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Trauma life support

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https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#1
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27913262/neurosurgeons-in-japan-are-exclusively-brain-surgeons
#2
REVIEW
Shunji Asamoto
In Japan, neurosurgeons have mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is just one of the many subspecialties in the neurosurgical field in Japan. Most patients with neurological deficits or suspected neurological diseases are taken to board-certified neurosurgeons or go to them directly in Japan, not through referrals from family doctors or specialists in other fields. Problems originating in the spine and spinal cord have been overlooked or misdiagnosed in these situations...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27912037/avalanche-accidents-causing-fatalities-are-they-any-different-in-the-summer
#3
Mathieu Pasquier, Olivier Hugli, Alexandre Kottmann, Frank Techel
: Pasquier, Mathieu, Olivier Hugli, Alexandre Kottmann, and Frank Techel. Avalanche accidents causing fatalities: are they any different in the summer? High Alt Med Biol. 16:000-000, 2016. AIMS: This retrospective study investigated the epidemiology of summer avalanche accidents that occurred in Switzerland and caused at least one fatality between 1984 and 2014. Summer avalanche accidents were defined as those that occurred between June 1st and October 31st. RESULTS: Summer avalanches caused 21 (4%) of the 482 avalanches with at least one fatality occurring during the study period, and 40 (6%) of the 655 fatalities...
December 2, 2016: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27907846/modelling-life-satisfaction-and-adjustment-to-trauma-in-children-exposed-to-ongoing-military-violence-an-exploratory-study-in-palestine
#4
Guido Veronese, Alessandro Pepe, Alaa Jaradah, Feda Al Muranak, Husam Hamdouna
Exposure to war and ongoing political violence increases mental health risks among children, especially in terms of posttraumatic stress disorder (PTSD), and depressive or somatic symptoms. However, an exclusive focus on negative functioning can lead to underestimating the coping abilities and natural potential for adjusting to trauma of war-affected children at different developmental phases. Using structural equation modelling, we tested the extent to which data gathered in a predominantly nonclinical sample of Palestinian children (N=1276) living in refugee camps supported a conceptual model in which the relationship between subjective wellbeing and the effects of trauma is mainly top-down in direction...
November 28, 2016: Child Abuse & Neglect
https://www.readbyqxmd.com/read/27906867/external-validation-of-the-air-medical-prehospital-triage-score-for-identifying-trauma-patients-likely-to-benefit-from-scene-helicopter-transport
#5
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different dataset is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study (PTOS) registry. METHODS: Patients age≥16years undergoing scene HEMS or ground EMS (GEMS) transport in the PTOS registry 2000-2013 were included...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27904968/outcome-measures-of-extracorporeal-life-support-ecls-in-trauma-patients-versus-patients-without-trauma-a-7-year-single-center-retrospective-cohort-study
#6
Christopher Ull, Thomas A Schildhauer, Justus T Strauch, Justyna Swol
This single-center retrospective study included a total of 99 extracorporeal life support (ECLS) cannulated patients assigned to a traumatic extracorporeal life-support cohort (TECLS) or a non-traumatic extracorporeal life-support cohort (NTECLS). Forty-nine TECLS patients and 50 NTECLS patients were compared. The TECLS patients were significantly younger [49.9 years 16.6-86.2 vs. 57.1 (21.4-78.6); p = 0.007] and had lower body mass indices (BMIs) [27.7 kg/m(2) (20-37) vs. 32.5 (19-88.5); p = 0.001] than the NTECLS patients...
November 30, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#7
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27866692/does-the-number-of-emergency-medical-technicians-affect-the-neurological-outcome-of-patients-with-out-of-hospital-cardiac-arrest
#8
Shuichi Hagiwara, Kiyohiro Oshima, Makoto Aoki, Dai Miyazaki, Atsushi Sakurai, Yoshio Tahara, Ken Nagao, Naohiro Yonemoto, Arino Yaguchi, Naoto Morimura
BACKGROUND: It is unclear whether the number of paramedics in an ambulance improves the outcome of patients with out-of-hospital cardiac arrest (OHCA) or not. METHODS AND RESULTS: This study was a prospective, observational study conducted on patients with OHCA. Patients were divided into the One-paramedic group (Group O) and the Two-or-more-paramedic group (Group T) and we analyzed the differences. Patients who were treated with only basic life support during transportation, and whose cause of cardiac arrest were extrinsic cause such as trauma and poisoning were excluded...
November 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27866648/extracorporeal-life-support-is-safe-in-trauma-patients
#9
Christopher R Burke, Angelena Crown, Titus Chan, D Michael McMullan
INTRODUCTION: The role of extracorporeal life support (ECLS) in the critically ill trauma patient is poorly defined, possibly leading to the underutilization of this lifesaving therapy in this population. This study examined survival rates and risk factors for death in trauma patients who received ECLS. METHODS: Data from the National Trauma Data Bank was retrospectively reviewed to identify trauma patients who received ECLS from January 2012 to December 2014. Clinical outcomes and risk factors for death were examined in these patients...
November 11, 2016: Injury
https://www.readbyqxmd.com/read/27849460/a-narrative-review-of-the-prevalence-and-risk-factors-associated-with-development-of-knee-osteoarthritis-after-traumatic-unilateral-lower-limb-amputation
#10
Shawn Farrokhi, Brittney Mazzone, Adam Yoder, Kristina Grant, Marilynn Wyatt
INTRODUCTION: Young military Service Members with traumatic unilateral lower limb amputations may be at a high risk for developing knee osteoarthritis (OA). There is growing evidence for potential influence and predictive value of nonsystemic risk factors on development and progression of primary knee OA in older adults. Proposed factors include chronic knee pain, obesity, abnormal knee joint mechanics, muscle weakness, previous knee trauma, and altered physical activity level. However, there is limited information available regarding whether such nonsystemic risk factors could also be responsible for the increased risk of knee OA after traumatic, unilateral lower limb amputation in young military Service Members...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849457/the-center-for-rehabilitation-sciences-research-advancing-the-rehabilitative-care-for-service-members-with-complex-trauma
#11
Brad M Isaacson, Brad D Hendershot, Seth D Messinger, Jason M Wilken, Christopher A Rábago, Elizabeth Russell Esposito, Erik Wolf, Alison L Pruziner, Christopher L Dearth, Marilynn Wyatt, Steven P Cohen, Jack W Tsao, Paul F Pasquina
The Center for Rehabilitation Sciences Research (CRSR) was established to advance the rehabilitative care for service members with combat-related injuries, particularly those with orthopedic, cognitive, and neurological complications. The center supports comprehensive research projects to optimize treatment strategies and promote the successful return to duty and community reintegration of injured service members. The center also provides a unique platform for fostering innovative research and incorporating clinical/technical advances in the rehabilitative care for service members...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27845777/newer-insights-into-the-role-of-mirna-a-tiny-genetic-tool-in-psychiatric-disorders-focus-on-post-traumatic-stress-disorder
#12
REVIEW
V V Giridharan, R A Thandavarayan, G R Fries, C Walss-Bass, T Barichello, N J Justice, M K Reddy, J Quevedo
Post-traumatic stress disorder (PTSD) is a mental disorder occurring in about 2-9% of individuals after their exposure to life-threatening events, such as severe accidents, sexual abuse, combat or a natural catastrophe. Because PTSD patients are exposed to trauma, it is likely that epigenetic modifications have an important role in disease development and prognosis. For the past two decades, abnormal expression of the epigenetic regulators microRNAs (miRs) and miR-mediated gene regulation have been given importance in a variety of human diseases, such as cancer, heart disease and viral infection...
November 15, 2016: Translational Psychiatry
https://www.readbyqxmd.com/read/27843362/isolated-oculomotor-nerve-palsy-resulting-from-acute-traumatic-tentorial-subdural-hematoma
#13
Victoria Cui, Timur Kouliev
Acute subdural hematoma (SDH) resulting from head trauma is a potentially life-threatening condition that requires expedient diagnosis and intervention to ensure optimal patient outcomes. Rapidly expanding or large hematomas, elevated intracranial pressure, and associated complications of brain herniation are associated with high mortality rates and poor recovery of neurological function. However, smaller bleeds (clot thickness <10 mm) or hematomas occurring in infrequent locations, such as the tentorium cerebelli, may be difficult to recognize and patients may present with unusual or subtle signs and symptoms, including isolated cranial nerve palsies...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27833687/application-of-circumferential-compression-device-binder-in-pelvic-injuries-room-for-improvement
#14
Rahul Vaidya, Matthew Roth, Bradley Zarling, Sarah Zhang, Christopher Walsh, Jessica Macsuga, John Swartz
INTRODUCTION: The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve pelvic stabilization by both decreasing pelvic volume and limiting inter-fragmentary motion has become commonplace, and is a well-established component of Advanced Trauma Life Support (ATLS) protocol in the treatment of pelvic ring injuries. The purpose of this study was to evaluate the following: 1) how consistently a PCCD was placed on patients who arrived at our hospital with unstable pelvic ring injuries; 2) if they were placed in a timely manner; and 3) if hemodynamic instability influenced their use...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27832475/recovery-support-mediates-the-relationship-between-parental-warmth-and-quality-of-life-among-women-with-substance-use-disorders
#15
Suzanne Brown, Bryan Victor, Laurel M Hicks, Elizabeth M Tracy
PURPOSE: Historically, recovery from substance use disorders (SUD) has focused exclusively on the use or non-use of the addictive substance(s). More recently, SAMSHA [1] has defined recovery in a more holistic way, using quality of life (QoL) as a measure of recovery for individuals with substance use and mental health disorders. However, little is known about the myriad experiences that inform and affect QoL for individuals with substance use disorders. Using an attachment informed stress-buffering framework, the purpose of this study was to examine the contribution of parental warmth and recovery support to QoL among women in substance abuse treatment...
November 10, 2016: Quality of Life Research
https://www.readbyqxmd.com/read/27825381/cornerstone-program-for-transition-age-youth-with-serious-mental-illness-study-protocol-for-a-randomized-controlled-trial
#16
Michelle R Munson, Andrea Cole, Victoria Stanhope, Steven C Marcus, Mary McKay, James Jaccard, Shelly Ben-David
BACKGROUND: Transition-age youth have elevated rates of mental disorders, and they often do not receive services. This is a serious public health concern, as mental health conditions persist into adulthood. Continuing to engage this population has been a pervasive challenge for the mental health care system worldwide. Few mental health interventions have been developed for transition-age youth, and even fewer have been found to be effective over the transition to adulthood. Cornerstone, a theoretically guided intervention has shown promise for addressing the mental health and psychosocial needs of this population as they emerge into adulthood...
November 8, 2016: Trials
https://www.readbyqxmd.com/read/27825327/treatment-of-trauma-affected-refugees-with-venlafaxine-versus-sertraline-combined-with-psychotherapy-a-randomised-study
#17
Charlotte Sonne, Jessica Carlsson, Per Bech, Ask Elklit, Erik Lykke Mortensen
BACKGROUND: The prevalence of trauma-related psychiatric disorders is high among refugees. Despite this, little is known about the effect of pharmacological treatment for this patient group. The objective of the present study was therefore to examine differences in the effects of venlafaxine and sertraline on Post-Traumatic Stress Disorder (PTSD), depression and functional impairment in trauma-affected refugees. METHODS: The study was a randomised pragmatic trial comparing venlafaxine and sertraline in combination with psychotherapy and social counselling...
November 8, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27822127/objective-triage-in-the-disaster-setting-will-children-and-expecting-mothers-be-treated-like-others
#18
Timur Kouliev
The study of disaster triage is made difficult by the complex emotional response of potentially lifesaving intervention that a triage officer must make basing decisions on a succinct and efficient algorithm. A survey of triage professionals in international settings was designed to identify possible emotionally led bias that affects objective decision making in identifying victims most likely to benefit from immediate life support intervention. This survey suggests a lack of correlation between triage priority and predictable clinical outcomes as predicted by the Revised Trauma Score tool...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27820707/resuscitative-endovascular-balloon-occlusion-of-the-aorta-promise-practice-and-progress
#19
Zane B Perkins, Robbie A Lendrum, Karim Brohi
PURPOSE OF REVIEW: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research. RECENT FINDINGS: REBOA is a feasible method of achieving temporary aortic occlusion and can be performed rapidly, with a high degree of success, in the emergency setting (including at the scene of injury) by appropriately trained clinicians...
November 4, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27811560/advanced-extracorporeal-therapy-in-trauma
#20
David Zonies, Matthias Merkel
PURPOSE OF REVIEW: The purpose is to review the current application of extracorporeal life support (ECLS) in trauma patients. In addition, programmatic development is described. RECENT FINDINGS: ECLS use is increasing among trauma patients. Several recent studies among trauma patients report survival rates of 65-79%. Despite the high bleeding risk, extracorporeal membrane oxygenation (ECMO) may be safely implemented in trauma patients based on a strict protocol-driven policy...
December 2016: Current Opinion in Critical Care
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