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https://www.readbyqxmd.com/read/28214925/missed-opportunities-in-neonatal-deaths-in-rwanda-applying-the-three-delays-model-in-a-cross-sectional-analysis-of-neonatal-death
#1
Efua Wilmot, Marcel Yotebieng, Alison Norris, Fidele Ngabo
Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered...
February 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28204851/improved-outcomes-for-hepatic-trauma-in-england-and-wales-over-a-decade-of-trauma-and-hepatobiliary-surgery-centralisation
#2
J Barrie, S Jamdar, M F Iniguez, O Bouamra, T Jenks, F Lecky, D A O'Reilly
BACKGROUND: Over the last decade trauma services have undergone a reconfiguration in England and Wales. The objective is to describe the epidemiology, management and outcomes for liver trauma over this period and examine factors predicting survival. METHODS: Patients sustaining hepatic trauma were identified using the Trauma Audit and Research Network database. Demographics, management and outcomes were assessed between January 2005 and December 2014 and analysed over five, 2-year study periods...
February 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28190515/early-experience-with-a-split-bolus-single-pass-ct-protocol-in-paediatric-trauma
#3
V J Leung, M Grima, N Khan, H R Jones
AIM: To determine the adequacy of the split-bolus computed tomography (CT) technique in terms of vascular enhancement and solid-organ injury assessment in paediatric trauma. MATERIALS AND METHODS: A retrospective review was undertaken of all split-bolus trauma CT examinations performed in patients <16 years during the period from 1 January 2015 to 31 January 2016. Twelve examinations were performed in this time on patients with an age range of 2-15 years (mean 10...
February 9, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28186929/cross-sectional-examination-of-the-association-of-co-occurring-alcohol-misuse-and-traumatic-brain-injury-on-mental-health-and-conduct-problems-in-adolescents-in-ontario-canada
#4
Gabriela Ilie, Robert E Mann, Angela Boak, Edward M Adlaf, Hayley Hamilton, Mark Asbridge, Jürgen Rehm, Michael D Cusimano
OBJECTIVE: This study describes the impact of traumatic brain injury (TBI) and hazardous drinking on mental health and behavioural issues among Ontario adolescents. In particular, we assessed the incremental co-occurrence of hazardous drinking with a history of TBI, in comparison to experiencing just one of these conditions. METHODS: A cross-sectional subsample of 3130 Ontario adolescents attending grades 9-12, and aged 10-21 were surveyed in 2013 as a part of the Centre for Addiction and Mental Health's Ontario Student Drug Use and Health Survey...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28163926/rapid-analgesia-for-prehospital-hip-disruption-rapid-protocol-for-feasibility-study-of-randomised-controlled-trial
#5
Jenna K Bulger, Alan Brown, Bridie A Evans, Greg Fegan, Simon Ford, Katy Guy, Sian Jones, Leigh Keen, Ashrafunnesa Khanom, Ian Pallister, Nigel Rees, Ian T Russell, Anne C Seagrove, Helen A Snooks
BACKGROUND: Adequate pain relief at the point of injury and during transport to hospital is a major challenge in all acute traumas, especially for those with hip fractures, whose injuries are difficult to immobilise and whose long-term outcomes may be adversely affected by administration of opiate analgesics. Fascia iliaca compartment block (FICB) is a procedure routinely undertaken by doctors and nurses in the emergency department for patients with hip fracture but not yet evaluated for use by paramedics at the scene of emergency calls...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28139662/use-of-antibiotic-and-prevalence-of-antibiotic-associated-diarrhoea-in-patients-with-spinal-cord-injuries-a-uk-national-spinal-injury-centre-experience
#6
S Wong, P Santullo, J O'Driscoll, A Jamous, S P Hirani, M Saif
BACKGROUND: This was a retrospective audit, with the aims being to (1) record the use of antibiotics; (2) establish the prevalence of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CDAD); and (3) assess if there was any seasonal variation in antibiotic use and incidence of AAD. METHODS: The study was performed at a single spinal cord injury (SCI) centre in the UK. Data were collected using a standardised questionnaire during October 2014 to June 2015...
January 31, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28130346/the-use-of-whole-body-computed-tomography-in-major-trauma-variations-in-practice-in-uk-trauma-hospitals
#7
Ian Ayenga Sammy, Hridesh Chatha, Omar Bouamra, Marisol Fragoso-Iñiguez, Fiona Lecky, Antoinette Edwards
INTRODUCTION: Whole-body CT (WBCT) use in patients with trauma in England and Wales is not well documented. WBCT in trauma can reduce time to definitive care, thereby increasing survival. However, its use varies significantly worldwide. METHODS: We performed a retrospective observational study of Trauma Audit and Research Network (TARN) data from 2012 to 2014. The proportion of adult patients receiving WBCT during initial resuscitation at major trauma centres (MTCs) and trauma units/non-designated hospitals (TUs/NDHs) was compared...
January 27, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28129710/interventions-for-resuming-driving-after-traumatic-brain-injury
#8
Pamela E Ross, Marilyn Di Stefano, Judith Charlton, Gershon Spitz, Jennie L Ponsford
PURPOSE: To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment. METHOD: Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of on-road training lessons and reassessments, time from injury to independent driving, license restrictions, years licensed, physical/visual impairments and injury severity...
January 27, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28126353/auditing-access-to-outpatient-rehabilitation-services-for-children-with-traumatic-brain-injury-and-public-insurance-in-washington-state
#9
Molly M Fuentes, Leah Thompson, D Alex Quistberg, Wren L Haaland, Karin Rhodes, Deborah Kartin, Cheryl Kerfeld, Susan Apkon, Ali Rowhani-Rahbar, Frederick P Rivara
OBJECTIVE: Identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. DESIGN: Audit study, with paired calls where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury (TBI) and public or private insurance. SETTING: Outpatient rehabilitation clinics in Washington State PARTICIPANTS: 195 physical therapy clinics (PTc), 109 occupational therapy clinics (OTc), 102 speech therapy clinics (STc) and 11 rehabilitation medicine clinics INTERVENTIONS: None MAIN OUTCOME MEASURES: Acceptance of public insurance, business days until the next available appointment...
January 23, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28123747/improving-visual-assessment-documentation-in-patients-with-periorbital-trauma-through-an-eye-assessment-teaching-session-and-a-proforma-sticker
#10
Tharsika Myuran
Up to 30% of patients who have periorbital trauma will have ocular injury with devastating consequences if missed. All staff working with acutely injured Oral and Maxillofacial Surgery (OMFS) patients should be competent in a basic eye examination with documentation of visual acuity, gross visual fields, eye movements, diplopia, and pupillary responses at a minimum. As a standard we adapted guidance published by the Emergency Care Institute New South Wales to assess the documentation of the eye examination in OMFS patients at King's College Hospital with any periorbital injury...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28119351/are-first-rib-fractures-a-marker-for-other-life-threatening-injuries-in-patients-with-major-trauma-a-cohort-study-of-patients-on-the-uk-trauma-audit-and-research-network-database
#11
Ian Ayenga Sammy, Hridesh Chatha, Fiona Lecky, Omar Bouamra, Marisol Fragoso-Iñiguez, Abdo Sattout, Michael Hickey, John E Edwards
BACKGROUND: First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted. METHODS: Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network...
January 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28108854/elective-icp-monitoring-how-long-is-long-enough
#12
S D Thompson, A Coutts, C L Craven, A K Toma, L W Thorne, L D Watkins
BACKGROUND: Intracranial pressure monitoring is commonly undertaken to assess and manage acute patients following head injury. However, ICP monitoring can also be a useful diagnostic tool in the management of CSF dynamics in elective patients. To date, there is little published research to suggest how long these elective patients require ICP monitoring in order to gain an accurate picture of a patient's ICP dynamics. At the author's institution, a minimum of 48-h data collection is currently undertaken in patients with a suspected ICP abnormality...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28107309/-delay-to-operating-room-fails-to-identify-adverse-outcomes-at-a-level-i-trauma-center
#13
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28089060/evaluating-services-at-a-major-trauma-center-before-helipad-construction
#14
Danny Jon Nian Wong, James Robert Bedford, Simon Luck, Roger Bloomer
INTRODUCTION: Two of the 4 hospitals designated as major trauma centers in London, UK, currently operate on-site helicopter landing pads. King's College Hospital (KCH) is constructing a third. We evaluate current trauma services at King's College Hospital, before the helipad entering service, establishing baseline workload and mortality measures. METHODS: We retrospectively analyzed data from patients admitted January 1, 2014, to December 31, 2015, to KCH after major trauma with on-scene helicopter emergency medical services involvement (N = 427) using the Trauma Audit and Research Network database...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28068978/effectiveness-of-the-yourcall%C3%A2-text-message-intervention-to-reduce-harmful-drinking-in-patients-discharged-from-trauma-wards-protocol-for-a-randomised-controlled-trial
#15
Shanthi Ameratunga, Bridget Kool, Sarah Sharpe, Papaarangi Reid, Arier Lee, Ian Civil, Gordon Smith, Vanessa Thornton, Matthew Walker, Robyn Whittaker
BACKGROUND: Behavioural brief interventions (BI) can support people to reduce harmful drinking but multiple barriers impede the delivery and equitable access to these. To address this challenge, we developed YourCall™, a novel short message service (SMS) text message intervention incorporating BI principles. This protocol describes a trial evaluating the effectiveness of YourCall™ (compared to usual care) in reducing hazardous drinking and alcohol related harm among injured adults who received in-patient care...
January 9, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28068906/cherish-collaboration-for-hospitalised-elders-reducing-the-impact-of-stays-in-hospital-protocol-for-a-multi-site-improvement-program-to-reduce-geriatric-syndromes-in-older-inpatients
#16
Alison M Mudge, Merrilyn D Banks, Adrian G Barnett, Irene Blackberry, Nicholas Graves, Theresa Green, Gillian Harvey, Ruth E Hubbard, Sharon K Inouye, Sue Kurrle, Kwang Lim, Prue McRae, Nancye M Peel, Jessica Suna, Adrienne M Young
BACKGROUND: Older inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital...
January 9, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28063724/pressure-injury-prevalence-in-intensive-care-versus-non-intensive-care-patients-a-state-wide-comparison
#17
Fiona Coyer, Sandra Miles, Sandra Gosley, Paul Fulbrook, Kirstine Sketcher-Baker, Jane-Louise Cook, Jacqueline Whitmore
BACKGROUND: Hospital-acquired pressure injury is associated with increased morbidity and mortality and considered to be largely preventable. Pressure injury prevalence is regarded as a marker of health care quality. OBJECTIVE: To compare the state-wide prevalence, severity and location of pressure injuries of intensive care unit patients compared to patients in non-intensive care wards. METHOD: The study employed a secondary data analysis design to extract and analyse de-identified pressure injury data from all Queensland Health hospitals with level I-III intensive care facilities that participated in Queensland Bedside Audits between 2012-2014...
January 4, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28058552/complications-after-hepatectomy-for-hepatocellular-carcinoma-independently-shorten-survival-a-western-single-center-audit
#18
Alexandre Doussot, Chetana Lim, Eylon Lahat, Chady Salloum, Michael Osseis, Concepción Gómez Gavara, Eric Levesque, Cyrille Feray, Philippe Compagnon, Daniel Azoulay
BACKGROUND: The impact of postoperative complications (POCs) on long-term outcomes following hepatocellular carcinoma (HCC) resection remains to be ascertained. METHODS: All consecutive HCC resected at a single center were analyzed. Patients with POCs, classified according to Clavien classification, were compared to those without in terms of demographics, pathology, management, overall survival (OS), and disease-free survival (DFS). Independent prognostic factors of POCs were identified using multivariable regression models...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28056919/computerized-alcohol-screening-identified-more-at-risk-drinkers-in-a-level-2-than-a-level-1-trauma-center
#19
Ghasem Imani, Cristobal Barrios, Craig L Anderson, Maryam Hosseini Farahabadi, Faried Banimahd, Bharath Chakravarthy, Wirachin Hoonpongsimanont, Christopher E McCoy, Georginne Mercado, Babak Farivar, Jacqueline K Pham, Shahram Lotfipour
BACKGROUND: Alcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients...
January 6, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28052919/traumatic-brain-injuries-in-older-adults-6-years-of-data-for-one-uk-trauma-centre-retrospective-analysis-of-prospectively-collected-data
#20
Carol Hawley, Magdy Sakr, Sarah Scapinello, Jesse Salvo, Paul Wrenn
OBJECTIVES: Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. METHODS: Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma...
January 4, 2017: Emergency Medicine Journal: EMJ
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