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M Maegele
Based upon the results of CRASH-2, early administration of antifibrinolytic tranexamic acid (TXA) is recommended in bleeding trauma patients or trauma patients presumed to bleed. Many trauma centers and emergency medical services have adopted this practice into their routine algorithms. The pitfalls of CRASH-2 have been discussed in the literature, but the positive effects could sometimes not be reproduced in follow-up studies. The mechanism of action of TXA in trauma is still not clear and major knowledge gaps with TXA in the context of trauma have been identified...
September 14, 2016: Der Unfallchirurg
(no author information available yet)
This year, National Child Passenger Safety Week is September 18-24. In the United States, motor vehicle-related injuries are a leading cause of death among children (1). In 2014, a total of 602 passenger vehicle occupants aged 0-12 years died as a result of a crash (2), and more than 121,350 were injured (1). Of the children who died in 2014, 34% were known to be unrestrained (2). To keep child passengers as safe as possible, drivers should use age- and size-appropriate restraints for all child passengers until adult seat belts fit properly (a lap belt should lay across upper thighs, not abdomen, and a shoulder belt should lay across shoulder and chest, not neck or face) and follow the American Academy of Pediatrics child passenger safety recommendations (3)...
2016: MMWR. Morbidity and Mortality Weekly Report
Shahrzad Bazargan-Hejazi, Fereshteh Zamani-Alavijeh, Parvin Shahri, Rezvan Yazdani, Amir Shafiee
OBJECTIVE: Motorcycle-related crashes and injuries continue to be of great concern in Iran. This study seeks to explore how motorcyclists' perspectives and impressions of a crash are shaped and influence their future riding behaviors. METHODS: This was a qualitative study conducted in 3 major cities in Iran between March 2011 and February 2012. Participants included 31 male motorcyclists, of whom 22 participated in 4 focus groups and 9 in in-depth interviews. Findings were derived through the thematic method of analysis...
November 16, 2016: Traffic Injury Prevention
A E Talypov, A Yu Kordonsky, V V Krylov
Despite the introduction of new diagnostic and therapeutic methods, traumatic brain injury (TBI) remains one of the leading cause of death and disability worldwide. Standards and recommendations on conservative and surgical treatment of TBI patients should be based on concepts and methods with proven efficacy. The authors present a review of studies of the treatment and surgery of severe TBI: DECRA, RESCUEicp, STITCH(TRAUMA), CRASH, CRASH-2, CAPTAIN, NABIS: H ll, Eurotherm 3235. Important recommendations of the international group IMPACT are considered...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
David S Strosberg, Michelle C Nguyen, Lisa Mostafavifar, Howard Mell, David C Evans
OBJECTIVE: Early administration of tranexamic acid (TXA) has been shown to reduce all-cause mortality and death secondary to trauma. Our objective was to develop a collaborative prehospital TXA administration protocol between a ground EMS and academic medical center. METHODS: Physicians, pharmacists, and EMS and fire department personnel developed a prehospital TXA administration protocol between a local fire and EMS center with a Midwest tertiary care health system based on results from the CRASH-2 Trial...
July 2016: Prehospital Emergency Care
Neal Stuart Gerstein, Janet Kathryn Brierley, Matthew Douglas Culling
BACKGROUND CONTEXT: Our case highlights the underappreciated thrombotic risks of tranexamic acid (TXA) use in non-cardiac surgery and emphasizes the need to elucidate these risks with appropriate clinical trials. PURPOSE: The use of TXA in non-cardiac surgery has significantly expanded in the past 5 years, especially after the 2010 publication of the CRASH-2 Trial. We submit a case with the intent to highlight the thrombotic risk of TXA use during non-cardiac surgery and discuss the need for careful risk stratification before the use of TXA in this context...
February 2016: Spine Journal: Official Journal of the North American Spine Society
Ben Thurston, Sharfuddin Chowdhury, Sorin Edu, Andrew J Nicol, Pradeep Harkison Navsaria
BACKGROUND: Haemorrhage is responsible for about a third of in-hospital trauma deaths. The CRASH-2 trial demonstrated that early administration of tranexamic acid, ideally within 3 hours, can reduce mortality from trauma-associated bleeding by up to 32%. OBJECTIVE: To explore whether, in our trauma network in a middle-income country, patients arrived at hospital soon enough after injury for tranexamic acid administration to be effective and safe. METHODS: A prospective cohort study of 50 consecutive patients admitted to our trauma unit was undertaken...
March 2015: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Sophia Binz, Jonathon McCollester, Scott Thomas, Joseph Miller, Timothy Pohlman, Dan Waxman, Faisal Shariff, Rebecca Tracy, Mark Walsh
This paper reviews the application of tranexamic acid, an antifibrinolytic, to trauma. CRASH-2, a large randomized controlled trial, was the first to show a reduction in mortality and recommend tranexamic acid use in bleeding trauma patients. However, this paper was not without controversy. Its patient recruitment, methodology, and conductance in moderate-to-low income countries cast doubt on its ability to be applied to trauma protocols in countries with mature trauma networks. In addition to traditional vetting in scientific, peer-reviewed journals, CRASH-2 came about at a time when advances in communication technology allowed debate and influence to be leveraged in new forms, specifically through the use of multimedia campaigns, social media, and Internet blogs...
2015: Journal of Blood Transfusion
Kristofer D Kusano, Hampton C Gabler
OBJECTIVES: The U.S. New Car Assessment Program (NCAP) now tests for forward collision warning (FCW) and lane departure warning (LDW). The design of these warnings differs greatly between vehicles and can result in different real-world field performance in preventing or mitigating the effects of collisions. The objective of this study was to compare the expected number of crashes and injured drivers that could be prevented if all vehicles in the fleet were equipped with the FCW and LDW systems tested under the U...
2015: Traffic Injury Prevention
Alain Chichom-Mefire, Julius Atashili, Jean G Tsiagadigui, Clovis Fon-Awah, Marcelin Ngowe-Ngowe
BACKGROUND: Low and middle-income countries carry over ninety per cent of the burden of injury related mortality and disability. Motorcycles are gradually becoming a major mode of transportation in Cameroon and other African countries in the absence of an organized public transport. Consequently, the contribution of motorcycle crash to injury-related deaths seems to be on the rise. Currently, data addressing motorcycle crash characteristics, pattern, and severity of motorcycle-related injuries in Cameroon are scarce...
2015: BMC Public Health
Allison E Curry, Melissa R Pfeiffer, Michael R Elliott
OBJECTIVE: Young driver studies have applied quasi-induced exposure (QIE) methods to assess relationships between demographic and behavioral factors and at-fault crash involvement, but QIE's primary assumption of representativeness has not yet been validated among young drivers. Determining whether nonresponsible young drivers in clean (i.e., only one driver is responsible) 2-vehicle crashes are reasonably representative of the general young driving population is an important step toward ensuring valid QIE use in young driver studies...
May 18, 2016: Traffic Injury Prevention
Seyed Taghi Heydari, Kamran B Lankarani, Mehrdad Vossoughi, Kazem Javanmardi, Yaser Sarikhani, Kourosh Mahjoor, Mojtaba Mahmoodi, Mohammad Khabaz Shirazi, Maryam Akbari
BACKGROUND: Crash helmet plays an important role in protecting the deriver's head during crashes and reduces the rate of severe injuries and fatalities. Although it has been proved that wearing the crash helmet can save the deriver's life by around 42%; previous studies showed that the rate of wearing crash helmet has not been acceptable in Iran. Due to the huge number of motorcyclists on the roads in Iran, the use of crash helmet is an important area of research. The aim of this study was to assess the factors that could possibly relate to or affect the use of crash helmet by the motorcyclists...
January 2016: Journal of Injury & Violence Research
Andrew J Young, Luke Wolfe, Glenn Tinkoff, Therese M Duane
Despite the potentially devastating impact of missed cervical spine injuries (CI), there continues to be a large disparity in how institutions attempt to make the diagnosis. To better streamline the approach among institutions, understanding incidence and risk factors across the country is paramount. We evaluated the incidence and risk factors of CI using the National Trauma Databank for 2008 and 2009. We performed a retrospective review of the National Trauma Databank for 2008 and 2009 comparing patients with and without CI...
September 2015: American Surgeon
Shamsunnahar Yasmin, Naveen Eluru, Abdul R Pinjari
Fatality Analysis Reporting System (FARS) and Generalized Estimates System (GES) data are most commonly used datasets to examine motor vehicle occupant injury severity in the United States (US). The FARS dataset focuses exclusively on fatal crashes, but provides detailed information on the continuum of fatality (a spectrum ranging from a death occurring within thirty days of the crash up to instantaneous death). While such data is beneficial for understanding fatal crashes, it inherently excludes crashes without fatalities...
November 2015: Accident; Analysis and Prevention
Rocío Palmera-Suárez, Teresa López-Cuadrado, Javier Almazán-Isla, Rafael Fernández-Cuenca, Enrique Alcalde-Cabero, Iñaki Galán
BACKGROUND: Road traffic accidents cause substantial morbidity and disease burden; few studies have examined their impact on disability. OBJECTIVE: To estimate the magnitude and distribution of disability due to road traffic accidents according to socio-demographic variables, and its main socioeconomic and health determinants. METHODS: A cross-sectional study was conducted in community-dwelling participants in the "2008 Spanish National Disability Survey", a representative sample of 91,846 households with 20,425 disabled persons older than 15 years; 443 had disability due to road traffic accidents...
September 2015: Gaceta Sanitaria
Eneko Barbería, Josep M Suelves, Alexandre Xifró, Jordi Medallo
OBJECTIVE: To study immediate (same day of the collision) and delayed (within 30 days of the collision) deaths due to traffic injuries in Catalonia (Spain) according to forensic sources and to assess the differences between the two kinds of deaths. MATERIAL AND METHODS: An observational study was conducted of all the traffic accident deaths registered in the Institute of Legal Medicine of Catalonia between January 1(st) 2005 and December 31(st) 2014. Data analysis was performed using the SPSS v...
September 2015: Gaceta Sanitaria
Marta Olabarria, Elena Santamariña-Rubio, Marc Marí-Dell'Olmo, Mercè Gotsens, Ana M Novoa, Carme Borrell, Katherine Pérez
OBJECTIVE: To describe the magnitude and characteristics of crashes and drivers involved in head-on crashes on two-way interurban roads in Spain between 2007 and 2012, and to identify the factors associated with the likelihood of head-on crashes on these roads compared with other types of crash. METHODS: A cross-sectional study was conducted using the National Crash Register. The dependent variables were head-on crashes with injury (yes/no) and drivers involved in head-on crashes (yes/no)...
September 2015: Gaceta Sanitaria
Saeed Mahmood, Hassan Al-Thani, Ayman El-Menyar, Mushrek Alani, Ammar Al-Hassani, Saji Mathrdikkal, Ruben Peralta, Rifat Latifi
BACKGROUND AND AIMS: Tramadol is commonly used to treat moderate to moderately-severe pain in adults. We aimed to analyze the clinical relevance of tramadol use during weaning and extubation in patients with traumatic brain injury (TBI). MATERIAL AND METHODS: A retrospective observational study was conducted and included all the intubated TBI patients at the level I trauma center between 2011 and 2012. Data included patient's demographics, mechanism of injury (MOI), Glasgow Coma Scale (GCS), injury severity score, length of Intensive Care Unit (ICU) stay length of stay (LOS), agitation scale, analgesics, failure of extubation and tracheostomy...
July 2015: Journal of Anaesthesiology, Clinical Pharmacology
Jing-Yang Liou, Mei-Yung Tsou, Chien-Kun Ting
Drug interaction is fundamental in performing anesthesia. A response surface model (RSM) is a very useful tool for investigating drug interactions. The methodology appeared many decades ago, but did not receive attention in the field of anesthesia until the 1990s. Drug investigations typically start with pharmacokinetics, but it is the effects on the body clinical anesthesiologists really care about. Typically, drug interactions are divided into additive, synergistic, or infra-additive. Traditional isobolographic analysis or concentration-effect curve shifts are limited to a single endpoint...
December 2015: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Jianqiang Wang, Yang Zheng, Xiaofei Li, Chenfei Yu, Kenji Kodaka, Keqiang Li
This paper considers a comprehensive naturalistic driving experiment to collect driving data under potential threats on actual Chinese roads. Using acquired real-world naturalistic driving data, a near-crash database is built, which contains vehicle status, potential crash objects, driving environment and road types, weather condition, and driver information and actions. The aims of this study are summarized into two aspects: (1) to cluster different driving-risk levels involved in near-crashes, and (2) to unveil the factors that greatly influence the driving-risk level...
November 2015: Accident; Analysis and Prevention
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