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Trauma life support

M Gioffrè-Florio, L M Murabito, C Visalli, F P Pergolizzi, F Famà
AIM: Trauma, in geriatric patients, increases with age, and is a leading cause of disability and institutionalization, resulting in morbidity and mortality. The aim of our study was to analyse the prevalence of trauma, the related risk factors, mortality and sex differences in the prevalence in a geriatric population. PATIENTS AND METHOD: We observed 4,554 patients (≥65 years) with home injuries or car accidents. Patients were evaluated with ISS (Injury Severity Score) and major trauma with ATLS (Advanced Trauma Life Support)...
January 2018: Il Giornale di Chirurgia
N Tehrani
Background: Working with victims and offenders of child abuse can impact on the health and well-being of police officers and staff. Aims: To identify the effects of tenure, work ability, gender and a personal experience of child abuse on symptoms of anxiety, depression and primary and secondary trauma in child abuse investigators (CAIs). Methods: Screening questionnaires were sent to police officers and staff. The officers and staff worked in child protection in seven police forces...
March 13, 2018: Occupational Medicine
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
Justyna Swol, Daniel Brodie, Lena Napolitano, Pauline K Park, Ravi Thiagarajan, Ryan P Barbaro, Roberto Lorusso, David McMullan, Nicholas Cavarocchi, Ali Ait Hssain, Peter Rycus, David Zonies
No abstract text is available yet for this article.
March 12, 2018: Journal of Trauma and Acute Care Surgery
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Liza Jachens, Jonathan Houdmont, Roslyn Thomas
There is a paucity of research on the subjective stress-related experiences of humanitarian aid workers. Most evaluations of stress among these individuals focus on trauma and related conditions or adopt a quantitative approach. This interview-based study explored how 58 humanitarian aid workers employed by a United Nations-aligned organisation perceived the transactional stress process. The thematic analysis revealed eight main topics of interest: an emergency culture was found where most employees felt compelled to offer an immediate response to humanitarian needs; employees identified strongly with humanitarian goals and reported a high level of engagement; the rewards of humanitarian work were perceived as motivating and meaningful; constant change and urgent demands resulted in work overload; and managing work-life boundaries and receiving positive support from colleagues and managers helped to buffer perceived stress, work overload, and negative health outcomes...
March 13, 2018: Disasters
Marilyn Ballantyne, Stephanie Bernardo, Aubrey Sozer, Taryn Orava, Amy C McPherson, Paige Church, Darcy Fehlings
BACKGROUND: Parents' experiences transitioning their children from neonatal to developmental/rehabilitation services (DRS) are unknown. METHODS: A qualitative descriptive approach was used, including interviews with 18 parents (13 mothers and 5 fathers) of children born preterm and diagnosed with cerebral palsy (CP), located in a large urban center in Canada. Interview data underwent thematic analysis. RESULTS: Parents' experiences with transition to DRS were a whole new world with three key themes: Wanting to know what to expect, feeling supported in their transition, and getting there emotionally and physically...
March 12, 2018: Developmental Neurorehabilitation
Marta Novelo, Armin von Gunten, Gabriel Behr Gomes Jardim, Lucas Spanemberg, Irani Iracema de Lima Argimon, Eduardo L Nogueira
Childhood maltreatment is a risk factor for depression in nonelderly individuals. We investigated the effect of childhood abuse and neglect on the development of geriatric depression and its severity in socioeconomically disadvantaged individuals. A cross-sectional study investigated 449 individuals aged 60-103 years sorted by data using the enrollment list health coverage from the city of Porto Alegre, Brazil. The fifteen-item Geriatric Depression Scale was used to assess depression. The Childhood Trauma Questionnaire was used to identify emotional and physical neglect, in addition to emotional, physical, and sexual abuse...
March 6, 2018: Child Abuse & Neglect
Nicholas R Phillips, Derek E Kunz
While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax...
March 2018: Current Sports Medicine Reports
Maria L Pacella, Jeffrey M Girard, Aidan G C Wright, Brian Suffoletto, Clifton W Callaway
OBJECTIVES: Psychosocial factors and responses to injury modify the transition from acute to chronic pain. Specifically, posttraumatic stress disorder symptoms (PTSS; reexperiencing, avoidance, and hyperarousal symptoms) exacerbate and co-occur with chronic pain. Yet no study has prospectively considered the associations among these psychological processes and pain reports using experience sampling methods (ESM) during the acute aftermath of injury. This study applied ESM via daily text messaging to monitor and detect relationships among psychosocial factors and post-injury pain across the first 14-days after emergency department (ED) discharge...
March 7, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Neal E Winblad, Michael Changaris, Phyllis K Stein
Background: Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE®) is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS) dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience...
2018: Frontiers in Neuroscience
Cory Taylor, Jamie C Fertal, Solomon Liao
BACKGROUND: Withdrawal of life-support for an individual with refractory schizophrenia following attempted suicide remains controversial. Discussion regarding prognosis of mental illness and the distinction between somatic and mental illness brings out many ethical issues. This paper will examine the role and weight of severe persistent mental illness in the withdrawal of life support following attempted suicide. CASE DESCRIPTION: A 30-year-old gentleman with deafness and schizophrenia was admitted with multiple self-inflicted visceral stab wounds...
February 26, 2018: Journal of Pain and Symptom Management
Olav B Nielssen, William Stone, Naidene M Jones, Sarah Challis, Amelia Nielssen, Gordon Elliott, Nicholas Burns, Astrid Rogoz, Lucy E Cooper, Matthew M Large
OBJECTIVE: To describe the characteristics of people attending mental health clinics at shelters for the homeless in inner city Sydney. DESIGN: Retrospective review of medical records of homeless hostel clinic attenders. SETTING: Mental health clinics located in three inner city homeless hostels. PARTICIPANTS: Consecutive series of clinic attenders, 21 July 2008 - 31 December 2016. MAIN OUTCOME MEASURES: Demographic characteristics; social, medical and mental health histories of homeless people...
March 5, 2018: Medical Journal of Australia
Erin Hulfish, Maria Carmen G Diaz, Megan Feick, Catherine Messina, Glenn Stryjewski
BACKGROUND: Advanced Trauma Life Support resuscitation follows a strict protocolized approach to the initial trauma evaluation. Despite this structure, elements of the primary and secondary assessments can still be omitted. The aim of this study is to determine if a cognitive aid checklist reduces omissions and speeds the time to assessment completion. We additionally investigated if a displayed checklist improved performance further. METHODS: A series of 131 simulated trauma resuscitations were performed...
February 28, 2018: Pediatric Emergency Care
Jo Hodgekins, Rebecca Lower, Jon Wilson, Hannah Cole, Uju Ugochukwu, Sarah Maxwell, David Fowler
AIM: The prevalence of psychotic-like experiences (PLEs) was explored in a sample of 14- to 25-year-olds with non-psychotic mental health difficulties. Associations between PLEs, psychopathology, functioning, trauma history, and pathways to care were examined. METHODS: Data were collected for 202 young people. Clinicians rated PLEs using the Primary Care Checklist (PCC) and functioning using Global Assessment Scales. Eighty-three young people completed self-report assessments of PLEs using the Prodromal Questionnaire (PQ-16) and measures of social anxiety, depression, trauma history, and pathways to care...
February 27, 2018: British Journal of Clinical Psychology
Elizabeth A Evans, Dawn L Glover, Donna L Washington, Alison B Hamilton
BACKGROUND: Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. OBJECTIVES: We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. METHODS: Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015...
February 27, 2018: Substance Use & Misuse
Liang Zhang, DaLong Wan, LeLe Zhang, ShiGuo Xu, HaiYang Xie, ShengZhang Lin
RATIONALE: Currently, percutaneous catheter drainage (PCD) is regarded as the first-line treatment modality of pyogenic liver abscess. Severe complications associated with PCD were uncommon. Hepatic rupture is an uncommon but life-threatening liver trauma with high mortality. Its management is challenging because a delay in the diagnosis may lead to fatal hemorrhagic shock. To our knowledge, PCD-associated hepatic rupture has never been reported. PATIENT CONCERNS: We report herein a rare case of PCD-associated hepatic rupture...
January 2018: Medicine (Baltimore)
Khuram Khan, Saqib Saeed, Alexius Ramcharan, Sanjiv Gray
INTRODUCTION: Traumatic brain injury (TBI) is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction...
February 9, 2018: International Journal of Surgery Case Reports
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
February 22, 2018: Prehospital Emergency Care
Adrienne O'Neil, Anna J Scovelle, Allison J Milner, Anne Kavanagh
The social gradient for cardiovascular disease (CVD) onset and outcomes is well established. The American Heart Association's Social Determinants of Risk and Outcomes of Cardiovascular Disease Scientific Statement advocates looking beyond breakthroughs in biological science toward a social determinants approach that focuses on socioeconomic position, race and ethnicity, social support, culture and access to medical care, and residential environments to curb the burden of CVD going forward. Indeed, the benefits of this approach are likely to be far reaching, enhancing the positive effects of advances in CVD related to prevention and treatment while reducing health inequities that contribute to CVD onset and outcomes...
February 20, 2018: Circulation
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