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https://www.readbyqxmd.com/read/28416153/a-critical-review-of-patient-safety-indicators-attributed-to-trauma-surgeons
#1
Nicole Fox, Rebecca Willcutt, Adrienne Elberfeld, John Porter, Anthony J Mazzarelli
BACKGROUND: The Agency for Health Care Research and Quality (AHRQ) developed patient safety indicators (PSIs) to identify events with a high likelihood of representing medical error. The purpose of this study was to validate PSIs attributed to trauma surgeons and compare validated PSIs to performance improvement (PI) and morbidity and mortality (M&M) data. We hypothesized that PSIs are not an indicator of quality of care in trauma. METHODS: PSI's attributed to trauma surgeons (n=9) at our institution were reviewed (Jan-Dec 2015)...
April 1, 2017: Injury
https://www.readbyqxmd.com/read/28340081/retroocular-and-subdural-hemorrhage-or-hemosiderin-deposits-in-pediatric-autopsies
#2
Marc R Del Bigio, Susan M Phillips
The presence of hemosiderin in the optic nerve sheath and/or retina is sometimes used to estimate the timing of injury in infants or children with suspected non-accidental head trauma. To determine the prevalence of hemosiderin in deaths not associated with trauma, we performed a prospective study of retroocular orbital tissue, cranial convexity, and cervical spinal cord dura mater in infants and children <2.5 years age. In 53 cases of non-traumatic death, approximately 70% had blood or hemosiderin within the orbital fat, ocular muscles, and parasagittal cranial and/or cervical spinal subdural compartment...
April 1, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28338594/the-association-of-non-accidental-trauma-with-historical-factors-exam-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#3
Mauricio A Escobar, Marc Auerbach, Katherine Flynn-O'Brien, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly Falcone, Rita Burke, John M Cox, Sabine Maguire
Early identification of non-accidental trauma (NAT) is a critical component of pediatric trauma care. Literature searches were conducted related to the association of NAT with seven key areas: history, exam findings (burns, oral trauma, bruising) and imaging (fractures, abdominal and brain injuries). When available, odds ratios (OR) with 95% confidence intervals (CI) for associations with NAT are presented. Systematic reviews have been published in six of the seven key areas and are described. The operational definition of NAT was widely variable across studies, prohibiting meta-analysis...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#4
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS>15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and AIS to predict mortality and define optimal thresholds of severe injury in pediatric trauma. METHODS: Patients from the Pennsylvania trauma registry 2000-2013 were included...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28316319/epileptic-spasms-in-paediatric-post-traumatic-epilepsy-at-a-tertiary-referral-centre
#5
Jun T Park, Harry T Chugani
To recognize epileptic spasms (ES) as a seizure type after traumatic brain injury (TBI), accidental or non-accidental, in infants and children. In the process, we aim to gain some insight into the mechanisms of epileptogenesis in ES. A retrospective electronic chart review was performed at the Children's Hospital of Michigan from 2002 to 2012. Electronic charts of 321 patients were reviewed for evidence of post-traumatic epilepsy. Various clinical variables were collected including age at TBI, mechanism of trauma, severity of brain injury, electroencephalography/neuroimaging data, and seizure semiology...
March 17, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28302284/hospital-based-screening-tools-in-the-identification-of-non-accidental-trauma
#6
Dani O Gonzalez, Katherine J Deans
Over 700,000 children are victims of abuse and neglect each year in the United States. Effective screening programs that entail broad capture of suspected non-accidental trauma (NAT) may help to identify sentinel injuries. This can facilitate earlier detection and psychosocial interventions in hopes of decreasing recurrent NAT, which confers a higher mortality rate. The purpose of this article is to outline essential components of hospital-based NAT screening tools and highlight existing programs. In general, these tools should include several components: education sessions for healthcare providers on how to identify signs of NAT, automated notes or checklists within the electronic medical record to prompt specialty referrals, and a multidisciplinary team of experts that can address the needs of these children in the acute care setting...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28236132/double-read-of-skeletal-surveys-in-suspected-non-accidental-trauma-what-we-learned
#7
Boaz Karmazyn, Elise M Miller, Sara E Lay, James M Massey, Matthew R Wanner, Megan B Marine, S Gregory Jennings, Fangqian Ouyang, Roberta A Hibbard
BACKGROUND: Missing a fracture in a child on skeletal surveys for suspected non-accidental trauma can have devastating results. Double-read has the potential to improve fracture detection. However the yield of double-read is unknown. OBJECTIVE: To determine the advantage of double-read versus single-read of radiographic skeletal surveys for suspected non-accidental trauma. MATERIALS AND METHODS: The study was performed in two phases. In the first phase (April 2013 to September 2013), double-read was performed for all skeletal surveys obtained during weekday working hours...
February 24, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28007317/examining-the-role-of-follow-up-skeletal-surveys-in-non-accidental-trauma
#8
Rebecca D Powell-Doherty, Nora E Raynor, Donna A Goodenow, David G Jacobs, Anthony Stallion
BACKGROUND: Diagnosing NAT (non-accidental trauma) includes a skeletal survey to identify injuries. A follow-up survey is performed for missed injuries. This study examines the necessity of follow-up surveys. METHODS: The trauma database identified cases of suspected NAT in <4 years olds (2013-2014). Data were stratified by survey, age, injury, then analyzed for the prevalence of findings. All analyses (relative risk, prevalence and odds ratios) utilized RealStats Resource Pack (Trento, Italy)...
December 11, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27941195/mucoceles-of-minor-salivary-glands-in-children-own-clinical-observations
#9
Bogumił Lewandowski, Robert Brodowski, Paweł Pakla, Aleksander Makara, Wojciech Stopyra, Bartek Startek
INTRODUCTION: Mucoceles are benign lesions associated with the pathology of the oral mucosa of minor salivary glands. Two types of cysts are distinguished depending on their pathogenesis. Most often they occur as a result of mechanical trauma and mucus extravasation into tissues or obstruction of the gland ducts. AIM: The aim of the study was to present our own experiences regarding mucoceles of minor salivary glands in the oral cavity taking into account how frequently the individual types of cysts occur in children...
2016: Developmental Period Medicine
https://www.readbyqxmd.com/read/27862642/external-validation-of-the-pecarn-head-trauma-prediction-rules-in-japan
#10
Kentaro Ide, Satoko Uematsu, Kenichi Tetsuhara, Satoshi Yoshimura, Takahiro Kato, Tohru Kobayashi
OBJECTIVES: The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules are used to assist computed tomography (CT) decision-making for children with minor head trauma. Although the PECARN rules have been validated in North America and Europe, they have not yet been validated in Asia. In Japan, there are no clinical decision rules for children with minor head trauma. The rate of head CT for children with minor head trauma in Japan is high since CT is widely accessible across the country...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27832341/non-accidental-trauma-the-role-of-radiology
#11
Cory M Pfeifer, Matthew R Hammer, Kate L Mangona, Timothy N Booth
Non-accidental trauma is a significant source of morbidity and mortality in the pediatric population. Given the vulnerable state of the child, the radiologist can often provide valuable diagnostic information in the setting of suspected abuse. This review focuses on common findings of abusive trauma and serves as a guide to aid in clinical decision-making for providers of emergency medicine and pediatrics. Amid this discussion is an assessment of modern controversies regarding reported mimicking pathologies, recapitulation of the current state of evidence with respect to radiologic findings of abuse, and examination of the contribution that spine imaging may add to the diagnosis of possible abusive head trauma in the acutely injured child...
November 10, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27766468/early-diffusion-restriction-of-white-matter-in-infants-with-small-subdural-hematomas-is-associated-with-delayed-atrophy
#12
Cameron A Elliott, Vijay Ramaswamy, Francois D Jacob, Tejas Sankar, Vivek Mehta
BACKGROUND: Traumatic brain injury (TBI) is a major cause of infant morbidity and mortality. In these patients, magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) is the test of choice to describe the extent of microstructural injury. CASE PRESENTATION AND DISCUSSION: In this case series, we describe novel acute and chronic MRI findings in four infants (6-19 months) with small, unilateral subdural hematomas in whom the etiology of head injury was suspicious for non-accidental trauma (NAT)...
February 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27744559/performance-of-computed-tomography-of-the-head-to-evaluate-for-skull-fractures-in-infants-with-suspected-non-accidental-trauma
#13
Paige A Culotta, James E Crowe, Quynh-Anh Tran, Jeremy Y Jones, Amy R Mehollin-Ray, H Brandon Tran, Marcella Donaruma-Kwoh, Cristina T Dodge, Elizabeth A Camp, Andrea T Cruz
BACKGROUND: Young children with suspected abusive head trauma often receive skull radiographs to evaluate for fractures as well as computed tomography (CT) of the head to assess for intracranial injury. Using a CT as the primary modality to evaluate both fracture and intracranial injury could reduce exposure to radiation without sacrificing performance. OBJECTIVE: To evaluate the sensitivity of CT head with (3-D) reconstruction compared to skull radiographs to identify skull fractures in children with suspected abusive head trauma...
January 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/27624565/a-closer-look-at-non-accidental-trauma-caregiver-assault-compared-to-non-caregiver-assault
#14
Cristen N Litz, David J Ciesla, Paul D Danielson, Nicole M Chandler
PURPOSE: The purpose of this study was to examine the outcomes of non-accidental trauma (NAT) patients compared to other trauma (OT) patients across the state of Florida. In addition, NAT and OT patients with a mechanism of injury of assault were further analyzed. METHODS: A statewide database was reviewed from January 2010 to December 2014 for patients aged 0-18years who presented following trauma. Patients were sorted by admitting diagnosis into two groups: rule out NAT and all other diagnoses...
September 2, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27365018/unforeseen-rib-fracture-findings-in-infant-chest-radiographs-evidence-of-non-accidental-injury-or-simply-a-case-of-birth-trauma
#15
Nyla Alam Khan, Vincent Lam, Andrew Rickett, Fiona Dickinson
No abstract text is available yet for this article.
June 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27364279/characterization-and-comparison-of-injuries-caused-by-accidental-and-non-accidental-blunt-force-trauma-in-dogs-and-cats
#16
Nida P Intarapanich, Emily C McCobb, Robert W Reisman, Elizabeth A Rozanski, Pichai P Intarapanich
Motor vehicle accidents (MVA) are often difficult to distinguish from non-accidental injury (NAI). This retrospective case-control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion, abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, damage to claws, and evidence of older fractures...
July 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27339476/identifying-non-accidental-fractures-in-children-aged-2%C3%A2-years
#17
Laura A Leaman, William L Hennrikus, James J Bresnahan
PURPOSE: Fractures are the second most common presentation of child abuse following soft-tissue bruising and burns. It is often difficult to determine potential abuse in a child presenting with a non-rib fracture(s) and without soft-tissue injuries. METHODS: One hundred and fifteen consecutive patients aged ≤2 years who presented with a fracture between January 2010 and June 2012 to our emergency department (ED) or pediatric fracture clinic were retrospectively analyzed...
August 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27126582/core-curriculum-illustration-brain-subdural-hemorrhage-in-non-accidental-trauma
#18
Sibi Rajendran, David Nickels, Barbara Pawley
This is the 19 installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.aseronline.org/curriculum/toc.htm .
June 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27118367/-accident-or-maltreatment-radiographic-x%C3%A2-ray-patterns-in-non%C3%A2-accidental-trauma-the-concept-of-sentinel-injuries
#19
F W Hirsch, I Sorge, C Roth, J-H Gosemann
The focus of this review article is on child abuse and the radiographic pattern of X‑ray findings. The radiologist should be able to recognize typical injuries resulting from child abuse. In some cases the findings are highly specific for abuse and these include metaphyseal corner fractures of the long bones in children aged up to 24 months. In other cases the fractures are not specific but highly indicative of child abuse: rib fractures, for example can be associated with child abuse in more than 50 % of the cases; however, maltreatment is difficult to diagnose without taking the entire pattern of skeletal findings into consideration so that a radiological screening of the entire skeleton is often necessary...
May 2016: Der Radiologe
https://www.readbyqxmd.com/read/27117267/isolated-traumatic-retroclival-hematoma-case-report-and-review-of-literature
#20
Ha Son Nguyen, Saman Shabani, Sean Lew
BACKGROUND: Retroclival hematomas are a rare entity. The pathology can be categorized into epidural hematoma or subdural hematoma based on the anatomy of the tectorial membrane. Frequently, the etiology is related to accidental trauma, though other mechanisms have been observed, including coagulopathy, non-accidental trauma, and pituitary apoplexy. There have been only 2 prior cases where both epidural and subdural hematoma co-present. CASE PRESENTATION: An 8-year-old male was involved in a high-speed motor vehicle accident...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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