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https://www.readbyqxmd.com/read/27598587/impact-of-atls-guidelines-trauma-team-introduction-and-24-hour-mortality-due-to-severe-trauma-in-a-busy-metropolitan-italian-hospital-a-case-control-study
#1
Stefano Magnone, Andrea Allegri, Eugenia Belotti, Claudio Carlo Castelli, Marco Ceresoli, Federico Coccolini, Roberto Manfredi, Cecilia Merli, Fabrizio Palamara, Dario Piazzalunga, Tino Martino Valetti, Luca Ansaloni
BACKGROUND: Advanced Trauma Life Support (ATLS) guidelines are widely accepted for use in initial management of trauma patients. The application of ATLS guidelines and introduction of management by means of trauma team (TT) both took place in April 2011. The aim of the present study was to evaluate related effects on mortality in the shock room (SR) and at 24 hours after admission. METHODS: Data were retrieved by administrative software based on patient admission for trauma of at least 48 hours...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27574345/retrospective-evaluation-of-magnitude-severity-and-outcome-of-traumatic-hepatobiliary-injury-at-a-level-i-trauma-center-in-india
#2
Sanjay Kumar Yadav, Subodh Kumar, Mahesh Chander Misra, Sushma Sagar, V K Bansal
Liver injury is the major cause of morbidity and mortality in polytrauma patients. This study was conducted to know the burden of hepatobiliary injury and its outcome in our setup. It is a retrospective study of all patients with traumatic hepatobiliary injuries from January 2008 through April 2012 at JPNATC, New Delhi. All patients were resuscitated as per ATLS guidelines. Management of patients was based on hemodynamic status and associated injuries. Liver injury occurred in 7.52 % of all trauma admissions and 20...
August 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27395381/from-postpartum-haemorrhage-guideline-to-local-protocol-a-study-of-protocol-quality
#3
Mallory D Woiski, Helena C van Vugt, Anneke Dijkman, Richard P Grol, Abraham Marcus, Johanna M Middeldorp, Ben W Mol, Femke Mols, Martijn A Oudijk, Martina Porath, Hubertina J Scheepers, Rosella P Hermens
Objective Postpartum hemorrhage (PPH) has a continuously rising incidence worldwide, suggesting suboptimal care. An important step in optimizing care is the translation of evidence-based guidelines into comprehensive hospital protocols. However, knowledge about the quality of these protocols is lacking. The objective of this study was to evaluate the quality of PPH-protocols on structure and content in the Netherlands. Methods We performed an observational multicenter study. Eighteen PPH-protocols from 3 University Hospitals (UH), 8 Teaching Hospitals (TH) and 7 Non-Teaching hospitals (NTH) throughout the Netherlands were acquired...
October 2016: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/27344547/burn-care-on-cruise-ships-epidemiology-international-regulations-risk-situation-disaster-management-and-qualification-of-the-ship-s-doctor
#4
C Ottomann, B Hartmann, V Antonic
With the increasing numbers of passengers and crew on board vessels that are becoming larger and larger, the demand for ship's doctors who can adequately treat burns on board has also increased. In the cruise ship industry it is usually those doctor's with internal and general medical training who are recruited from an epidemiological point of view. Training content or recommendations for the treatment of thermal lesions with the limited options available in ship's hospitals and where doctors with no surgical training operate do not yet exist...
September 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27100433/the-diminishing-role-of-pelvic-stability-evaluation-in-the-era-of-computed-tomographic-scanning
#5
Chih-Yuan Fu, Lan-Hsuan Teng, Chien-Hung Liao, Yu-Pao Hsu, Shang-Yu Wang, Ling-Wei Kuo, Kuo-Ching Yuan
Pelvic fractures can result in life-threatening hemorrhages or other associated injuries. Therefore, computed tomography (CT) scanning plays a key role in the management of pelvic fracture patients. However, CT scanning is utilized as an adjunct in secondary survey according to traditional Advanced Trauma Life Support (ATLS) guidelines, whereas pelvic x-ray is used as a primary tool to evaluate pelvic stability and the necessity of further CT scanning. In the current study, we attempted to evaluate the role of CT scanning in the era of advanced technology...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27050881/imaging-before-transfer-to-designated-pediatric-trauma-centers-exposes-children-to-excess-radiation
#6
Yana Puckett, Louis Bonacorsi, Matthew Caley, Shannon Farmakis, Colleen Fitzpatrick, Kaveer Chatoorgoon, Yosef Greenspon, Dennis W Vane
BACKGROUND: Pediatric trauma patients transferred to pediatric trauma centers (PTCs) often have imaging at the originating hospital (OH). The increased use of computed tomography (CT) raises concerns about malignancy risk from ionizing radiation leading many PTCs to adopt radiation dose reduction strategies. We hypothesized that pediatric trauma patients are exposed to excess radiation from imaging before transfer. METHODS: A retrospective review of 1,383 scans was performed on all trauma patients with CT imaging before transfer to our Level I PTC from 2010 to 2014...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26686592/mcq-tests-in-advanced-trauma-life-support-atls%C3%A2-development-and-revision
#7
Jacqueline Bustraan, Walter Henny, John B Kortbeek, Karen J Brasel, Marzellus Hofmann, Inger B Schipper
BACKGROUND: In Advanced Trauma Life Support (ATLS©) courses, multiple choice question (MCQ) tests are used to assess student's post course knowledge. As part of the ninth Edition Revision Process, existing MCQ tests were reviewed and revised by an International MCQ Revision group. The aim of this study was to evaluate the revision procedure and its effects. METHODS: Based on psychometric data and evidence based guidelines for adequate MCQ item and test development, a detailed stepwise approach was determined and followed to evaluate the existing MCQs, and to guide test item revision or replacement...
March 2016: Injury
https://www.readbyqxmd.com/read/26679717/-standardisation-of-the-initial-treatment-of-severely-burned-patients-the-necessary-transfer-of-concepts-from-trauma-care
#8
M Münzberg, T Harbers, U Kneser, P A Grützner, B Reichert, T Kremer, C G Wölfl, J Horter, C Hirche
The initial treatment of severely burned patients remains a huge challenge for first responders in emergency services as well as emergency doctors who do not work in a centre for severe burn injuries. The reason for this is the low number of cases in developed countries and a lack of training concepts for the specific aspects of the initial treatment of severe burn injuries. Because of guidelines with limited evidence (S1, S2k) and a lack of structured treatment approaches, uncertainties with respect to initial treatment are still visible...
December 17, 2015: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/26438727/finding-the-fifth-intercostal-space-for-chest-drain-insertion-guidelines-and-ultrasound
#9
J S Bowness, K Nicholls, P M Kilgour, J Ferris, S Whiten, I Parkin, J Mooney, P Driscoll
OBJECTIVES: International guidelines exist for chest drain insertion and recommend identifying the fifth intercostal space or above, around the midaxillary line. In a recent study, applying these guidelines in cadavers risked insertion in the 6th intercostal space or below in 80% of cases. However, there are limitations of cadaveric studies and this investigation uses ultrasound to determine the intercostal space identified when applying these guidelines in healthy adult volunteers. METHODS: On each side of the chest wall in 31 volunteers, the position for drain insertion was identified using the European Trauma Course method, Advanced Trauma Life Support (ATLS) method, British Thoracic Society's 'safe triangle' and the 'traditional' method of palpation...
December 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26223847/-value-of-clinical-key-symptoms-in-the-primary-treatment-of-severely-injured-patients
#10
S Piatek, G Pliske, A Ballaschk, K Witzel, F Walcher
BACKGROUND: The initial diagnostic procedure of severely injured patients in the emergency room (ER) during the primary survey is first and foremost a clinical examination. The clinical S3 guidelines provide recommendations for the treatment of patients with severe and multiple injuries. OBJECTIVES: The study was performed to investigate the reliability of clinical key symptoms or red flags registered in the ER that lead to further diagnostic or therapeutic procedures...
August 2015: Der Unfallchirurg
https://www.readbyqxmd.com/read/26160129/-essential-measures-for-prehospital-treatment-of-severely-injured-patients-the-trauma-care-bundle
#11
G Matthes, H Trentzsch, C G Wölfl, T Paffrath, S Flohe, U Schweigkofler, A Ekkernkamp, S Schulz-Drost
BACKGROUND: In order to ensure adequate treatment and to avoid complications, care bundles are increasingly being implemented. These are comprehensive and evidence-based procedures for the treatment of individual diseases or injuries which should be carried out for every patient. The aim of this study was to define a care bundle for the prehospital treatment of severely injured patients. MATERIAL AND METHODS: The scientific contents of the bundle were gathered from the interdisciplinary evidence-based S3 guidelines for the treatment of severely injured patients by the German Trauma Society...
August 2015: Der Unfallchirurg
https://www.readbyqxmd.com/read/26104319/systematic-review-effect-of-whole-body-computed-tomography-on-mortality-in-trauma-patients
#12
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: The initial diagnostic evaluation and management of trauma patients is mainly based on Advanced Trauma Life Support (ATLS) guidelines worldwide. Based on ATLS principles, conventional diagnostics such as conventional radiography (CR) and focused abdominal sonography in trauma (FAST) should precede selective use of CT. Whole-body CT (WBCT) is highly accurate and allows detection of life threatening injuries with good sensitivity and specificity. WBCT is faster than conventional diagnostics and saves more time in management of trauma patients...
July 2015: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/25894400/level-of-evidence-analysis-for-the-latest-german-national-guideline-on-treatment-of-patients-with-severe-and-multiple-injuries-and-atls
#13
COMPARATIVE STUDY
Matthias Münzberg, Manuel Mutschler, Thomas Paffrath, Heiko Trentzsch, Arasch Wafaisade, Felix Walcher, Marcus Raum, Sascha Flohé, Christoph Wölfl
PURPOSE: Advanced Trauma Life Support (ATLS®) is one of the world's best-known training programs for medical providers. Revisions of the ATLS manual have been evidence based for a number of years. In 2011, a level 3 (S3) evidence- and consensus-based guideline on the treatment of patients with severe and multiple injuries was published in Germany. The scope of this study was the systematic comparison of the educational content of the ATLS concept and the interdisciplinary "S3 polytrauma guideline...
August 2015: World Journal of Surgery
https://www.readbyqxmd.com/read/25867559/physicians-knowledge-of-cardiopulmonary-resuscitation-guidelines-and-current-certification-status-at-the-university-hospital-of-the-west-indies-jamaica
#14
P Howell, I Tennant, R Augier, G Gordon-Strachan, H Harding-Goldson
OBJECTIVE: To determine physicians' knowledge of cardiopulmonary resuscitation (CPR) guidelines at the University Hospital of the West Indies (UHWI), Jamaica, and their current certification status in basic life support (BLS), advanced cardiac life support (ACLS), paediatric advanced life support (PALS) and advanced trauma life support (ATLS). METHODS: This was a cross-sectional study. A 23-item self-administered questionnaire was used to assess physicians practising at the UHWI, from the Departments of Anaesthesia, Surgery, Internal Medicine, Accident and Emergency, Obstetrics and Gynaecology and Oncology...
December 2014: West Indian Medical Journal
https://www.readbyqxmd.com/read/25738133/comparing-the-interpretation-of-traumatic-chest-x-ray-by-emergency-medicine-specialists-and-radiologists
#15
Saeed Safari, Alireza Baratloo, Ahmed Said Negida, Morteza Sanei Taheri, Behrooz Hashemi, Samaneh Hosseini Selkisari
BACKGROUND: Discrepancy between X-ray readings of emergency physicians (EPs) versus radiologists was reported between 0.95% and 16.8% in different studies. The discordance was even higher when specific studies such as chest X-rays (CXR) were probed. OBJECTIVES: This prospective study was conducted to assess the discrepancies between emergency and radiology departments with respect to interpretation of the traumatic chest X-rays. PATIENTS AND METHODS: This prospective study was conducted in Shohadaye Tajrish Hospital, Tehran, Iran, from March to April 2014...
November 2014: Archives of Trauma Research
https://www.readbyqxmd.com/read/25683210/the-significance-of-routine-thoracic-computed-tomography-in-patients-with-blunt-chest-trauma
#16
Seref Kerem Çorbacıoğlu, Erhan Er, Sahin Aslan, Meltem Seviner, Gökhan Aksel, Nurettin Özgür Doğan, Sertaç Güler, Aysen Bitir
PURPOSE: The purpose of this study is to investigate whether the use of thoracic computed tomography (TCT) as part of nonselective computed tomography (CT) guidelines is superior to selective CT during the diagnosis of blunt chest trauma. SUBJECTS AND METHODS: This study was planned as a prospective cohort study, and it was conducted at the emergency department between 2013 and 2014. A total of 260 adult patients who did not meet the exclusion criteria were enrolled in the study...
May 2015: Injury
https://www.readbyqxmd.com/read/25416730/guidelines-for-chest-drain-insertion-may-not-prevent-damage-to-abdominal-viscera
#17
J Bowness, P M Kilgour, S Whiten, I Parkin, J Mooney, P Driscoll
OBJECTIVES: Guidelines to improve the ease and safety of chest drain insertion recommend using the fifth intercostal space, around the midaxillary line (MAL). This study aimed to assess whether compliance with published guidelines reliably ensured such placement and avoided the potentially serious complications of subdiaphragmatic insertion and peripheral nerve injury. METHODS: Three international guidelines were assessed by identifying the intercostal space for chest drain insertion using 16 cadavers (32 sides) at a point 1 cm anterior to MAL...
August 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25284232/pre-hospital-and-early-in-hospital-management-of-severe-injuries-changes-and-trends
#18
REVIEW
Bjoern Hussmann, Sven Lendemans
The pre-hospital and early in-hospital management of most severely injured patients has dramatically changed over the last 20 years. In this context, the factor time has gained more and more attention, particularly in German-speaking countries. While the management in the early 1990s aimed at comprehensive and complete therapy at the accident site, the premise today is to stabilise trauma patients at the accident site and transfer them into the hospital rapidly. In addition, the introduction of training and education programmes such as Pre-hospital Trauma Life Support (PHTLS(®)), Advanced Trauma Life Support (ATLS(®)) concept or the TEAM(®) concept has increased the quality of treatment of most severely injured trauma patients both in the preclinical field and in the emergency trauma room...
October 2014: Injury
https://www.readbyqxmd.com/read/25227879/-interdisciplinary-management-of-trauma-patients-update-3-years-after-implementation-of-the-s3-guidelines-on-treatment-of-patients-with-severe-and-multiple-injuries
#19
REVIEW
B Donaubauer, J Fakler, A Gries, U X Kaisers, C Josten, M Bernhard
BACKGROUND: The recommendations still have to be implemented 3 years after publication of the S3 guidelines on the treatment of patients with severe and multiple injuries. AIM: This article reiterates some of the essential core statements of the S3 guidelines and also gives an overview of new scientific studies. MATERIAL AND METHODS: In a selective literature search new studies on airway management, traumatic cardiac arrest, shock classification, coagulation therapy, whole-body computed tomography, air rescue and trauma centers were identified and are discussed in the light of the S3 guideline recommendations...
November 2014: Der Anaesthesist
https://www.readbyqxmd.com/read/25062601/what-is-the-yield-of-routine-chest-radiography-following-tube-thoracostomy-for-trauma
#20
Victor Y Kong, George V Oosthuizen, Damian L Clarke
INTRODUCTION: Routine chest radiography (CXR) following tube thoracostomy (TT) is a standard practice in most trauma centres worldwide. Evidence supporting this routine practice is lacking and the actual yield is unknown. MATERIALS AND METHODS: We performed a retrospective review of 1042 patients over a 4-year period who had a routine post-insertion CXR performed in accordance with current ATLS® recommendations. RESULTS: A total 1042 TTs were performed on 1004 patients...
January 2015: Injury
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