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"Trauma" AND "Emergency Department"

Kıvılcım Karadeniz Cerit, Rabia Ergelen, Tural Abdullayev, Halil Tuğtepe, Tolga Emrullah Dağlı, Gürsu Kıyan
BACKGROUND: Although a nonoperative treatment approach is preferred for blunt liver and spleen trauma in childhood, there are significant differences between clinics in the algorithms used. The approach to high-grade liver and spleen injury is still controversial, particularly as grade V liver and spleen injuries are not included in the American Pediatric Surgical Association guideline. The aim of this study was to present experience with a non-operative treatment approach to children with high-grade liver and spleen injuries...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
B Ambroise, H Benateau, R Garmi, K Hauchard, R Prevost, A Veyssière
New technologies have over the past forty years become widespread across all domains of basic and applied research particularly in health-related fields. Telemedicine is a form of remote medical practice using information and communication technologies. It connects one or more health professionals with other health professionals or with patients. Within the framework of emergencies in maxillofacial surgery, requests received for specialist advice often pertain to procedures to be followed for facial wounds, bites, burns, maxillofacial bone trauma or facial cellulitis...
December 1, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Steven G Schauer, Jason F Naylor, Joseph K Maddry, Denise M Beaumont, Cord W Cunningham, Megan B Blackburn, Michael D April
OBJECTIVES: Airway failures are the second leading cause of potentially preventable death on the battlefield. Improvements in airway management depend on identifying current challenges. We sought to build on previously reported data on prehospital, combat airway management. METHODS: We used a series of emergency department procedure codes to identify patients within the Department of Defense Trauma Registry from January 2007 to August 2016. This is a subanalysis of those with a documented prehospital airway intervention...
December 2018: Southern Medical Journal
S Kargl, W Pumberger, S Luczynski, T Moritz
AIM: To assess the performance of paediatric skeletal radiography interpretation in the emergency department. MATERIALS AND METHODS: In a large paediatric referral centre, data from trauma patients with initially misdiagnosed skeletal radiography was collected from October 2014 to June 2015. Data analysis focused on demographic data, region of the injury and clinical consequences as well as outcome of treatment. RESULTS: In 125 of 2,316 patients aged from 1-17 years an initial misdiagnosis was documented (5...
November 30, 2018: Clinical Radiology
Oriol Yuguero, Ana Vena, Carles Forné, Jose Daniel Lacasta, Cecilia Llobet, Maria José Abadías
There are lack of indicators of quality of care in resuscitation units of emergency departments. With the aim of proposing a series of indicators to evaluate the quality of care delivered in hospital resuscitation areas, we conducted a descriptive study of 7579 admissions to the resuscitation unit of an emergency department at a Spanish hospital between 2012 and 2016. The proposed indicators were the percentage of patients attending to the emergency department admitted to the resuscitation area by level of triage, the length of stay, the percentage of patients moved to intensive care and surgery at disposition, the mortality in the area or in the emergency department within 24 hours of disposition, and the data completeness...
November 2018: Medicine (Baltimore)
Shail Rawal, Janice L Kwan, Fahad Razak, Allan S Detsky, Yishan Guo, Lauren Lapointe-Shaw, Terence Tang, Adina Weinerman, Andreas Laupacis, S V Subramanian, Amol A Verma
Importance: Trauma of hospitalization refers to the depersonalizing and stressful experience of a hospital admission and is hypothesized to increase the risk of readmission after discharge. Objectives: To characterize the trauma of hospitalization by measuring patient-reported disturbances in sleep, mobility, nutrition, and mood among medical inpatients, and to examine the association between these disturbances and the risk of unplanned return to hospital after discharge...
December 3, 2018: JAMA Internal Medicine
Matthew C Mauck, JunMei Hu, Christopher Sefton, Robert A Swor, David A Peak, Jeffrey S Jones, Niels K Rathlev, David C Lee, Robert M Domeier, Phyllis L Hendry, Samuel A McLean
Obesity has been found to increase the risk of musculoskeletal pain (MSP) in other settings, but to our knowledge the influence of increased body mass index on pain outcomes after common trauma exposures such as motor vehicle collision (MVC) has not been assessed. In addition, obesity results in biomechanical changes, as well as physiologic changes including reduced hypothalamic pituitary adrenal (HPA) axis negative feedback inhibition, but mechanisms by which obesity may result in worse post-traumatic outcomes remain poorly understood...
November 29, 2018: Pain
Kyle R Fischer, Katherine M Bakes, Theodore J Corbin, Joel A Fein, Erica J Harris, Thea L James, Marlene D Melzer-Lange
Violent traumatic injury remains a common condition treated by emergency physicians. The medical management of these patients is well described and remains an area of focus for providers. However, violently injured patients disproportionately carry a history of physical and psychological trauma that frequently affects clinical care in the emergency department. The alteration of our clinical approach, taking into consideration how a patient's previous experiences influence how he or she may perceive and react to medical care, is a concept referred to as trauma-informed care...
November 28, 2018: Annals of Emergency Medicine
Ryan M Boudreau, Erika O'Neal, Kelly M Besl, Shelley J Gordon, William Ralston, Joel B Elterman, Timothy A Pritts, Bryce R H Robinson
BACKGROUND: Despite a proven record of identifying injuries missed during clinical evaluation, the effect of autopsy on injury severity score (ISS) calculation is unknown. We hypothesized that autopsy data would alter final ISS and improve the accuracy of outcome data analyses. MATERIALS AND METHODS: All trauma deaths from January 2010 through June 2014 were reviewed. Trauma registrars calculated Abbreviated Injury Scale and ISS from clinical documentation alone...
January 2019: Journal of Surgical Research
Ryan M Boudreau, Keshav K Deshpande, Gregory M Day, William R Hinckley, Nicole Harger, Timothy A Pritts, Amy T Makley, Michael D Goodman
BACKGROUND: Tranexamic acid (TXA) has been shown to reduce mortality in the treatment of traumatic hemorrhage. This effect seems most profound when given early after injury. We hypothesized that extending a protocol for TXA administration into the prehospital aeromedical setting would improve outcomes while maintaining a similar safety profile to TXA dosed in the emergency department (ED). MATERIALS AND METHODS: We identified all trauma patients who received TXA during prehospital aeromedical transport or in the ED at our urban level I trauma center over an 18-mo period...
January 2019: Journal of Surgical Research
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
Abdul Q Alarhayem, Stephen M Cohn, Oliver Cantu-Nunez, Brian J Eastridge, Todd E Rasmussen
BACKGROUND: Six hours has long been considered the threshold of ischemia after peripheral artery injury. However, there is a paucity of evidence regarding the impact of operative delays on morbidity and mortality in patients with lower extremity arterial injuries. METHODS: We analyzed the records of 3,441,259 injured patients entered into the National Trauma Data Bank Research Dataset from 2012 to 2015. Patients (≥16 years) with lower extremity arterial injuries were identified by International Classification of Diseases, Ninth Revision injury and procedure codes...
November 26, 2018: Journal of Vascular Surgery
Maria Lampi, Johan P E Junker, John S Tabu, Peter Berggren, Carl-Oscar Jonson, Andreas Wladis
BACKGROUND: Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country...
November 29, 2018: BMC Emergency Medicine
Kei Hayashida, Shokei Matsumoto, Mitsuhide Kitano, Junichi Sasaki
BACKGROUND: A surgical airway is usually unpredictable in trauma patients. The aim of this study was to develop a predictable scoring system to determine the need for a surgical airway by using a database from a large multicenter trauma registry. METHODS: We obtained data from the nationwide trauma registry in Japan for adult blunt trauma patients who were intubated in the emergency department. Based on a multivariate logistic regression analysis in the development cohort, the Quick Surgical Airway Assessment for Trauma (qSAT) score was defined to predict the need for a surgical airway...
November 29, 2018: BMC Emergency Medicine
Lucia Liao, Lilia Reyes
OBJECTIVES: The aim of this study was to determine if a racial disparity exists in the administration of an analgesic, time to receiving analgesic, and type of analgesic administered to children with long-bone fractures. Prior studies have reported the existence of racial disparity but were mostly in adult and urban populations. METHODS: This is a retrospective chart review of 727 pediatric patients (aged 2-17 years) with International Classification of Diseases, Ninth Revision (or 10th revision) codes for long-one fractures in an emergency department that cares for a suburban and rural population between January 2013 and January 2016...
November 26, 2018: Pediatric Emergency Care
Fabrizio Gregori, Giorgio Santoro, Cristina Mancarella, Manolo Piccirilli, Maurizio Domenicucci
The formation of a post-traumatic delayed epidural hematoma (DEDH) is a rare but well-described complication in the literature. It is defined as an extradural bleeding not evident at the first computed tomography (CT) scan performed after trauma, but evidenced by further radiological evaluations. The most supported hypothesis about the mechanism responsible for the formation of a DEDH concerns above all the loss of a tamponade effect given by the reduction of intracranial pressure with medical or surgical treatment...
November 26, 2018: Acta Neurologica Belgica
Claire Hoysted, Laura Jobson, Eva Alisic
This pilot parallel group superiority randomized controlled trial investigated the efficacy and acceptability of a web-based training program on pediatric medical traumatic stress and trauma-informed care (Australian and New Zealand Clinical Trials Registry number: ACTRN12617001148369). Eligibility criteria for this study included being a nurse or physician working in an ED in Australia or New Zealand, being fluent in English and having Internet access. Emergency department (ED) staff (N = 71) were randomly assigned into the training (n = 32) or control group n = 39)...
November 26, 2018: Psychological Services
Monica S Vavilala, Mary A King, Jen-Ting Yang, Scott L Erickson, Brianna Mills, Rosemary M Grant, Carolyn Blayney, Qian Qiu, Randall M Chesnut, Kenneth M Jaffe, Bryan J Weiner, Brian D Johnston
BACKGROUND: As far as we know, there are no tested in-hospital care programmes for paediatric traumatic brain injury. We aimed to assess implementation and effectiveness of the Pediatric Guideline Adherence and Outcomes (PEGASUS) programme in children with severe traumatic brain injury. METHODS: We did a prospective hybrid implementation and effectiveness study at the Harborview Medical Center (Seattle, WA, USA). We included children (aged <18 years) with traumatic brain injury (trauma mechanism and image findings)...
November 22, 2018: The lancet child & adolescent health
Andrea Fabbri, Giuseppe Carpinteri, Germana Ruggiano, Elisabetta Bonafede, Antonella Sblendido, Alberto Farina, Amedeo Soldi
INTRODUCTION: Low-dose methoxyflurane, administered via a hand-held inhaler, has been used for short-term pain relief in emergency medicine in Australia and New Zealand for over 40 years, and was recently approved in Europe for the rapid relief of moderate-to-severe trauma-related pain in adults. There is currently a lack of data for methoxyflurane versus active comparators, therefore this trial will investigate the efficacy and safety of inhaled methoxyflurane compared with standard of care (SoC) in the treatment of acute trauma-related pain in pre-hospital and ED settings in Italy...
November 22, 2018: Advances in Therapy
A Pol, M Carter, S Bouchoucha
INTRODUCTION: Violence in healthcare settings is a concern for healthcare professionals and patients. Media reports, and debate within the healthcare profession, and the academic literature infer that workplaces such as intensive care units are becoming exposed to increasing violence. Increases in the incidence of violent behaviour are sometimes attributed to the increased pressure on emergency departments to accelerate the throughput of patients to meet targets. To ensure the wellbeing of patients and staff, there is a need to evaluate the impact of such targets...
November 19, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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