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"Trauma" AND ("Pre-Hospital" OR "Pre Hospital")

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
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
Joséphine Escutnaire, Michael Genin, Evgéniya Babykina, Cyrielle Dumont, François Javaudin, Valentine Baert, Pierre Mols, Jan-Thorsten Gräsner, Eric Wiel, Pierre-Yves Gueugniaud, Karim Tazarourte, Hervé Hubert
INTRODUCTION: The survival from traumatic vs. medical out-of-hospital cardiac arrest (OHCA) are not yet well described. The objective of this study was to compare survival to hospital discharge and 30-day survival of non-matched and matched traumatic and medical OHCA cohorts. MATERIAL & METHODS: National case-control, multicentre study based on the French national cardiac arrest registry. Following descriptive analysis, we compared survival rates of traumatic and medical cardiac arrest patients after propensity score matching...
July 27, 2018: Resuscitation
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
Alexander Timm, Marc Maegele, Klaus Wendt, Rolf Lefering, Hendrik Wyen
PURPOSE: The aim of this study was to compare the pre-hospital treatment of major trauma patients with similar injury patterns in Germany and the Netherlands. PATIENTS AND METHODS: This matched-pairs analysis is based on the TraumaRegister DGU®. The authors compared major trauma patients (ISS ≥ 16) from 2009 to 2015 treated in Dutch and German Level 1 trauma centers (TC). Endpoints were the pre-hospital times and interventions performed until hospital admission...
July 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Edward John Nevins, Nicholas Thomas Edward Bird, Hassan Zakria Malik, Simon Jude Mercer, Khalid Shahzad, Raimundas Lunevicius, John Vincent Taylor, Nikhil Misra
PURPOSE: Emergency department thoracotomy (EDT) is a potentially life-saving procedure, performed on patients suffering traumatic cardiac arrest. Multiple indications have been reported, but overall survival remains unclear for each indication. The objective of this systematic review is to determine overall survival, survival stratified by indication, and survival stratified by geographical location for patients undergoing EDT across the world. METHODS: Articles published between 2000 and 2016 were identified which detailed outcomes from EDT...
July 14, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Janett Kreutziger, Stefan Schmid, Nikolaus Umlauf, Hanno Ulmer, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen, Wolfgang Lederer
BACKGROUND: Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma. METHODS: We retrospectively investigated adult trauma patients treated by a nationwide helicopter emergency medical service (34 bases) between 2005 and 2013. All patients with recorded initial cardiac rhythms and blood glucose levels were enrolled...
July 13, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
M Einberg, S Saar, A Seljanko, A Lomp, U Lepner, P Talving
BACKGROUND AND AIMS: Cardiac injuries are highly lethal lesions following trauma and most of the patients decease in pre-hospital settings. However, studies on cardiac trauma in Estonia are scarce. Thus, we set out to study cardiac injuries admitted to Estonian major trauma facilities during 23 years of Estonian independence. MATERIALS AND METHODS: After the ethics review board approval, all consecutive patients with cardiac injuries per ICD-9 (861.0 and 861.1) and ICD-10 codes (S...
July 1, 2018: Scandinavian Journal of Surgery: SJS
Olivier Kubwimana
Background: Globally, there has been an increase in injuries as a major cause of death. This burden is mainly due to an increase in road traffic injuries, and it poses an enormous burden in low- and middle-income countries. Musculoskeletal and head injuries are the most prevalent ones, which has led to an overcrowding of traumatic surgical emergencies. Methodology: An unrestricted search was done in different research databases for articles published in English between January 2005 and November 2017 focusing on traumatic surgical emergencies...
2018: Open Access Emergency Medicine: OAEM
Leila Niemi-Murola, Jani Unkuri, Katri Hamunen
Introduction and aim Pain is a frequent symptom in emergency patients and opioids are commonly used to treat it at emergency departments and at pre-hospital settings. The aim of this systematic review is to examine the efficacy and safety of parenteral opioids used for acute pain in emergency medicine. Method Qualitative review of randomized controlled trials (RCTs) on parenteral opioids for acute pain in adult emergency patients. Main outcome measures were: type and dose of the opioid, analgesic efficacy as compared to either placebo or another opioid and adverse effects...
October 1, 2011: Scandinavian Journal of Pain
Michelle Ng, Jerrold Perrott, Sarah Burgess
INTRODUCTION: Tranexamic acid (TXA) has been shown to decrease mortality in adult trauma patients with or at significant risk of hemorrhage when administered within 3 h of injury. The use and appropriateness of TXA in adult trauma patients presenting to Royal Columbian Hospital (RCH) was investigated. METHODS: This retrospective chart review utilized the British Columbia Trauma Registry to identify 100 consecutive trauma patients that presented to the emergency department at RCH between April 2012 to June 2015 and met the following indications for TXA: systolic blood pressure <90 mm Hg and/or heart rate >110 bpm and presentation within 8 h of injury...
June 5, 2018: American Journal of Emergency Medicine
Patrick D Dißmann, Maxime Maignan, Paul D Cloves, Blanca Gutierrez Parres, Sara Dickerson, Alice Eberhardt
Trauma pain represents a large proportion of admissions to emergency departments across Europe. There is currently an unmet need in the treatment of trauma pain extending throughout the patient journey in emergency settings. This review aims to explore these unmet needs and describe barriers to the delivery of effective analgesia for trauma pain in emergency settings. A comprehensive, qualitative review of the literature was conducted using a structured search strategy (Medline, Embase and Evidence Based Medicine Reviews) along with additional Internet-based sources to identify relevant human studies published in the prior 11 years (January 2006-December 2017)...
June 2, 2018: Pain and Therapy
T Gauss, E Gayat, A Harrois, M Raux, A Follin, J-L Daban, F Cook, S Hamada
BACKGROUND: The role of vasopressors in trauma-related haemorrhagic shock (HS) remains a matter of debate. They are part of the most recent European recommendations on the management of HS and are regularly used in France. We assessed the effect of early administration of noradrenaline in 24 h mortality of trauma patients in HS, using a propensity-score analysis. METHODS: The study included patients from a multicentre prospective regional trauma registry. HS was defined as transfusion of ≥4 erythrocyte-concentrate units during the first 6 h...
June 2018: British Journal of Anaesthesia
M Decavèle, N Gault, T Gauss, S Pease, J D Moyer, C Paugam-Burtz, A Foucrier
BACKGROUND: The significance of cardiac troponin I (cTnI) elevation after trauma is debated. We therefore explored the association between cTnI elevation at admission after trauma and ICU mortality. METHODS: We performed a retrospective analysis from a prospectively constituted database, of patients admitted to ICU after trauma at a single centre, over a 36 month period. According to cTnI plasma concentration at admission, patients were categorised into three groups: normal (<0...
June 2018: British Journal of Anaesthesia
Tomokazu Motomura, Atsushi Hirabayashi, Hisashi Matsumoto, Nobutaka Yamauchi, Mitsunobu Nakamura, Hiroshi Machida, Kenji Fujizuka, Naomi Otsuka, Tomoko Satoh, Hideaki Anan, Hisayoshi Kondo, Yuichi Koido
More than 6,000 people died in the Great Hanshin (Kobe) Earthquake in 1995, and it was later reported that there were around 500 preventable trauma deaths. In response, the Japanese government developed the helicopter emergency medical service in 2001, known in Japan as the "Doctor-Heli" (DH), which had 46 DHs and 2 private medical helicopters as of April 2016. DHs transport physicians and nurses to provide pre-hospital medical care at the scene of medical emergencies. Following lessons learned in the Great East Japan Earthquake in 2011, a research group in the Ministry of Health, Labour and Welfare developed a command and control system for the DH fleet as well as the Disaster Relief Aircraft Management System Network (D-NET), which uses a satellite communications network to monitor the location of the fleet and weather in real-time during disasters...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Andrew T Reisner, Shwetha Edla, Jianbo Liu, Jiankun Liu, Maxim Y Khitrov, Jaques Reifman
BACKGROUND: Analyses of large databases have demonstrated that the association between heart rate (HR) and blood loss is weaker than what is taught by Advanced Trauma Life Support training. However, those studies had limited ability to generate a more descriptive paradigm, because they only examined a single HR value per patient. METHODS: In a comparative, retrospective analysis, we studied the temporal characteristics of HR through time in adult trauma patients with haemorrhage, based on documented injuries and transfusion of ≥3 units of red blood cells (RBCs)...
April 30, 2018: Injury
Sophie Rym Hamada, Anne Rosa, Tobias Gauss, Jean-Philippe Desclefs, Mathieu Raux, Anatole Harrois, Arnaud Follin, Fabrice Cook, Mathieu Boutonnet, Arie Attias, Sylvain Ausset, Mathieu Boutonnet, Gilles Dhonneur, Jacques Duranteau, Olivier Langeron, Catherine Paugam-Burtz, Romain Pirracchio, Guillaume de St Maurice, Bernard Vigué, Alexandra Rouquette, Jacques Duranteau
BACKGROUND: Haemorrhagic shock is the leading cause of early preventable death in severe trauma. Delayed treatment is a recognized prognostic factor that can be prevented by efficient organization of care. This study aimed to develop and validate Red Flag, a binary alert identifying blunt trauma patients with high risk of severe haemorrhage (SH), to be used by the pre-hospital trauma team in order to trigger an adequate intra-hospital standardized haemorrhage control response: massive transfusion protocol and/or immediate haemostatic procedures...
May 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
Homayoun Sadeghi-Bazargani, Bahram Samadirad, Nasrin Shahedifar, Mina Golestani
Objective: To study the epidemiology of car user road traffic fatalities (CURTFs) during eight years, in East Azerbaijan, Iran. Methods: A total of 3051 CURTFs registered in East Azerbaijan forensic medicine organization database, Iran, during 2006-2014, were analyzed using Stata 13 statistical software package. Descriptive statistics ( p <0.05) and inferential statistical methods such as Chi-squared test and multivariate logistic regression with p <0.1 were applied...
April 2018: Bulletin of Emergency and Trauma
D Massalou, C Ichai, D Mariage, P Baqué
INTRODUCTION: After the attacks in Paris, France was again struck by terrorism in the city of Nice during the night of July 14, 2016. At 22:33 in the evening, a 19-ton truck drove into the crowd of holiday celebrators. The attack resulted in 458 wounded and 86 deaths. The purpose of this study was to describe the management of patients with abdominal trauma admitted alive in our institution, in the context of a massive influx of victims. MATERIAL AND METHODS: We performed a retrospective analysis of the management of adults with abdominal trauma arising from the terrorist attack in Nice...
April 28, 2018: Journal of Visceral Surgery
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
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