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https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#1
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542045/massive-hemoptysis-through-endotracheal-tube-during-emergency-cesarean-delivery-a-case-report-and-literature-review
#2
Von Vee Ng, Mukesh Kumar Shah, Ting Ting Oh, Abirami Ramanathan, Thangavelautham Suhitharan
Severe pulmonary hemorrhage occurred through the endotracheal tube during an emergency cesarean delivery. Intubation trauma was excluded with fiberoptic bronchoscopy. Episodes of hemoptysis continued for 48 hours. The patient was subsequently diagnosed with diffuse alveolar hemorrhage because of systemic lupus erythematosus. The diagnostic workup, successful management, and literature review are presented.
May 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28542027/retrospective-population-based-study-of-emergency-medical-services-attended-out-of-hospital-cardiac-arrests-in-children-in-belgium
#3
Sophie Vandeplassche, Patrick van de Voorde
OBJECTIVE: This study presents an analysis of clinical data of the circumstances and outcome of paediatric (0-16 years) out-of-hospital cardiac arrests (p-OHCA) in Belgium. METHODS: This was a retrospective study of a prospective population-based registration of physician-attended [mobile emergency group (MUG)] emergency medical services (EMS) interventions of p-OHCA in Belgium between 2010 and 2012. RESULTS: We identified 365 OHCA in 18 295 paediatric MUG interventions (2%)...
May 24, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28541855/rate-and-reasons-for-repeat-ct-scanning-in-transferred-trauma-patients
#4
James F Holmes, Blake G Siglock, Michael T Corwin, Michael A Johnson, Edgardo S Salcedo, Gabriel S Espinoza, Ramit Lamba
To describe the reasons and additional radiation for CT scans repeated after transfer to a trauma center. Retrospective study of patients transferred to a trauma center. Patients had repeat CT if a CT of the same region was repeated at the trauma center's emergency department. Indications for repeat CT scanning were abstracted. Radiation dosage was calculated in millisieverts. A total of 370 had CT scans and were transferred. Mean age was 39.1 ± 28.0 years. Seventy-four [20.0%, 95% confidence interval (CI) 16...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28538846/-clinical-and-microbiological-study-of-catheter-associated-urinary-tract-infections-in-internal-medicine-services-of-a-venezuelan-university-hospital
#5
Pedro Quijada-Martínez, Ana Flores-Carrero, Indira Labrador, María Araque
Objectives: To determine the clinical and microbiological characteristics of catheter-associated urinary tract infections (CA-UTI) in patients admitted to the Internal Medicine services of the Hospital Universitario de Los Andes (HULA), Mérida, Venezuela and to establish the clonal distribution of multi-resistant Enterobacteriaceae that produce this infection. Materials and Methods: Seventy-three adult patients with bladder catheterization were studied between January and July 2015...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#6
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538645/increased-mortality-in-trauma-patients-who-develop-post-intubation-hypotension
#7
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Post-intubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada between 2000 and 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#8
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538629/outcomes-following-traumatic-injury-in-patients-with-preexisting-psychiatric-illness
#9
Erika Falsgraf, Kenji Inaba, Amory de Roulet, Megan Johnson, Elizabeth Benjamin, Lydia Lam, Kazuhide Matsushima, Aaron Strumwasser, Demetrios Demetriades
BACKGROUND: Patients with psychiatric illness have been shown to experience higher rates of traumatic injury. Injury patterns, treatment decisions, and outcomes have not been well characterized in patients with psychiatric illness after injury, in particular those who undergo acute surgical intervention. The purpose of this analysis was to determine mortality, complications, and surgical intervention rates in patients with psychiatric illness following traumatic injury. METHODS: This is a retrospective study of trauma patients ≥18 years old admitted to LAC+USC Medical Center between January 2008 and March 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538626/the-capacity-of-icd-10-cm-pcs-to-characterize-surgical-care
#10
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
The International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) have been in effect since October 1, 2015 and offer much greater capacity than previous classifications to characterize the nature and treatment of surgical conditions. However, the diagnosis codes of ICD-10-CM are unevenly specific across the spectrum of surgical conditions and currently do not adequately allow description of important distinctions in disease severity for many common surgical conditions...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538607/evaluation-of-highest-level-pediatric-trauma-activation-criteria
#11
Jessica A Zagory, Minna M Wieck, Brooke E Lerner, Suzanne Moody, Richard A Falcone, Rita V Burke
BACKGROUND: Despite the presence of a tiered in-hospital trauma triage system for the past decade, trauma centers still struggle with a definitive list of highest level activation criteria. In 2002, the American College of Surgeons (ACS) mandated 6 criteria for highest level activation. However, it is unknown if pediatric trauma centers follow these criteria. The purpose of this study is to identify and categorize the highest level pediatric trauma criteria used by pediatric trauma centers in the United States...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28535812/current-insights-in-noise-induced-hearing-loss-a-literature-review-of-the-underlying-mechanism-pathophysiology-asymmetry-and-management-options
#12
REVIEW
Trung N Le, Louise V Straatman, Jane Lea, Brian Westerberg
BACKGROUND: Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss, is a major health problem, is largely preventable and is probably more widespread than revealed by conventional pure tone threshold testing. Noise-induced damage to the cochlea is traditionally considered to be associated with symmetrical mild to moderate hearing loss with associated tinnitus; however, there is a significant number of patients with asymmetrical thresholds and, depending on the exposure, severe to profound hearing loss as well...
May 23, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28535246/designing-smartphone-mental-health-applications-for-emergency-service-workers
#13
M Deady, D Peters, H Lang, R Calvo, N Glozier, H Christensen, S B Harvey
Background: Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives. Aims: To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences...
May 23, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28534084/the-emerging-link-between-o-glcnacylation-and-neurological-disorders
#14
REVIEW
Xiaofeng Ma, He Li, Yating He, Junwei Hao
O-linked β-N-acetylglucosaminylation (O-GlcNAcylation) is involved in the regulation of many cellular cascades and neurological diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), and stroke. In the brain, the expression of O-GlcNAcylation is notably heightened, as is that of O-linked N-acetylglucosaminyltransferase (OGT) and β-N-acetylglucosaminidase (OGA), the presence of which is prominent in many regions of neurological importance. Most importantly, O-GlcNAcylation is believed to contribute to the normal functioning of neurons; conversely, its dysregulation participates in the pathogenesis of neurological disorders...
May 22, 2017: Cellular and Molecular Life Sciences: CMLS
https://www.readbyqxmd.com/read/28533989/iatrogenic-spinal-subdural-extra-arachnoid-hygroma-following-uncomplicated-lumbar-decompression
#15
Benjamin D Elder, Wataru Ishida, Rory C Goodwin, Ali Bydon
Intradural spinal arachnoid cysts (ISACs) have been reported in the current literature as either an idiopathic disease or exceedingly rare sequelae after lumbar puncture, spinal trauma, or meningitis. Other studies have more appropriately termed the iatrogenic pathology as a spinal subdural extra-arachnoid hygroma (SSEH), as there is not often a clear cyst wall as in a true arachnoid cyst. However, to the best of our knowledge, none of the previous studies described an SSEH following uncomplicated posterior lumbar surgery, as they have previously involved clear durotomies during the initial operation...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28533934/mortality-outcomes-in-trauma-patients-undergoing-prehospital-red-blood-cell-transfusion-a-systematic-literature-review
#16
REVIEW
Gregory S Huang, C Michael Dunham
The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. Eligible studies were combined for meta-analysis when tests for heterogeneity were insignificant. The synthesized mortality was 35.6% for systolic blood pressure ≤ 90 mmHg; 51.1% for ≤ 80 mmHg; and 63...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28531760/the-relationship-between-processing-style-trauma-memory-processes-and-the-development-of-posttraumatic-stress-symptoms-in-children-and-adolescents
#17
Anna McKinnon, Neil Brewer, Kate Cameron, Reginald D V Nixon
BACKGROUND AND OBJECTIVES: Data-driven processing, peri-event fear, and trauma memory characteristics are hypothesised to play a core role in the development of Posttraumatic Stress Disorder. We assessed the relationships between these characteristics and Posttraumatic Stress (PTS) symptoms in a sample of youth. METHODS: Study 1 (N = 36, 7-16 years), involved a sample of children who had undergone a stressful orthopaedic procedure. One week later they answered a series of probed recall questions about the trauma (assessed for accuracy by comparison to a video) and reported on their PTS symptoms...
April 21, 2017: Journal of Behavior Therapy and Experimental Psychiatry
https://www.readbyqxmd.com/read/28530775/a-surgical-approach-to-iatrogenic-vascular-injuries-in-pediatric-cases
#18
Yüksel Beşir, Orhan Gökalp, Börteçin Eygi, Banu Bahriye Lafcı, Gamze Gökalp, Levent Yılık, Hasan İner, Ali Gürbüz
BACKGROUND: Surgical intervention is mandatory in many children who present with vascular trauma or in complicated cases after medical interventions. In this study, surgical interventions applied after vascular injuries in children were analyzed. METHODS: Between January 2002 and December 2012, 17 patients (aged under 18) who were admitted to the emergency room with vascular injuries were retrospectively analyzed. The data was collected through hospital records...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530773/efficiency-of-instant-messaging-applications-in-coordination-of-emergency-calls-for-combat-injuries-a-pilot-study
#19
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/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#20
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
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