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https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#1
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29016592/availability-of-life-support-equipment-and-its-utilization-by-ambulance-drivers
#2
Rija Acharya, Angur Badhu, Tara Shah, Sharmila Shrestha
BACKGROUND: An effective ambulance is a vital requirement for providing an emergency medical service. Well-equipped ambulances with trained paramedics can save many lives during the golden hours of trauma care. The objective was to document the availability and utilization of basic life support equipment in the ambulances and to assess knowledge on first aid among the drivers. METHODS: Descriptive design was used. Total of 109 ambulances linked to B.P. Koirala Institute of Health Sciences were enrolled using purposive sampling method...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28979634/delayed-brachial-artery-reconstruction-after-traumatic-injury-a-case-for-sustainment-of-surgical-intervention
#3
Kelechi Emmanuel Okonta, Emmanuel Ossai Ocheli, Tombari Joseph Gbeneol
The brachial artery is the commonest artery injured in the extremities. Although the patients present late, nevertheless reconstructions is advocated in other to salvage the limb and maintain function of the hand. We retrospectively examined 25 consecutive patients with vascular injuries treated at The Cardiovascular and Thoracic Surgery Unit of a tertiary health centre over a period of 4 years. We assessed the pre-tertiary methods of stopping of bleeding injured brachial arteries, mechanisms of injury, associated injuries, treatment and the outcome following vascular repair in terms of functionality of the forearm and the volume of the radial pulsation...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28958368/assessment-and-resuscitation-in-trauma-management
#4
REVIEW
Stephen Gondek, Mary E Schroeder, Babak Sarani
The golden hour of trauma represents a crucial period in the management of acute injury. In an efficient trauma resuscitation, the primary survey is viewed as more than simple ABCs with multiple processes running in parallel. Resuscitation efforts should be goal oriented with defined endpoints for airway management, access, and hemodynamic parameters. In tandem with resuscitation, early identification of life-threatening injuries is critical for determining the disposition of patients when they leave the trauma bay...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28932408/golden-hour-of-neonatal-life-need-of-the-hour
#5
REVIEW
Deepak Sharma
"Golden Hour" of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept in neonatology has been adopted from adult trauma where the initial first hour of trauma management is considered as golden hour. The "Golden hour" concept includes practicing all the evidence based intervention for term and preterm neonates, in the initial sixty minutes of postnatal life for better long-term outcome. Although the current evidence supports the concept of golden hour in preterm and still there is no evidence seeking the benefit of golden hour approach in term neonates, but neonatologist around the globe feel the importance of golden hour concept equally in both preterm and term neonates...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28915168/fluid-management-in-sepsis-is-there-a-golden-hour-or-two
#6
Katherine L Nugent, Craig M Coopersmith
No abstract text is available yet for this article.
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28912650/the-effects-combining-cryocompression-therapy-following-an-acute-bout-of-resistance-exercise-on-performance-and-recovery
#7
William H DuPont, Brek J Meuris, Vincent H Hardesty, Emily C Barnhart, Landon H Tompkins, Morricia J P Golden, Clayton J Usher, Paul A Spence, Lydia K Caldwell, Emily M Post, Matthew K Beeler, William J Kraemer
Compression and cold therapy used separately have shown to reduce negative effects of tissue damage. The combining compression and cold therapy (cryocompression) as a single recovery modality has yet to be fully examined. To examine the effects of cryocompression on recovery following a bout of heavy resistance exercise, recreationally resistance trained men (n =16) were recruited, matched, and randomly assigned to either a cryocompression group (CRC) or control group (CON). Testing was performed before and then immediately after exercise, 60 minutes, 24 hours, and 48 hours after a heavy resistance exercise workout (barbell back squats for 4 sets of 6 reps at 80% 1RM, 90 sec rest between sets, stiff legged deadlifts for 4 sets of 8 reps at 1...
September 2017: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/28910467/the-golden-hour-offset-surgical-treatment-team-operational-concept-experience-of-the-102nd-forward-surgical-team-in-operation-freedom-s-sentinel-2015-2016
#8
Jerry M Benavides, Linda C Benavides, Diane F Hale, Jonathan B Lundy
Theater Special Operations Force (SOF) medical planners have begun using Army Forward Surgical Teams (FSTs) to maintain a golden hour for U.S. SOF during Operation Freedom's Sentinel required adaptation in FST training, configuration, personnel, equipment, and employment to form Golden Hour Offset Surgical Treatment Teams (GHOST-Ts). This article describes one such FST's experience in Operation Freedom's Sentinel while deployed for 9 months in support of SOF in southern Afghanistan.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910466/surgical-instrument-sets-for-special-operations-expeditionary-surgical-teams
#9
Diane F Hale, Justin C Sexton, Linda C Benavides, Jerry M Benavides, Jonathan B Lundy
BACKGROUND: The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. METHODS: The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28903862/in-a-stable-battlefield-avoid-using-austere-surgical-units-to-meet-the-golden-hour-of-trauma-time-to-care-goal
#10
EDITORIAL
Richard Childers, Paul Parker
No abstract text is available yet for this article.
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28855773/effectiveness-and-safety-of-polygeline-in-patients-with-hypovolemia-due-to-trauma
#11
Ajai Singh, Sabir Ali, Rohita Shetty
BACKGROUND: This retrospective study examined the effectiveness and safety of polygeline in adult patients with hypovolemia due to traumatic injury. MATERIALS AND METHODS: Polygeline was administered after evaluating the amount of blood loss and estimating hematological and biochemical parameters. Changes in vital signs, serum electrolytes, arterial pH, and serum lactate were evaluated. The safety was evaluated by recording the adverse events if any. RESULTS: Sixty patients with the mean age 37...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28852589/assessing-the-utility-of-urinary-and-fecal-cortisol-as-an-indicator-of-stress-in%C3%A2-golden-snub-nosed-monkeys-rhinopithecus-roxellana
#12
Haochun Chen, Hui Yao, Wanji Yang, Penglai Fan, Zuofu Xiang
Cortisol concentration (CC) is often used as a stress indicator in animals, as high CC is associated with elevated stress levels. During field research, non-invasive methods of measuring CC, such as collection of urine and feces, are superior to using blood samples when monitoring free-ranging animals' stress levels. However, due to different metabolic pathways, whether CC can be detected in urine and feces to reliably assess stress varies across species. Therefore, it is important to ascertain whether urine and fecal samples are a reliable source for determining CCs and to determine a suitable sampling regime...
2017: PeerJ
https://www.readbyqxmd.com/read/28837293/-%C3%A2-golden-hour-%C3%A2-and-the-sellick-manoeuvre-in-emergency-care-we-must-not-throw-out-the-baby-with-the-bathwater
#13
Lukas Bürki, Bertrand Yersin
This article evaluates 3 controversial subjects of pre-hospital emergency care : 1) The concept of the « Golden hour » predicates an increased morbidity and mortality for injured patients, if pre-hospital care exceeds 1 hour. In the subgroup of patients presenting with severe hemorrhagic injuries or penetrating trauma to the torso, a transport of 60 minutes or less decreases mortality ; 2) The Sellick manoeuvre is used to decrease the risk of bronchoaspiration in patients undergoing an emergency intubation...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28836385/the-time-paradox-of-emergency-medicine-another-inverted-u-curve
#14
Daniel M Fatovich
Time is integral to emergency medicine, but the importance of time is over-rated. Media promotes a focus on time over suffering. Terms such as the 'golden hour' and 'time is muscle' are embedded into our language, but is language that corrupts thought. Time-based metrics for ED quality measures focus on speed over accuracy, reflecting another inverted U curve in our system of care. We often fail to understand the importance of heterogeneity, and the heterogeneity of treatment effect, for example, sicker patients are more likely to benefit from the intervention, whereas less sick patients do not benefit but are more likely to be harmed...
August 23, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28835283/identifying-pre-hospital-factors-associated-with-outcome-for-major-trauma-patients-in-a-regional-trauma-network-an-exploratory-study
#15
Lee Thompson, Michael Hill, Caroline Davies, Gary Shaw, Matthew D Kiernan
BACKGROUND: Major trauma is often life threatening and the leading cause of death in the United Kingdom (UK) for adults aged less than 45 years old. This study aimed to identify pre-hospital factors associated with patient outcomes for major trauma within one Regional Trauma Network. METHOD: Secondary analysis of pre-hospital audit data and patient outcome data from the Trauma Audit Research Network (TARN) was undertaken. The primary outcome used in analysis was 'Status at Discharge' (alive/deceased)...
August 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28727578/physical-activity-and-survival-in-women-with-advanced-breast-cancer
#16
Oxana Palesh, Charles Kamen, Susan Sharp, Ashleigh Golden, Eric Neri, David Spiegel, Cheryl Koopman
BACKGROUND: Several empirical investigations have attempted to characterize the effect of physical activity on cancer mortality, but these investigations have rarely focused on patients with advanced breast cancer. OBJECTIVE: The current study examined the hypothesis that greater physical activity is associated with longer survival among women with advanced breast cancer. METHODS: We conducted a secondary data analysis of a prospective study of 103 patients with stage IV (n = 100) or locally recurrent (n = 3) breast cancer involved in a group psychotherapy trial...
July 19, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28710245/abciximab-induced-acute-profound-thrombocytopenia-postpercutaneous-coronary-intervention
#17
Todd Golden, Sehem Ghazala, Rita Wadeea, Shilpa Junna
Abciximab (c7E3 Fab) is one of the three potent intravenous glycoprotein IIb/IIIa receptor inhibitors (along with eptifibatide and tirofiban) that have shown significant positive outcomes when used in patients with intracoronary thrombus. However, major side effects have been reported with its use including hypotension, major bleeding and thrombocytopenia. This case is a 53-year-old man presenting with acute chest pain diagnosed with non-ST-elevation myocardial infarction, who underwent percutaneous coronary intervention with abciximab and heparin infusion and developed acute profound thrombocytopenia (platelet count <20,000/L) within 9 hours of infusion...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28671402/laceration-repair-a-practical-approach
#18
REVIEW
Randall T Forsch, Sahoko H Little, Christa Williams
The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been unable to define a "golden period" for which a wound can safely be repaired without increasing risk of infection. Depending on the type of wound, it may be reasonable to close even 18 or more hours after injury. The use of nonsterile gloves during laceration repair does not increase the risk of wound infection compared with sterile gloves...
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28601206/prolonged-field-care-beyond-the-golden-hour
#19
REVIEW
Sean Keenan, Jamie C Riesberg
Prolonged field care (PFC) has emerged as a recent area of focus for US military Special Operations Forces (SOF) medical experts. Focused on the current reality of providing medical care to military forces often deployed in remote and austere locations far from medical support or a robust casualty evacuation chain, PFC encompasses evolving operational situations not unlike many wilderness medicine practice environments. SOF currently operates in all areas of the world and on a variety of different missions, which finds these small teams far from the accustomed practice environment of robust deployed medical infrastructure commonly seen during the last 15 years of military conflicts...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599036/the-role-i-resuscitation-team-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#20
Andrew D Fisher, William A Teeter, Christopher B Cordova, Megan L Brenner, Michael P Szczepanski, Ethan A Miles, Joseph M Galante, Joseph J DuBose, Todd E Rasmussen
The medical advancements made during the wars in Iraq and Afghanistan have resulted in an unprecedented survival rate, yet there is still a significant number of deaths that were potentially survivable. Additionally, the ability to deliver casualties to definitive surgical care within the "golden hour" is diminishing in many areas of conflict. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been implemented successfully in the hospital setting. REBOA may be a possible adjunct for the Role I and point-of-injury (POI) care to provide temporary control of noncompressible torso hemorrhage (NCTH) and junctional hemorrhage...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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