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https://www.readbyqxmd.com/read/28108683/improving-decannulation-and-swallowing-function-a-comprehensive-multidisciplinary-approach-to-post-tracheostomy-care
#1
EDITORIAL
John W Mah, Ilene I Staff, Sylvia R Fisher, Karyn L Butler
BACKGROUND: Multidisciplinary tracheostomy teams have been successful in improving operative outcomes; however, limited data exist on their effect on postoperative care. We aimed to determine the effectiveness of a multidisciplinary tracheostomy service alone and following implementation of a post-tracheostomy care bundle on rates of decannulation and tolerance of oral diet before discharge. METHODS: Prospective data on all subjects requiring tracheostomy by any trauma/critical care surgeon were collected from January 2011 to December 2013 following development of a tracheostomy service and continued following implementation of the post-tracheostomy care bundle...
February 2017: Respiratory Care
https://www.readbyqxmd.com/read/28103120/compassionate-options-for-pediatric-ems-cope-addressing-communication-skills
#2
Aaron W Calhoun, Erica R H Sutton, Anita P Barbee, Beth McClure, Carrie Bohnert, Richard Forest, Peter Taillac, Mary E Fallat
INTRODUCTION: Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28101127/mental-health-and-trauma-in-asylum-seekers-landing-in-sicily-in-2015-a-descriptive-study-of-neglected-invisible-wounds
#3
Anna Crepet, Francesco Rita, Anthony Reid, Wilma Van den Boogaard, Pina Deiana, Gaia Quaranta, Aurelia Barbieri, Francesco Bongiorno, Stefano Di Carlo
BACKGROUND: In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28096009/perceptions-of-dying-well-and-distressing-death-by-acute-care-nurses
#4
Christine A Becker, Greg Wright, Kristen Schmit
AIM: This study aims to identify perceptions of nurses practicing in four adult inpatient units regarding their actions to provide quality end of life care for dying patients, their definitions of dying well, and their symptoms of distress and actions they took for relief. BACKGROUND: Nurses caring for patients who are dying want them to have the best death possible; however, many nurses are not prepared for every death which may occur. METHODS: Qualitative questionnaire data were collected from 49 nurses on four adult inpatient nursing units to analyze nurse perceptions of distressing death and dying well...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28087958/the-teaching-of-trauma-management-in-undergraduate-medical-education
#5
S K Lum, T Subramaniam
BACKGROUND: The teaching of trauma in medical schools faces many educational and logistic challenges. Issues on what to teach, how to teach, when to teach, who will teach and whether medical students with insufficient exposure to clinical medicine can benefit from a trauma course are unclear. MATERIALS AND METHODS: A well-designed one day intensive trauma course concentrating on the primary survey was taught to semester seven and semester eight students by a multi-disciplinary team comprising of surgeons, anaesthetists, emergency physicians and trained medical officers...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#6
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#7
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#8
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#9
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28056150/trends-in-otolaryngology-consultation-patterns-at-an-academic-quaternary-care-center
#10
Kevin J Choi, Russel R Kahmke, Matthew G Crowson, Liana Puscas, Richard L Scher, Seth M Cohen
Importance: The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. Objective: To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. Design, Setting, and Participants: A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014...
January 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28050641/children-presenting-in-delayed-fashion-after-minor-head-trauma-with-scalp-swelling-do-they-require-further-workup
#11
Jonathan N Sellin, Amee Moreno, Sheila L Ryan, Sandi K Lam, Marcella Donaruma-Kwoh, Thomas G Luerssen, Andrew Jea
PURPOSE: It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. We explore the value of further workup in this setting. METHODS: We conducted a retrospective review of a prospectively collected cohort of children ≤24 months of age presenting to the Texas Children's Hospital with scalp swelling more than 24 h following a head trauma...
January 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28033144/daily-electronic-health-record-reports-meet-meaningful-use-requirements-improve-care-efficiency-and-provide-a-layer-of-safety-for-trauma-patients
#12
Christopher E Stimson, Anita L Botruff
The electronic health record (EHR) is frequently viewed as a government-mandated charting system. As simply a replacement for the paper record, however, it was also frequently found to be inconvenient and a distraction to patient care. Broader use of the technology inherent in the EHR in the form of daily reports focused on key information that allows trauma clinical teams to efficiently monitor important information such as specific laboratory results or medications that might be missed or overlooked. In addition, other clinical personnel can monitor and assist in the care of trauma patients from remote locations such as an administrative office...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28031040/when-a-vehicle-becomes-a-weapon-intentional-vehicular-assaults-in-israel
#13
Gidon Almogy, Asaf Kedar, Miklosh Bala
BACKGROUND: We have recently witnessed an epidemic of intentional vehicular assaults (IVA) aimed at pedestrians. We hypothesized that IVA are associated with a specific injury pattern and severity. METHODS: Retrospective analysis of prospectively acquired data of patients injured following IVA from October 2008 to May 2016 who were admitted to the Hadassah Level I trauma center in Jerusalem, Israel. Comparison of injury parameters and outcome caused by vehicular attacks to non-intentional pedestrian trauma (PT)...
December 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28030532/the-application-of-a-simple-surveillance-method-for-detecting-the-prevalence-and-impact-of-overuse-injuries-in-professional-men-s-basketball
#14
K Weiss, M McGuigan, T Besier, C Whatman
The aim of this study was to use the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire to record overuse injuries over a single season for a men's professional basketball team in order to; (i) assess the prevalence and severity of overuse injuries and (ii) determine the efficacy of this method in identifying overuse injuries in comparison to the team physiotherapist's detection of these injuries. Thirteen athletes from a men's professional basketball team participated in this study. The self-reported, OSTRC injury questionnaire was used to record overuse conditions of the ankle, knee, lower back over an entire 24-week season...
December 24, 2016: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#15
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27992887/post-war-research-on-post-traumatic-stress-disorder-part-i-research-before-1989
#16
REVIEW
Krzysztof Rutkowski, Edyta Dembińska
The paper presents the post-war history of post-traumatic research conducted at the Department of Psychiatry of the Jagiellonian University and the analysis of the main research approaches and selected publications. The time after World War II passed in Poland in two directions: coping with the finished war trauma and simultaneously the experience of communist persecution trauma. First scientific publications appeared in the fifties and were focused on the research of former concentration camps prisoners (KZ-Syndrome)...
October 31, 2016: Psychiatria Polska
https://www.readbyqxmd.com/read/27992236/creating-new-opportunities-to-educate-families-on-the-impact-of-frailty-and-cognitive-impairment-in-a-trauma-intensive-care-unit-results-of-a-quality-improvement-project
#17
Mohana B Karlekar, Cathy A Maxwell, Mary S Dietrich, Richard S Miller
BACKGROUND: Older adults comprise a rapidly growing proportion of admissions to acute care hospitals and trauma centers. Older adults admitted to a trauma intensive care unit (TICU) often have a more complicated inpatient and posthospital course. This is the most pronounced in frail elders with cognitive dysfunction. We aimed at integrating validated screening instruments for physical frailty and cognitive impairment into the standard nursing assessment of all older trauma patients admitted to our TICU and stepdown unit...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27984449/operative-treatment-of-rib-fractures-in-flail-chest-injuries-a-meta-analysis-and-cost-effectiveness-analysis
#18
Eric Swart, Joseph Laratta, Gerard Slobogean, Samir Mehta
OBJECTIVES: Flail chest is a common injury sustained by patients who suffer from high energy blunt chest trauma, and results in severe respiratory compromise due to altered mechanics of respiration. There has been increased interest in operative fixation of these injuries with the intention of restoring the mechanical integrity of the chest wall, and several studies have shown that ventilation requirements and pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate fixation of rib fractures in flail chest injuries using cost effectiveness analysis, supported by systematic review and meta-analysis...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27979477/maximizing-efficiency-on-trauma-surgeon-rounds
#19
Aliaksandr Ramaniuk, Barbara J Dickson, Sean Mahoney, Michael S O'Mara
BACKGROUND: Rounding by trauma surgeons is a complex multidisciplinary team-based process in the inpatient setting. Implementation of lean methodology aims to increase understanding of the value stream and eliminate nonvalue-added (NVA) components. We hypothesized that analysis of trauma rounds with education and intervention would improve surgeon efficacy. MATERIALS AND METHODS: Level 1 trauma center with 4300 admissions per year. Average non-intensive care unit census was 55...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27976464/methods-for-collecting-paired-observations-from-emergency-medical-services-and-emergency-department-providers-for-pediatric-cervical-spine-injury-risk-factors
#20
Fahd A Ahmad, Hamilton Schwartz, Lorin R Browne, Sherry Lassa-Claxton, Michael Wallendorf, E Brooke Lerner, Nathan Kuppermann, Julie C Leonard
OBJECTIVES: Cervical spine injuries (CSI) after blunt trauma in children are rare but cause substantial morbidity and mortality. Emergency medical services (EMS) and emergency department (ED) providers routinely use spinal precautions and cervical spine imaging respectively during the management of children experiencing blunt trauma. These practices lack evidence, and there is concern that they may be harmful. A pediatric CSI risk-assessment tool is needed to inform EMS and ED provider decision-making...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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