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https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#1
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538636/the-role-of-nigms-p50-sponsored-team-science-in-our-understanding-of-multiple-organ-failure
#2
Frederick A Moore, Ernest E Moore, Timothy R Billiar, Yoram Vodovotz, Anirban Banerjee, Lyle L Moldawer
The history of the National Institute of General Medical Sciences (NIGMS) Research Centers in Peri-operative Sciences (RCIPS) is the history of clinical, translational and basic science research into the etiology and treatment of posttraumatic multiple organ failure (MOF). Born out of the activism of trauma and burn surgeons after the Viet Nam war, the P50 trauma research centers have been a nidus of research advances in the field, and the training of future academic physician-scientists in the fields of trauma, burns, sepsis and critical illness...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538454/open-tibia-shaft-fractures-and-soft-tissue-coverage-the-effects-of-management-by-an-orthopaedic-microsurgical-team
#3
James VandenBerg, Daniel Osei, Martin I Boyer, Michael J Gardner, William M Ricci, Amanda Spraggs-Hughes, Christopher M McAndrew
OBJECTIVES: To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team. DESIGN: Retrospective cohort study. SETTING: A single level 1 trauma center. PATIENTS: Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28530773/efficiency-of-instant-messaging-applications-in-coordination-of-emergency-calls-for-combat-injuries-a-pilot-study
#4
Sami Eksert, Mehmet Burak Aşık, Sinan Akay, Kenan Keklikçi, Fevzi Nuri Aydın, Mehmet Çoban, Ali Kantemir, Onur Güngör, Beyazıt Garip, Mustafa Suphi Turgut, Kenan Olcay
BACKGROUND: Coordination of an emergency response team is an important determinant of prompt treatment for combat injuries in hospitals. The authors hypothesized that instant messaging applications for smartphones could be appropriate tools for notifying emergency response team members. The objective of this study was to investigate the efficiency of a commercial instant messaging application (WhatsApp, Mountain View, CA) as a communication tool for the emergency team in a level-I trauma center...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28513531/who-should-lead-a-trauma-team-surgeon-or-non-surgeon-a-systematic-review-and-meta-analysis
#5
Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients...
June 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28513414/-prehospital-triage-in-trauma-patients-ambulance-care-and-deployment-of-a-mobile-medical-team
#6
M van Heijl, D den Hartog
- The prehospital trauma triage system consisting of regional ambulance services and overarching availability of mobile medical teams, the level criteria for trauma centres and in-hospital care for trauma patients are well-organised in the Netherlands.- However, the quality of prehospital triage in the Netherlands is inadequate at the moment, with an average under-triage rate of more than 30%. There is, thus, much room for improvement in the quality of prehospital triage.- Research in this area is now taking off, partly because of the arrival of a new quality indicator from the Netherlands National Health Care Institute, which states that at least 90% of multiple-trauma patients should be primarily taken to a level 1 trauma centre...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28504987/secondary-reconstruction-of-maxillofacial-trauma
#7
Jaime Castro-Núñez, Joseph E Van Sickels
PURPOSE OF REVIEW: Craniomaxillofacial trauma is one of the most complex clinical conditions in contemporary maxillofacial surgery. Vital structures and possible functional and esthetic sequelae are important considerations following this type of trauma and intervention. Despite the best efforts of the primary surgery, there are a group of patients that will have poor outcomes requiring secondary reconstruction to restore form and function. The purpose of this study is to review current concepts on secondary reconstruction to the maxillofacial complex...
May 12, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#8
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#9
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28489272/fear-learning-alterations-after-traumatic-brain-injury-and-their-role-in-development-of-posttraumatic-stress-symptoms
#10
Daniel E Glenn, Dean T Acheson, Mark A Geyer, Caroline M Nievergelt, Dewleen G Baker, Victoria B Risbrough
BACKGROUND: It is unknown how traumatic brain injury (TBI) increases risk for posttraumatic stress disorder (PTSD). One potential mechanism is via alteration of fear-learning processes that could affect responses to trauma memories and cues. We utilized a prospective, longitudinal design to determine if TBI is associated with altered fear learning and extinction, and if fear processing mediates effects of TBI on PTSD symptom change. METHODS: Eight hundred fifty two active-duty Marines and Navy Corpsmen were assessed before and after deployment...
May 10, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28488551/-emergency-laparotomy-in-a-trauma-patient
#11
F Hietbrink, R K J Simmermacher, M B de Vries, K J P van Wessem, M B de Jong, L P H Leenen
- Emergency laparotomy in trauma patients can be part of the resuscitation process, is based on damage control principles and is therefore fundamentally different from elective laparotomy, for example in case of malignancies. - Indications for emergency laparotomy after trauma are based on haemodynamic instability of the patient and the procedure is focused on restoring the patient's physiological condition.- Haemodynamic and biochemical parameters are used to determine the rest of the strategy. In order to optimize the procedure, the entire treatment team should be practiced in this...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28486323/the-trauma-time-out-evaluating-the-effectiveness-of-protocol-based-information-dissemination-in-the-traumatically-injured-patient
#12
Heather R Nolan, Michael Fitzgerald, Brett Howard, Joey Jarrard, Danny Vaughn
Procedural time-outs are widely accepted safety standards that are protocolized in nearly all hospital systems. The trauma time-out, however, has been largely unstudied in the existing literature and does not have a standard protocol outlined by any of the major trauma surgery organizations. The goal of this study was to evaluate our institution's use of the trauma time-out and assess how trauma team members viewed its effectiveness. A multiple-answer survey was sent to trauma team members at a Level I trauma center...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#13
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28486265/effect-of-family-presence-on-advanced-trauma-life-support-task-performance-during-pediatric-trauma-team-evaluation
#14
Karen J OʼConnell, Elizabeth A Carter, Jennifer L Fritzeen, Lauren J Waterhouse, Randall S Burd
IMPORTANCE: In many hospitals, family members are separated from their children during the early phases of trauma care. Including family members during this phase of trauma care varies by institution and is limited by concerns for adverse effects on clinical care. OBJECTIVE: The aim of this study is to evaluate the effect of family presence (FP) on advanced trauma life support primary and secondary survey task performance by pediatric trauma teams. We hypothesized that trauma care with FP would be noninferior to care when families were absent...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486263/predicting-thoracic-injury-in-children-with-multitrauma
#15
Kirstin D Weerdenburg, Paul W Wales, Derek Stephens, Suzanne Beno, Jessica Gantz, Jessie Alsop, Suzanne Schuh
OBJECTIVES: Previous pediatric trauma studies focused on predictors of abnormal chest radiographs or included patients with low injury severity. This study identified predictors of thoracic injury (TI) diagnoses in a high-risk population and determined TI rate without predictors. METHODS: This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28480184/trauma-surgery-without-proper-compensation-under-the-current-korean-national-health-insurance-system
#16
Kyoungwon Jung, Yunjung Heo, John Cook-Jong Lee, Mijin Lee, Suni Son, Hee Suk Park, Joo-Ok Kim, Jeong Hee Lee
PURPOSE: This study aimed to evaluate the situations and problems of the current health insurance fees for trauma surgeries. METHODS: We reviewed the medical records and billing data from trauma surgeries performed in the hospital from August 2012 to July 2014. The name and number of surgeries were investigated and the code and number of operations prescribed by surgeons were compared with the number of cases actually billed to insurance. In addition, the results returned by the Health Insurance Review & Assessment Services (HIRA) after deduction were investigated and compared to verify the insurance review findings...
May 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28470640/vermeidung-von-feuer-brand-explosion-im-op
#17
Hartmut Gehring, Klaas Rackebrandt
The combination of an oxidant source, ignition energy and flammable material is the reason for fire, burning and explosion (FBE) in the OR. Attending anaesthesiologists face these risks in their daily routine. Mostly, a situation with FBE arises in an unexpected situation. It is essential to have at hand a catalogue of measures to prevent severe injuries to patients and avoid material damages. There is a systematic way to decrease the risk: awareness and definition of high-risk situations; team work; building up a strategy to avoid the occurrence of fire, burning and explosion in high-risk situations...
April 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28467026/prehospital-notification-for-major-trauma-patients-requiring-emergency-hospital-transport-a-systematic-review
#18
Anneliese Synnot, Adrian Karlsson, Lisa Brichko, Melissa Chee, Mark Fitzgerald, Mahesh C Misra, Teresa Howard, Joseph Mathew, Thomas Rotter, Michelle Fiander, Russell L Gruen, Amit Gupta, Satish Dharap, Madonna Fahey, Michael Stephenson, Gerard O'Reilly, Peter Cameron, Biswadev Mitra
OBJECTIVE: This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (< 30 days) and early (< 24 hours) mortality, hospital reception and trauma team presence (or equivalent) on arrival, time to critical interventions and length of hospital stay. METHODS: Experimental and observational studies of pre-hospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included...
May 3, 2017: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/28465003/the-modified-rapid-emergency-medicine-score-a-novel-trauma-triage-tool-to-predict-in-hospital-mortality
#19
Ross T Miller, Niaman Nazir, Tracy McDonald, Chad M Cannon
BACKGROUND: Trauma systems currently rely on imperfect and subjective tools to prioritize responses and resources, thus there is a critical need to develop a more accurate trauma severity score. Our objective was to modify the Rapid Emergency Medicine (REMS) Score for the trauma population and test its accuracy as a predictor of in-hospital mortality when compared to other currently used scores, including the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the "Mechanism, Glasgow Coma Scale, Age and Arterial Pressure" (MGAP) score, and the Shock Index (SI) score...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28463947/impact-of-interfacility-transport-method-and-specialty-teams-on-outcomes-of-pediatric-trauma-patients
#20
Shetal C Patel, Stephen Murphy, Scott Penfil, Debra Romeo, James H Hertzog
OBJECTIVE: The aim of the study was to evaluate the impact of ground versus air transport and use of pediatric specialty versus generalist transport teams on outcomes of pediatric trauma victims requiring interfacility transport. METHODS: A retrospective review of our hospital's trauma registry database was performed. Children with traumatic injuries who were transported from a referring hospital by either our pediatric specialty transport team or an outside generalist transport team were included in the analysis...
May 1, 2017: Pediatric Emergency Care
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