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https://www.readbyqxmd.com/read/29792280/resource-utilization-and-indications-for-helicopter-transport-of-head-injured-children
#1
Clay M Elswick, Deidre Wyrick, Lori A Gurien, Malik Rettiganti, Marie Gowen, Ambre' Pownall, Diaa Bahgat, R Todd Maxson, Eylem Öcal, Gregory W Albert
INTRODUCTION: Helicopter emergency medical services (HEMS) have provided benefit for severely injured patients. However, HEMS are likely overused for the transportation of both adult and pediatric trauma patients. In this study, we aim to evaluate the degree of overuse of helicopter as a mode of transport for head-injured children. In addition, we propose criteria that can be used to determine if a particular patient is suitable for air versus ground transport. MATERIALS AND METHODS: We identified patients who were transported to our facility for head injuries...
May 1, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29791967/global-emergency-medicine-a-review-of-the-literature-from-2017
#2
Torben K Becker, Indi Trehan, Alison Schroth Hayward, Braden J Hexom, Sean M Kivlehan, Kevin M Lunney, Payal Modi, Maxwell Osei-Ampofo, Amelia Pousson, Daniel K Cho, Adam C Levine
OBJECTIVES: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. METHODS: This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM...
May 23, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29790139/-the-process-of-healing-child-physical-abuse-sprouting-and-twining
#3
Hsin-Yi Chang, Jui-Ying Feng, Ren-Mei Tseng
BACKGROUND: Child physical abuse impacts the physical and psychological health of survivors. Healing child abuse is an essential process that helps survivors reorganize the meaning of the trauma and pursue a normal life. Considering the trauma of child physical abuse within the social context allows the experiences of individual survivors to be reflected in their process of healing. PURPOSE: To explore the social interaction and construction process of healing experienced by survivors of child physical abuse...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29789141/patterns-of-peritraumatic-threat-perceptions-in-patients-evaluated-for-suspected-acute-coronary-syndrome-according-to-prior-and-current-posttraumatic-stress-symptoms
#4
Deanna R Zhu, Jacob Julian, Sung J A Lee, Anusorn Thanataveerat, Jennifer A Sumner
OBJECTIVE: Prior posttraumatic stress disorder (PTSD) and elevated threat perceptions predict posttraumatic psychopathology after evaluation for acute coronary syndrome (ACS), but most research has measured threat retrospectively. We investigated how threat perceptions during ACS evaluation in the emergency department (ED) and upon recall were associated with posttraumatic psychopathology burden due to prior trauma and the suspected ACS. METHODS: Perceived threat was assessed in the ED, and ED threat recall was assessed upon inpatient transfer/discharge, along with acute stress disorder (ASD) symptoms due to suspected ACS and PTSD symptoms due to prior trauma...
May 9, 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29788913/prevalence-and-outcome-of-injury-in-patients-visiting-the-emergency-department-of-yirgalem-general-hospital-southern-ethiopia
#5
Abel Negussie, Andarge Getie, Elias Manaye, Tamrat Tekle
BACKGROUND: Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. METHODS: A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017...
May 22, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29787558/a-new-weighted-injury-severity-scoring-system-better-predictive-power-for-pediatric-trauma-mortality
#6
Junxin Shi, Jiabin Shen, Sarah Caupp, Angela Wang, Kathryn E Nuss, Brian Kenney, Krista K Wheeler, Bo Lu, Henry Xiang
BACKGROUND: An accurate injury severity measurement is essential for the evaluation of pediatric trauma care and outcome research. The traditional Injury Severity Score (ISS) does not consider the differential risks of the Abbreviated Injury Scale (AIS) from different body regions nor is it pediatric specific. The objective of this study was to develop a weighted injury severity scoring (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. METHODS: Based on the association between mortality and AIS from each of the six ISS body regions, we generated different weights for the component AIS scores used in the calculation of ISS...
May 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787555/implementation-of-a-ct-scan-practice-guideline-for-pediatric-trauma-patients-reduces-unnecessary-scans-without-impacting-outcomes
#7
Patrick R McGrew, Paul J Chestovich, Jay D Fisher, Deborah A Kuhls, Douglas R Fraser, Purvi P Patel, Chad W Katona, Syed Saquib, John J Fildes
INTRODUCTION: Computed Tomography (CT) scans are useful in the evaluation of trauma patients, but are costly and pose risks from ionizing radiation in children. Recent literature has demonstrated the utility of CT scan guidelines in the management of pediatric trauma. This study objective is to review our treatment of pediatric blunt trauma patients and evaluate CT utilization before and after CT-guideline implementation. METHODS: Our Pediatric Level 2 Trauma Center (TC) implemented a CT scan practice guideline for pediatric trauma patients in March 2014...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787553/logistics-of-air-medical-transport-when-and-where-does-helicopter-transport-reduce-prehospital-time-for-trauma
#8
Xilin Chen, Mark L Gestring, Matthew R Rosengart, Andrew B Peitzman, Timothy R Billiar, Jason L Sperry, Joshua B Brown
BACKGROUND: Trauma is a time sensitive disease. Helicopter emergency medical services (HEMS) have shown benefit over ground EMS (GEMS), which may be related to reduced prehospital time. The distance at which this time benefit emerges depends on many factors that can vary across regions. Our objective was to determine the threshold distance at which HEMS has shorter prehospital time than GEMS under different conditions. METHODS: Patients in the PA trauma registry 2000-2013 were included...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787547/interrupted-versus-continuous-fascial-closure-in-patients-undergoing-emergent-laparotomy-a-randomized-controlled-trial
#9
Thomas Peponis, Jordan D Bohnen, Sandra Muse, Eva Fuentes, Gwendolyn M van der Wilden, Ali Mejaddam, Hasan Alam, Haytham M A Kaafarani, Peter J Fagenholz, David R King, D Dante Yeh, George C Velmahos, Marc A de Moya
BACKGROUND: The optimal method of fascial closure, interrupted versus continuous (IFC and CFC respectively) has never been studied exclusively in the setting of emergency surgery. We hypothesized that IFC decreases postoperative incisional hernia development following emergent laparotomies. METHODS: Between August 2008 and September 2015, patients undergoing emergent laparotomies were consented and randomly assigned to either IFC or CFC. Patients were followed postoperatively for at least three months and assessed for incisional hernia, dehiscence, or wound infection...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787545/recent-advances-in-austere-combat-surgery-use-of-aortic-balloon-occlusion-as-well-as-blood-challenges-by-special-operations-medical-forces-in-recent-combat-operations
#10
D Marc Northern, Justin D Manley, Regan Lyon, Daniel Farber, Benjamin J Mitchell, Kristopher J Filak, Jonathan Lundy, Joe J DuBose, Todd E Rasmussen, John B Holcomb
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) for control of non-compressible torso hemorrhage is a technology that is increasingly being utilized in the combat casualty setting. Its use in the resource restricted environment holds potential to improve hemorrhage control, decrease blood product utilization, decrease morbidity, and improve combat mortality. The objective of this report is to present the single largest series of REBOA use on severely injured combat casualties...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787536/a-meta-analysis-of-the-incidence-of-complications-associated-with-groin-access-after-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients
#11
Ramiro Manzano-Nunez, Claudia P Orlas, Juan P Herrera-Escobar, Samuel Galvagno, Joseph DuBose, Juan J Melendez, Jose J Serna, Alexander Salcedo, Camilo A Peña, Edison Angamarca, Tal Horer, Camilo J Salazar, Valeria Lopez-Castilla, Juan Ruiz-Yucuma, Fernando Rodriguez, Michael W Parra, Carlos A Ordoñez
BACKGROUND: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients. METHODS: We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients that underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787533/high-volume-hospitals-are-associated-with-lower-mortality-among-high-risk-emergency-general-surgery-patients
#12
Gerald O Ogola, Marie L Crandall, Shahid Shafi
INTRODUCTION: We have previously demonstrated that Emergency General Surgery (EGS) patients treated at high-volume hospitals experience lower mortality rates than those treated at low-volume hospitals. However, EGS comprises a wide spectrum of diseases. Our goal was to determine which EGS diseases had better outcomes at high volume hospitals. METHODS: We undertook a retrospective analysis of National Inpatient Sample database for 2013 (a nationwide representative sample)...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787512/browning-of-human-subcutaneous-adipose-tissue-after-its-transplantation-in-nude-mice
#13
Lihong Qiu, Zhaoxiang Zhang, Hui Zheng, Shaoheng Xiong, Yingjun Su, Xianjie Ma, Chenggang Yi
BACKGROUND: The clinical unpredictability of autologous fat grafting originates partially from the unique characteristics of adipose tissue. Evidences of adipose remodeling toward browning (developing of brown-like adipocytes in white adipose tissue) in response to trauma are emerging. With regard to fat grafting surgery procedure by which adipose tissue depots are directly and ubiquitously traumatized, whether it affect adipose phenotype change toward browning has not been previously reported...
May 16, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#14
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786021/developing-and-implementing-a-global-emergency-medicine-course-lessons-learned-from-rwanda
#15
Sojung Yi, Olivier Félix Umuhire, Doris Uwamahoro, Mindi Guptill, Giles N Cattermole
Background: There is a growing demand by medical trainees for meaningful, short-term global emergency medicine (EM) experiences. EM programs in high-income countries (HICs) have forged opportunities for their trainees to access this experience in low-and middle-income countries (LMICs). However, few programs in LMICs have created and managed such courses. As more LMICs establish EM programs, these settings are ideal for developing courses beneficial for all participants. We describe our experience of creating and implementing a short-term global EM course in Rwanda...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29784656/lessons-identified-from-the-2017-manchester-and-london-terrorism-incidents-part-two-the-reception-and-definitive-care-hospital-phases
#16
REVIEW
Paul Hunt
The provision of medical care during the reception and definitive care phases of a terrorist incident will likely take place in designated receiving hospitals such as Major Trauma Centres. There is a need for an enhanced capability in such units to receive, initially manage and hold casualties with more serious injuries. Also, even less severely injured casualties may require significant time and clinical input such as risk management in potential bloodborne viruses.The distribution of casualties from the incident scene requires advance consideration of the injury pattern and regional network organisation of specialist services, such as maxillofacial, neurosurgery or severe burns care...
May 21, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29784473/tailbone-pain-from-coccyx-injuries-on-water-slides-a-case-series
#17
Patrick M Foye, Dena M Abdelshahed, Evish Kamrava, Renee Enriquez, Gerard J D'Onofrio
BACKGROUND: Water slides and rides are increasingly popular attractions at amusement parks. There has been some documentation of various patterns of injury associated with these rides, most notably vaginal injuries caused by water jets. But we find no previous medical publications reporting the association between water slides/rides with coccydynia (coccyx pain) and tailbone injuries. CASE REPORT: Our purpose in this case report was to assess for an association between water slides/rides with injuries to the coccyx causing coccyx pain...
May 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#18
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29781945/appropriateness-of-pediatric-orthopaedic-transfers-to-a-level-1-hospital
#19
Jaclyn McKenna, David Novikov, Amanda Pawlak, Jihye Park, Jie Yang, Hariharan Iyer, James Barsi
OBJECTIVE: The purpose of this study was to compare a cohort of transferred pediatric orthopaedic patients with orthopaedic patients who primarily presented to a Level 1 pediatric emergency department to identify risk factors for transfer. DESIGN: Retrospective cohort study. SETTING: This study was performed at a level one trauma center in New York. PATIENTS: The cohort consisted of patients under age 18 who presented to one level 1 pediatric trauma center between January 1, 2013 - December 31, 2013 with an orthopaedic fracture diagnosis code (ICD-9 805...
May 16, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29780910/aerial-drone-misadventure-a-novel-case-of-trauma-resulting-in-ocular-globe-rupture
#20
Eliza E Moskowitz, Yonaton M Siegel-Richman, George Hertner, Thomas Schroeppel
Purpose: The purpose of this case report is to present the novel findings of a drone causing such a traumatic ocular injury and provide recommendations for how it might be prevented. Observations: We report on a recent case where a child presented to our Emergency Department after incurring a blow to the face by the propeller of a remote controlled drone. The patient suffered significant trauma including rupture of the right globe. Conclusions: As drone sales continue to rise, it is important that physicians be prepared to treat the potential injuries that may result from using these devices...
June 2018: American Journal of Ophthalmology Case Reports
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