Sewalt, Eveline J A Wiegers, Esmee Venema, Fiona E Lecky, Stephanie C E Schuit, Dennis Den Hartog, Hester F Lingsma
BACKGROUND: The volume-outcome relationship in severely injured patients remains under debate and this has consequences for the designation of trauma centers. OBJECTIVES: The aim of this study was to evaluate the relationship between hospital or surgeon volume and health outcomes in severely injured patients. METHODS: Six electronic databases were searched from 1980 up to January 30 2018 to identify studies that describe the relationship between hospital or surgeon volume and health outcomes in severely injured patients (preferably Injury Severity Score (ISS) above 15)...
August 6, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30086044/risk-factors-for-kidney-dysfunction-with-the-use-of-gentamicin-in-open-fracture-antibiotic-treatment
#19
Jacob Folse, Charles E Hill, Matthew L Graves, George V Russell, Josie Hydrick, LaRita C Jones, William H Replogle, Patrick F Bergin, Clay A Spitler
OBJECTIVES: To evaluate all patients who received gentamicin for open fracture treatment and determine the incidence of, and risk factors for, kidney injury in this population. DESIGN: Retrospective, Case Control SETTING:: Single institution; Level 1 trauma center PATIENTS/PARTICIPANTS:: A retrospective chart review identified patients who received gentamicin for open fracture antibiotic treatment from January 2008-December 2012. Overall, 371 patients met inclusion criteria and were categorized into 2 groups using RIFLE criteria: normal kidney function (74...
July 30, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/30086043/sleep-disturbance-in-orthopaedic-trauma-patients
#20
Matthew Swann, Miles Batty, Gene Hu, Thomas Mitchell, Hayden Box, Adam Starr
OBJECTIVE: To evaluate the prevalence and severity of sleep disturbance experienced by patients who have sustained a traumatic orthopaedic injury, how sleep disturbance affects the patient's perceived health quality and identify factors associated with sleep disturbance. DESIGN: Cross-Sectional Cohort study. SETTING: Urban Level-I trauma center. PATIENTS/PARTICIPANTS: 335 non-consecutive patients who presented to clinic at various stages of treatment for their traumatic orthopaedic injuries...
July 30, 2018: Journal of Orthopaedic Trauma
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