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initial assessment and management of a trauma patient

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https://www.readbyqxmd.com/read/27919714/initial-testing-of-a-behavioural-pain-assessment-tool-within-trauma-units
#1
Julie Gregory
Pain is common in trauma patients who may be older and also may have cognitive impairment leading to reduced communication about their pain. A number of observational pain assessment tools are available and have been found to have limited clinical usefulness. The Bolton Pain Assessment Tool (BPAT) was developed following a trial of three established tools and includes a section to involve family and/or close carers in the pain assessment process. The aim of this paper is to present the findings of initial testing of BPAT...
September 7, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#2
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27857493/are-standard-antero-posterior-and-20%C3%A2-caudal-radiographs-a-true-assessment-of-mid-shaft-clavicular-fracture-displacement
#3
Jonathan Wright, Nick Aresti, Charlotte Heuveling, Livio Di Mascio
AIMS: Decision-making in management of clavicle fractures is often based on the degree of displacement and shortening present on plain radiographs. We aimed to evaluate whether plain radiographs provide an accurate representation of the true displacement present, which can be difficult to image in orthogonal planes. METHODS: Consecutive high-energy trauma patients with midshaft clavicular fractures requiring further CT imaging of the thorax/abdomen for other associated injuries between 2009 and 2012 were evaluated...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27855665/evaluation-of-a-new-imaging-tool-for-use-with-major-trauma-cases-in-the-emergency-department
#4
Moritz Crönlein, Konstantin Holzapfel, Marc Beirer, Lukas Postl, Karl-Georg Kanz, Dominik Pförringer, Stefan Huber-Wagner, Peter Biberthaler, Chlodwig Kirchhoff
BACKGROUND: The aim of this study was to evaluate potential benefits of a new diagnostic software prototype (Trauma Viewer, TV) automatically reformatting computed tomography (CT) data on diagnostic speed and quality, compared to CT-image data evaluation using a conventional CT console. METHODS: Multiple trauma CT data sets were analysed by one expert radiology and one expert traumatology fellow independently twice, once using the TV and once using the secondary conventional CT console placed in the CT control room...
November 17, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27843433/successful-treatment-of-lasiodiplodia-theobromae-keratitis-assessing-the-role-of-voriconazole
#5
Stephen Tak-Lun Li, Evan Po-Fat Yiu, Angela Hiu-Yan Wong, John Chun-Ting Yeung, Lester Wang-Hon Yu
PURPOSE: The aim of this paper is to report the successful management of the first case of Lasiodiplodia theobromae keratitis in Hong Kong. METHODS: We conducted a case report. RESULTS: A 43-year-old Chinese male with a history of diabetes developed left eye keratitis after a trauma during tree felling. Fungal keratitis was diagnosed using a confocal microscope on day 1, and L. theobromae was confirmed from the culture. He was given oral voriconazole, topical natamycin, and topical and intracameral amphotericin B...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/27832693/distance-learning-can-be-as-effective-as-traditional-learning-for-medical-students-in-the-initial-assessment-of-trauma-patients
#6
Shervin Farahmand, Ebrahim Jalili, Mona Arbab, Mojtaba Sedaghat, Mandana Shirazi, Fatemeh Keshmiri, Arsalan Azizpour, Somayeh Valadkhani, Shahram Bagheri-Hariri
Distance learning is expanding and replacing the traditional academic medical settings. Managing trauma patients seems to be a prerequisite skill for medical students. This study has been done to evaluate the efficiency of distance learning on performing the initial assessment and management in trauma patients, compared with the traditional learning among senior medical students. One hundred and twenty senior medical students enrolled in this single-blind quasi-experimental study and were equally divided into the experimental (distance learning) and control group (traditional learning)...
September 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27823937/orbital-blowout-fractures-a-novel-computed-tomographic-measurement-that-can-predict-the-likelihood-of-surgical-management
#7
Tamer N Mansour, Megan Rudolph, Derek Brown, Natalie Mansour, M Reza Taheri
OBJECTIVE: The purpose of this study is to identify an accurate and reliable computed tomographic (CT) measurement that can identify those patients presenting to the emergency department (ED) with orbital floor fracture (BOF) who require surgical repair to prevent ensuing visually debilitating diplopia and/or enophthalmos. METHODS: In this retrospective institutional review board-approved study, we reviewed 99 patients older than 18 years with orbital fractures treated in a level I trauma center from 2011 through 2015...
October 14, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27818032/laryngeal-injury-and-pneumomediastinum-due-to-minor-blunt-neck-trauma-case-report
#8
Yasutaka Kuniyoshi, Azusa Kamura, Sumie Yasuda, Makoto Tashiro, Yoichiro Toriyabe
BACKGROUND: Serious isolated laryngeal injuries are uncommon in children. CASE REPORT: We describe the case of an 8-year-old boy with laryngeal injury and pneumomediastinum due to minor blunt neck trauma. He presented to the emergency department complaining of odynophagia and hoarseness, but without respiratory distress. Emphysema was seen between the trachea and vertebral body on initial cervical spine x-ray study, and flexible laryngoscopy revealed erythema and mild edema of both the right vocal cord and the arytenoid region...
November 3, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27809989/management-of-polytrauma-patients-in-the-uk-is-there-a-weekend-effect
#9
Vasileios Giannoudis, Michalis Panteli, Peter V Giannoudis
BACKGROUND/PURPOSE: It has been suggested that hospital admission during weekends poses a risk for adverse outcomes and increased patient mortality, the so-called 'weekend effect'. We undertook an evaluation of the impact of weekend admissions to the management of polytraumatised patients, in a Level I Major Trauma Centre (MTC) in the UK. MATERIALS AND METHODS: A retrospective review of prospectively documented data of polytrauma patients (injury severity score (ISS)>15), admitted between April 2013 and August 2015 was performed...
November 2016: Injury
https://www.readbyqxmd.com/read/27800590/implementation-of-the-world-health-organization-trauma-care-checklist-program-in-11-centers-across-multiple-economic-strata-effect-on-care-process-measures
#10
Angela Lashoher, Eric B Schneider, Catherine Juillard, Kent Stevens, Elizabeth Colantuoni, William R Berry, Christina Bloem, Witaya Chadbunchachai, Satish Dharap, Sydney M Dy, Gerald Dziekan, Russell L Gruen, Jaymie A Henry, Christina Huwer, Manjul Joshipura, Edward Kelley, Etienne Krug, Vineet Kumar, Patrick Kyamanywa, Alain Chichom Mefire, Marcos Musafir, Avery B Nathens, Edouard Ngendahayo, Thai Son Nguyen, Nobhojit Roy, Peter J Pronovost, Irum Qumar Khan, Junaid Abdul Razzak, Andrés M Rubiano, James A Turner, Mathew Varghese, Rimma Zakirova, Charles Mock
BACKGROUND: Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would improve care for injured patients in low-, middle-, and high-income countries. METHODS: From 2010 to 2012, the impact of the World Health Organization (WHO) Trauma Care Checklist program was assessed in 11 hospitals using a stepped wedge pre- and post-intervention comparison with randomly assigned intervention start dates...
October 31, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27798008/does-angiography-increase-the-risk-of-impairment-in-renal-function-during-non-operative-management-of-patients-with-blunt-splenic-injuries-a-cross-sectional-study-in-southern-taiwan
#11
Ting-Min Hsieh, Tzu-Hsien Tsai, Chih-Che Lin, Ching-Hua Hsieh
OBJECTIVES: The aim of the present study was to assess whether angiography after contrast-enhanced CT (CECT) as per the policy of non-operative management would add to the risk of acute kidney injury in patients with blunt splenic injuries (BSIs). DESIGN: Cross-sectional study. SETTING: Taiwan. PARTICIPANTS: Patients with BSI aged >16 years, admitted to a level I trauma centre during the period of January 2004 to December 2014, were retrospectively reviewed...
October 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27778039/variation-in-practice-preferences-in-management-of-open-injuries-of-extremities-an-international-survey-by-sicot-research-academy
#12
Arun Kamal, Raja Bhaskara Kanakeshwar, Ashok Shyam, Dheenadayalan Jayaramaraju, Devendra Agraharam, Ramesh Perumal, Shanmuganathan Rajasekaran
PURPOSE: Open fractures are challenging injuries and there is a lot of variation in practice preferences which may reflect the wide variations in outcome in different units across the world. A survey was done amongst the international community of SICOT membership to document the practice preferences and variations. METHODS: An online questionnaire containing 23 questions which were sub-divided into three sections covering the various aspects of open injury management was sent by email to orthopaedic trauma surgeons across the world...
October 24, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27770153/traumatic-diaphragmatic-rupture-in-pediatric-age-review-of-the-literature
#13
F Marzona, N Parri, A Nocerino, M Giacalone, E Valentini, S Masi, L Bussolin
PURPOSE: Traumatic diaphragm rupture (TDR) is a rare complication of trauma in pediatric age and may be easily missed by the severity of associated injuries so that delayed emergent presentation can occur with increased rate of morbidity and mortality. No review has been available to guide clinicians through the pitfalls and the initial diagnostic approach to pediatric TDR. METHODS: A Medline thorough search on TDR was conducted using different queries. English language citations were identified during the period of January 2000 through December 2014 limiting the search to pediatric age (0-18 years)...
October 21, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27765527/effects-of-health-literacy-on-treatment-outcome-and-satisfaction-in-patients-with-mallet-finger-injury
#14
Young Hak Roh, Beom Koo Lee, Min Ho Park, Jung Ho Noh, Hyun Sik Gong, Goo Hyun Baek
STUDY DESIGN: Prospective cohort. INTRODUCTION: Patient comprehension of their injury, its treatment, and health care provider's instructions plays an important role in health management and recovery from trauma. PURPOSE OF THE STUDY: This study investigates the effects of health literacy (the ability to obtain, process, and understand health information needed to make appropriate health decisions) on treatment outcomes and satisfaction in patients with mallet finger injuries...
October 17, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/27694584/resident-education-in-orthopaedic-trauma-the-future-role-of-competency-based-medical-education
#15
M T Nousiainen, S A McQueen, J Hall, W Kraemer, P Ferguson, J L Marsh, R R Reznick, M R Reed, R Sonnadara
As residency training programmes around the globe move towards competency-based medical education (CBME), there is a need to review current teaching and assessment practices as they relate to education in orthopaedic trauma. Assessment is the cornerstone of CBME, as it not only helps to determine when a trainee is fit to practice independently, but it also provides feedback on performance and guides the development of competence. Although a standardised core knowledge base for trauma care has been developed by the leading national accreditation bodies and international agencies that teach and perform research in orthopaedic trauma, educators have not yet established optimal methods for assessing trainees' performance in managing orthopaedic trauma patients...
October 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27692532/retrievable-inferior-vena-cava-filters-in-trauma-patients-prevalence-and-management-of-thrombus-within-the-filter
#16
Y Pan, J Zhao, J Mei, M Shao, J Zhang, H Wu
OBJECTIVE: The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS: The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27618379/utility-of-repeat-head-computed-tomography-for-intracranial-hemorrhage-after-trauma-and-importance-of-direct-patient-care
#17
Mary Ellen Zimmermann, Zachary Brown, Praise Matemavi, Gloria Melnic, Jason Sample
At many institutions, it is common practice for trauma patients with traumatic intracranial hemorrhage (ICH) to receive routine repeat head computed tomographic (CT) scans after the initial CT scan, regardless of symptoms, to evaluate progression of the injury. The purpose of this study was to assess quantifiable risk factors (age, anticoagulation, gender) that could place patients at greater risk for progression of injury, thus requiring surgical intervention (craniotomy, craniectomy) for which serial CT scanning would be useful...
September 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27613632/the-efficacy-and-safety-of-burr-hole-craniotomy-without-continuous-drainage-for-chronic-subdural-hematoma-and-subdural-hygroma-in-children-under-2%C3%A2-years-of-age
#18
Kazuya Matsuo, Nobuyuki Akutsu, Kunitoshi Otsuka, Kazuki Yamamoto, Atsufumi Kawamura, Tatsuya Nagashima
PURPOSE: Various treatment modalities have been used in the management of chronic subdural hematoma and subdural hygroma (CSDH/SDHy) in children. However, few studies have examined burr-hole craniotomy without continuous drainage in such cases. Here, we retrospectively evaluated the efficacy and safety of burr-hole craniotomy without continuous drainage for CSDH/SDHy in children under 2 years old. We also aimed to determine the predictors of CSDH/SDHy recurrence. METHODS: We conducted a retrospective chart review of 25 children under 2 years old who underwent burr-hole craniotomy without continuous drainage for CSDH/SDHy at a pediatric teaching hospital over a 10-year period...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27612533/new-clinical-decision-rule-to-exclude-subarachnoid-haemorrhage-for-acute-headache-a-prospective-multicentre-observational-study
#19
Akio Kimura, Kentaro Kobayashi, Hitoshi Yamaguchi, Takeshi Takahashi, Masahiro Harada, Hideki Honda, Yoshio Mori, Keika Hirose, Noriko Tanaka
OBJECTIVE: To ensure good outcomes in the management of subarachnoid haemorrhage (SAH), accurate prediction is crucial for initial assessment of patients presenting with acute headache. We conducted this study to develop a new clinical decision rule using only objectively measurable predictors to exclude SAH, offering higher specificity than the previous Ottawa SAH Rule while maintaining comparable sensitivity. DESIGN: Multicentre prospective cohort study. SETTING: Tertiary-care emergency departments of five general hospitals in Japan from April 2011 to March 2014...
September 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/27595259/-the-radiologist-physician-in-major-trauma-evaluation
#20
Gaspar Alberto Motta-Ramírez
BACKGROUND: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team. OBJECTIVE: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography...
July 2016: Gaceta Médica de México
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