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"Trauma" AND "Emergency Department"

S Rafael Arceo, Robert P Runner, Tony D Huynh, Michael B Gottschalk, Mara L Schenker, Thomas J Moore
OBJECTIVES: To describe differences in follow-up compliance and emergency department (ED) visits between ballistic and non-ballistic operative lower extremity fracture patients. DESIGN: Retrospective study. SETTING: Urban level 1 trauma center. PATIENTS/PARTICIPANTS: Patients age ≥18 years with ≥1 tibia or femur fractures treated with ORIF or intramedullary nailing (IMN) between September 1, 2013 and August 31, 2015...
October 4, 2018: Injury
Christopher W Snyder, Jeremy D Kauffman, Etienne E Pracht, Paul D Danielson, David J Ciesla, Nicole M Chandler
BACKGROUND: Effective and sustainable pediatric trauma care requires systems of regionalization and interfacility transfer. Avoidable transfer, also known as secondary overtriage, occurs when a patient is transferred to a regional trauma center after initial evaluation at another facility that is capable of providing definitive care. The purpose of this study was to identify risk factors for avoidable transfer among pediatric trauma patients in southwest Florida. METHODS: All pediatric trauma patients two years and older transferred from outlying hospitals to the emergency department (ED) of a single state-designated pediatric trauma center between 2009 and 2017 were obtained from the institutional registry...
October 11, 2018: Journal of Trauma and Acute Care Surgery
Sherby Suet Ying Pang, Christian Fang, Jimmy Yu Wai Chan
Importance: Orbital floor fracture is common among patients suffering from facial trauma. Open reduction and reconstruction of the orbital floor with Medpor is the treatment of choice in our centre to correct diplopia and enophthalmos. Objective: Application of locally available 3D printing service in perioperative planning of orbital floor reconstruction with porous polyethylene. Design: We present two patients who suffered from orbital floor fracture complicated by diplopia...
October 2018: Trauma case reports
Cumhur Murat Tulay, Sadik Yaldiz, Adnan Bilge
Introduction: The duration of pain after rib fracture is the question physicians are most frequently asked. The duration of pain following a traumatic rib fracture without any comorbidity is not widely published. Aim: We report our experience to investigate the duration of pain following isolated traumatic rib fractures without any traumatic comorbidity. Material and methods: We examined 182 patients with isolated rib fracture without any trauma to other body parts...
September 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Natalie Kuchen, Christian Gmuer, Othmar Schoeb
INTRODUCTION: Isolated complete transection of the small bowel is extremely rare in blunt abdominal trauma. If it occurs, it is often associated with high-energy impact, as seen in motor vehicle accidents and falls from heights. In this case, a trivial trauma due to a handlebar injury caused a complete transection of the middle jejunum. CASE PRESENTATION: A 47-year-old man walked into the emergency department with moderate abdominal pain ∼10 hours after a fall on to a bicycle's handlebar from a standing position...
October 8, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Chukwudi Chiaghana, Christopher Giordano, Danielle Cobb, Terrie Vasilopoulos, Patrick J Tighe, Joshua W Sappenfield
BACKGROUND: In the 1990s, emergency medicine (EM) physicians were responsible for intubating about half of the patients requiring airway management in emergency rooms. Since then, no studies have characterized the airway management responsibilities in the emergency room. METHODS: A survey was sent via the Eastern Association for Surgery and Trauma and the Trauma Anesthesiology Society listservs, as well as by direct solicitation. Information was collected on trauma center level, geographical location, department responsible for intubation in the emergency room, department responsible for intubation in the trauma bay, whether these roles differed for pediatrics, whether an anesthesiologist was available "in-house" 24 hours a day, and whether there was a protocol for anesthesiologists to assist as backup during intubations...
October 8, 2018: Anesthesia and Analgesia
Joseph R England, Jordan S Gross, Eric A White, Dakshesh B Patel, Jasmin T England, Phillip M Cheng
OBJECTIVE: The purpose of this study is to determine whether a deep convolutional neural network (DCNN) trained on a dataset of limited size can accurately diagnose traumatic pediatric elbow effusion on lateral radiographs. MATERIALS AND METHODS: A total of 901 lateral elbow radiographs from 882 pediatric patients who presented to the emergency department with upper extremity trauma were divided into a training set (657 images), a validation set (115 images), and an independent test set (129 images)...
October 9, 2018: AJR. American Journal of Roentgenology
Alexander Grant, Matthew Stuttard, Thomas Mitchell
BACKGROUND: The Accident and Emergency Department (A&E) is a busy environment that requires time- and resource-efficient teaching. Managing cervical spine (c-spine) trauma is often an unfamiliar skill for new doctors starting work in A&E. This study investigated the efficacy of brief teaching interventions in changing clinician behaviour within A&E. The Accident and Emergency Department is a busy environment that requires time- and resource-efficient teaching METHODS: Data for 482 patients receiving c-spine computed tomography (CT) imaging in two Gloucestershire A&Es before and after multimodal departmental teaching were compared...
October 9, 2018: Clinical Teacher
Stephanie Ruest, Ghid Kanaan, Jessica L Moore, Amy P Goldberg
OBJECTIVES: To determine the prevalence of incidental rib fractures identified by chest radiograph (CXR) obtained for indications unrelated to accidental trauma or nonaccidental trauma (NAT), and describe the histories associated with cases of incidental rib fractures and their proposed etiologies. It is hypothesized that incidental rib fractures are rare and alternative explanations for rib fractures occasionally used in a medico-legal context such as minor accidental trauma, undiagnosed medical conditions, and transient metabolic bone disturbances are unlikely to be the etiology of incidental rib fractures...
October 5, 2018: Journal of Pediatrics
Mark Schieren, Andreas B Böhmer, Rolf Lefering, Thomas Paffrath, Frank Wappler, Jerome Defosse
INTRODUCTION: Chest trauma and obesity are both associated with increased risks for respiratory complications (e.g. hypoxia, hypercarbia, pneumonia), which are frequent causes of posttraumatic morbidity and mortality. However, as there is only limited and inconsistent evidence, the aim of our study was to analyse the effect of body mass index (BMI) on patient outcomes after thoracic trauma. PATIENTS AND METHODS: We screened 50.519 patients entered in TraumaRegister DGU® , between 2004-2009, when the BMI was part of the standardized dataset...
September 28, 2018: Injury
Blessing Ogbemudia, Jodi Raymond, LaRanna S Hatcher, Ashley N Vetor, Thomas Rouse, Aaron E Carroll, Teresa M Bell
BACKGROUND: Currently there is limited knowledge on compliance with follow-up care in pediatric patients after abdominal trauma. The Indiana Network for Patient Care (INPC) is a large regional health information exchange with both structured clinical data (e.g., diagnosis codes) and unstructured data (e.g., provider notes). The objective of this study is to determine if regional health information exchanges can be used to evaluate whether patients receive all follow-up care recommended by providers...
September 21, 2018: Journal of Pediatric Surgery
Mark D Fleming, Janet K Shim, Irene Yen, Meredith Van Natta, Christoph Hanssmann, Nancy J Burke
Hospitals throughout the United States are implementing new forms of care delivery meant to address social needs for structurally vulnerable patients as a strategy to prevent emergency department visits and hospitalizations and to thereby reduce costs. This article examines how the deployment of social assistance within a neoliberal institutional logic involves the negotiation and alignment of economistic values with ethics of care. We focus on care practices meant to stabilize the socioeconomic conditions of the most expensive patients in the health care system-the "super-utilizers"-through the provisioning of basic resources such as housing, food, transportation, and social support...
October 6, 2018: Medical Anthropology Quarterly
Alain Cunqueiro, Alejandra Durango, Daniel M Fein, Kenny Ye, Meir H Scheinfeld
BACKGROUND: Children presenting to the emergency department with acute psychosis or hallucinations sometimes undergo a head CT to evaluate for a causative lesion. The diagnostic yield of head CT in this scenario has not been reported. OBJECTIVE: To determine the yield for head CT in children with acute psychosis or hallucinations. MATERIALS AND METHODS: We retrospectively searched the radiology report database over a 7.5-year period for head CT reports for pediatric emergency department patients using the following keywords: hallucination, psychosis, psychotic or "hearing voices...
October 5, 2018: Pediatric Radiology
Taerim Kim, Kwang Yul Jung, Kyunga Kim, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Won Chul Cha
OBJECTIVE: The increasing frequency of bicycle-related injuries is due to the growing elderly population and their increasing physical activity. This study aimed to compare the protective effects of helmets on bicycle-related injuries in elderly individuals compared with those in younger adults. METHODS: Data from the Korean emergency department-based Injury In-depth Surveillance database from eight emergency departments during 2011-2016 were retrospectively analysed...
October 5, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Robert M Rodriguez, Karla Canseco, Brigitte M Baumann, William R Mower, Mark I Langdorf, Anthony J Medak, Deirdre R Anglin, Gregory W Hendey, Newton Addo, Daniel Nishijima, Ali S Raja
STUDY OBJECTIVE: Although traditional teachings in regard to pneumothorax and hemothorax generally recommend chest tube placement and hospital admission, the increasing use of chest computed tomography (CT) in blunt trauma evaluation may detect more minor pneumothorax and hemothorax that might indicate a need to modify these traditional practices. We determine the incidence of pneumothorax and hemothorax observed on CT only and the incidence of isolated pneumothorax and hemothorax (pneumothorax and hemothorax occurring without other thoracic injuries), and describe the clinical implications of these injuries...
October 1, 2018: Annals of Emergency Medicine
Olivera Djuric, Ljiljana Markovic-Denic, Bojan Jovanovic, Vesna Bumbasirevic
After three national point prevalence studies (PPS) of healthcare associated infections (HAI) conducted in Serbian acute care hospitals using US (CDC/NHSN) surveillance definitions, Serbia is about to switch to European (ECDC) criteria for the purpose of the fourth HAI PPS. The aim of this study was to compare the US and the European HAI definitions in Serbian trauma intensive care unit (ICU). Prospective surveillance was performed at two surgical-trauma ICUs of the Emergency department of Clinical Center of Serbia...
2018: PloS One
Foscarina Della Rocca, Miranda Zoleo, Francesca Pignatiello, Fabia De Lazzari, Anna Chiara Frigo, Gianna Vettore, Donata Favretto, Rossella Snenghi
INTRODUCTION: Driving under the influence of alcohol and/or psychoactive substances increases the risk of road accidents, but it is controversial whether this affects site and severity of injuries. MATERIAL AND METHODS: We search for alcohol, cannabinoids, cocaine, benzodiazepines, opioids, methadone, amphetamines and barbiturates in biological fluids of 1764 traumatized drivers admitted to the Emergency Department (ED) of Padua between 2010 and 2014. RESULTS: We note correlation between alcohol and benzodiazepines and admission in ICU and between all the intoxications and the reserved prognosis...
July 2018: Annali Dell'Istituto Superiore di Sanità
Tyler Vajdic, Kelly R Bergmann, Alicia Zagel, Henry Ortega
An estimated 14.8 million youth under the age of 25 years participate in recreational fishing. Despite its popularity, fishing can be associated with injuries ranging from mild to severe trauma. There is a paucity of research available that describes characteristics of fishing-related injuries among youth. We examined the National Electronic Injury Surveillance System 1997-2016 to describe injury patterns by age and sex. Linear regressions estimated changes in injuries over time. There were an estimated 412 171 pediatric patients treated in US emergency departments for fishing-related injuries...
October 4, 2018: Clinical Pediatrics
Helder Nogueira, Joana Pereira, André Couto, Jorge Alves, Daniel Lopes, Joana Freitas, Nuno Alegrete, Gilberto Costa
This is a case report of pyogenic sacroiliitis in a pediatric patient caused by Streptococcus intermedius . The patient is a 16-year-old boy who presented to an emergency department with sudden onset of back pain radiating to the left lower extremity. The diagnosis was confounded by the presence of isthmic spondylolisthesis. Plain radiography demonstrated mild isthmic spondylolisthesis but no radiographic signs of tumor, trauma, infection, arthritis, or other developmental problems. The C-reactive protein level was 23 mg/L...
July 2018: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Kristin A Sonderman, Lindsey L Wolf, Arin L Madenci, Alana L Beres
BACKGROUND: Nonaccidental trauma (NAT) is a leading cause of injury and death in early childhood. We sought to understand the association between insurance status and mortality in a national sample of pediatric NAT patients. MATERIALS AND METHODS: We performed a retrospective cohort study using the 2012-2014 National Trauma Databank. We included children ≤18 y hospitalized with NAT (The International Classification of Diseases, Ninth Revision codes: E967-968)...
November 2018: Journal of Surgical Research
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