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David Häske, Lance Stuke, Michael Bernhard, Axel R Heller, Uwe Schweigkofler, Bernhard Gliwitzky, Matthias Münzberg
BACKGROUND: The Prehospital Trauma Life Support (PHTLS) concept is well established throughout the world. The aim is to improve prehospital care for patients with major trauma. In 2011, a German Level 3 (S3) evidence- and consensus-based guideline on the treatment of patients with severe and multiple injuries was published. The scope of this study was the systematic comparison between the educational content of the worldwide PHTLS concept and the German S3 Guideline. METHODS: A total of 62 key recommendations of the German S3 Guideline were compared with the content of the English PHTLS manual (eighth edition)...
August 2016: Journal of Trauma and Acute Care Surgery
Pedro Monteiro Menezes, Timothy Wayne Cook, Luciana Tricai Cavalini
OBJECTIVES: To present the technical background and the development of a procedure that enriches the semantics of Health Level Seven version 2 (HL7v2) messages for software-intensive systems in telemedicine trauma care. METHODS: This study followed a multilevel model-driven approach for the development of semantically interoperable health information systems. The Pre-Hospital Trauma Life Support (PHTLS) ABCDE protocol was adopted as the use case. A prototype application embedded the semantics into an HL7v2 message as an eXtensible Markup Language (XML) file, which was validated against an XML schema that defines constraints on a common reference model...
January 2016: Healthcare Informatics Research
Floran A Reynard, Alexandros N Flaris, Eric R Simms, Olivier Rouvière, Pascal Roy, Nicolas J Prat, Jean-Gabriel Damizet, Jean-Louis Caillot, Eric J Voiglio
INTRODUCTION: Pre-hospital pelvic stabilisation is advised to prevent exsanguination in patients with unstable pelvic fractures (UPFs). Kendrick's extrication device (KED) is commonly used to extricate patients from cars or crevasses. However the KED has not been tested for potential adverse effects in patients with pelvic fractures. The aim of this study was to examine the effect of the KED on pubic symphysis diastasis (SyD) with and without the use of a trochanteric belt (TB) during the extraction process following a MVC...
March 2016: Injury
M Münzberg, T Harbers, U Kneser, P A Grützner, B Reichert, T Kremer, C G Wölfl, J Horter, C Hirche
The initial treatment of severely burned patients remains a huge challenge for first responders in emergency services as well as emergency doctors who do not work in a centre for severe burn injuries. The reason for this is the low number of cases in developed countries and a lack of training concepts for the specific aspects of the initial treatment of severe burn injuries. Because of guidelines with limited evidence (S1, S2k) and a lack of structured treatment approaches, uncertainties with respect to initial treatment are still visible...
December 17, 2015: Zentralblatt Für Chirurgie
Marc Maegele
For the German speaking countries, Tscherne's definition of "polytrauma" which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
G Matthes, H Trentzsch, C G Wölfl, T Paffrath, S Flohe, U Schweigkofler, A Ekkernkamp, S Schulz-Drost
BACKGROUND: In order to ensure adequate treatment and to avoid complications, care bundles are increasingly being implemented. These are comprehensive and evidence-based procedures for the treatment of individual diseases or injuries which should be carried out for every patient. The aim of this study was to define a care bundle for the prehospital treatment of severely injured patients. MATERIAL AND METHODS: The scientific contents of the bundle were gathered from the interdisciplinary evidence-based S3 guidelines for the treatment of severely injured patients by the German Trauma Society...
August 2015: Der Unfallchirurg
Bjoern Hussmann, Sven Lendemans
The pre-hospital and early in-hospital management of most severely injured patients has dramatically changed over the last 20 years. In this context, the factor time has gained more and more attention, particularly in German-speaking countries. While the management in the early 1990s aimed at comprehensive and complete therapy at the accident site, the premise today is to stabilise trauma patients at the accident site and transfer them into the hospital rapidly. In addition, the introduction of training and education programmes such as Pre-hospital Trauma Life Support (PHTLS(®)), Advanced Trauma Life Support (ATLS(®)) concept or the TEAM(®) concept has increased the quality of treatment of most severely injured trauma patients both in the preclinical field and in the emergency trauma room...
October 2014: Injury
B Donaubauer, J Fakler, A Gries, U X Kaisers, C Josten, M Bernhard
BACKGROUND: The recommendations still have to be implemented 3 years after publication of the S3 guidelines on the treatment of patients with severe and multiple injuries. AIM: This article reiterates some of the essential core statements of the S3 guidelines and also gives an overview of new scientific studies. MATERIAL AND METHODS: In a selective literature search new studies on airway management, traumatic cardiac arrest, shock classification, coagulation therapy, whole-body computed tomography, air rescue and trauma centers were identified and are discussed in the light of the S3 guideline recommendations...
November 2014: Der Anaesthesist
Christian B Frank, Christoph G Wölfl, Aidan Hogan, Arnold J Suda, Thorsten Gühring, Bernhard Gliwitzky, Matthias Münzberg
BACKGROUND: The goal of this study was to examine PHTLS Provider courses in Germany and to proof the assumption that formation of physicians and paramedics in prehospital trauma care can be optimized. METHODS: PHTLS participants were asked to fill out standardized questionnaires during their course preparation and directly after the course. There were some open questions regarding their professional background and closed questions concerning PHTLS itself. Further questions were to be answered on an analog scale in order to quantify subjective impressions of confidence, knowledge and also to describe individual levels of education and training...
2014: Journal of Trauma Management & Outcomes
Rick Hong, Molly Meenan, Erin Prince, Ronald Murphy, Caitlin Tambussi, Rick Rohrbach, Brigitte M Baumann
INTRODUCTION: We wanted to compare 3 existing emergency medical services (EMS) immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based); the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria); and the Hankins' criteria (immobilization for patients <12 or >65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness).To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance...
July 2014: Western Journal of Emergency Medicine
Keith Wesley, Karen Wesley
No abstract text is available yet for this article.
May 2014: JEMS: a Journal of Emergency Medical Services
Arturo Garcia, Terrence H Liu, Gregory P Victorino
BACKGROUND: The American College of Surgeons' Committee on Trauma's recent prehospital trauma life support recommendations against prehospital spine immobilization (PHSI) after penetrating trauma are based on a low incidence of unstable spine injuries after penetrating injuries. However, given the chronic and costly nature of devastating spine injuries, the cost-utility of PHSI is unclear. Our hypothesis was that the cost-utility of PHSI in penetrating trauma precludes routine use of this prevention strategy...
February 2014: Journal of Trauma and Acute Care Surgery
Stavros Gourgiotis, George Gemenetzis, Hemant M Kocher, Stavros Aloizos, Nikolaos S Salemis, Stylianos Grammenos
Severity of hemorrhage and rate of bleeding are fundamental factors in the outcomes of trauma. Intravenous administration of fluid is the basic treatment to maintain blood pressure until bleeding is controlled. The main guideline, used almost worldwide, Advanced Trauma Life Support, established by the American College of Surgeons in 1976, calls for aggressive administration of intravenous fluids, primarily crystalloid solutions. Several other guidelines, such as Prehospital Trauma Life Support, Trauma Evaluation and Management, and Advanced Trauma Operative Management, are applied according to a patient's current condition...
December 2013: Critical Care Nurse
David Häske, Michael Kreinest, Christoph G Wölfl, Christian Frank, Götz Brodermann, Johannes Horter, Arnold J Suda, Bernhard Gliwitzky, Stefan K Beckers, Ulrich Stöckle, Matthias Münzberg
In recent years, the emergency medical services in Wiesbaden and the Rheingau-Taunus district made great efforts to standardise structures. Since there are only few established procedures in the annual examinations for paramedics, there is reason to assume that treatment procedures for patients have not been standardised either. Materials and equipment are not handled uniformly, and employee satisfaction has significantly decreased over the last few years. To solve these problems, all paramedics undergo standardised and structured trainings...
2013: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Hans Blomberg, Bodil Svennblad, Karl Michaelsson, Liisa Byberg, Jakob Johansson, Rolf Gedeborg
BACKGROUND: There is limited evidence that the widely implemented Prehospital Trauma Life Support (PHTLS) educational program improves patient outcomes. The primary aim of this national study in Sweden was to investigate the association between regional implementation of PHTLS training and mortality after traffic injuries. STUDY DESIGN: We extracted information from the Swedish National Patient Registry and the Cause of Death Registry on victims of motor-vehicle traffic injuries in Sweden from 2001 to 2004 (N = 28,041)...
December 2013: Journal of the American College of Surgeons
Norman E McSwain
No abstract text is available yet for this article.
July 2013: Journal of Trauma and Acute Care Surgery
Manuel Mutschler, Ulrike Nienaber, Matthias Münzberg, Tobias Fabian, Thomas Paffrath, Christoph Wölfl, Bertil Bouillon, Marc Maegele
OBJECTIVE: Validation of the classification of hypovolaemic shock suggested by the prehospital trauma life support (PHTLS) in its sixth student course manual. METHODS: Adults, entered into the TraumaRegister DGU(®) database between 2002 and 2011, were classified into reference ranges for heart rate (HR), systolic blood pressure (SBP) and Glasgow coma scale (GCS) according to the PHTLS classification of hypovolaemic shock. First, patients were grouped by a combination of all three parameters (HR, SBP and GCS) as suggested by PHTLS...
January 2014: Emergency Medicine Journal: EMJ
M Helm, A Bitzl, S Klinger, R Lefering, L Lampl, M Kulla
BACKGROUND: The trauma register of the German Society of Trauma Surgery (TraumaRegister DGU®/TR-DGU) has been proven to be a valuable tool for external assessment of quality in the treatment of patients with major trauma. This publication shows for the first time how the quality of trauma treatment in a level I trauma centre could be improved over a period of almost ten years with the help of continuous quality management, i.e. recognizing a problem, developing a solution and evaluating its effect...
July 2013: Der Unfallchirurg
Ajay H Bhandarwar, Girish D Bakhshi, Mukund B Tayade, Gajanan S Chavan, Sachin S Shenoy, Ashish S Nair
BACKGROUND: Mumbai, one of the industrial capitals cities of the world, has witnessed a series of terror attacks over the last two decades. The 2008 Mumbai terror attacks referred as "26/11" drew widespread global condemnation and killed 166 people, in addition to wounding more than 300 people. The mortality pattern and the pathophysiology of organ injuries are presented. The objective of this study was to determine the different patterns of injury in a terrorist attack of such magnitude and clinical implications in reducing mortality...
May 2012: Journal of Trauma and Acute Care Surgery
Jakob Johansson, Hans Blomberg, Bodil Svennblad, Lisa Wernroth, Håkan Melhus, Liisa Byberg, Karl Michaëlsson, Rolf Karlsten, Rolf Gedeborg
BACKGROUND: The Prehospital Trauma Life Support (PHTLS) course has been widely implemented and approximately half a million prehospital caregivers in over 50 countries have taken this course. Still, the effect on injury outcome remains to be established. The objective of this study was to investigate the association between PHTLS training of ambulance crew members and the mortality in trauma patients. METHODS: A population-based observational study of 2830 injured patients, who either died or were hospitalized for more than 24 h, was performed during gradual implementation of PHTLS in Uppsala County in Sweden between 1998 and 2004...
October 2012: Resuscitation
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