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Advanced trauma life support

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https://www.readbyqxmd.com/read/28362252/maxillofacial-trauma-managing-potentially-dangerous-and-disfiguring-complex-injuries
#1
Devjanl Das, Lea Salazar
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face...
April 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28355371/characteristics-of-training-and-motivation-of-physicians-working-in-emergency-medicine
#2
Gilson Soares Feitosa-Filho, Marcelo Kirschbaum, Yuri Costa Sarno Neves, Bruna Melo Coelho Loureiro, Victor Augusto Camarinha de Castro Lima, Rafael Marques Calazans, Camila Kruschewsky Falcão, Renata Trindade El Fahl, Bianca Recarey Barreto
Introduction: Emergency medicine is an area in which correct decisions often need to be made fast, thus requiring a well-prepared medical team. There is little information regarding the profile of physicians working at emergency departments in Brazil. Objective: To describe general characteristics of training and motivation of physicians working in the emergency departments of medium and large hospitals in Salvador, Brazil. Method: A cross-sectional study with standardized interviews applied to physicians who work in emergency units in 25 medium and large hospitals in Salvador...
February 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28325461/neurocritical-care-of-acute-subdural-hemorrhage
#3
REVIEW
Fawaz Al-Mufti, Stephan A Mayer
Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28314418/facial-injuries-in-sports-soft-tissue-injuries-abrasions-contusions-lacerations
#4
REVIEW
Guy L Lanzi
This article reviews the diagnosis and treatment of facial soft tissue injuries in athletics. General diagnostic algorithms are presented, including initial assessment aligned with Advanced Trauma Life Support guidelines. Specific injury types are discussed along with possible collateral damage and adverse sequelae to limit morbidity. Treatment modalities are described using generally accepted principles refined to fit athlete patients. Return-to-play issues are outlined relative to level of participation, with the emphasis on safe return...
April 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/28291468/navy-en-route-care-a-3-year-review-of-428-navy-air-evacuations
#5
Benjamin Walrath, Alejandra Mora, Victoria Ganem, Stephen Harper, Elliot Ross, Chetan Kharod, Gerard Demers, Vikhyat S Bebarta
BACKGROUND: Navy medical personnel have been recording en route care (ERC) missions through Search and Rescue (SAR) reports since the 1970's. Our objective was to report clinical ERC cases treated by Navy operational assets from January 2012 to January 2015. METHODS: The Search and Rescue Model Manager office collects SAR reports for all patient transports involving Navy personnel and equipment. From these reports, descriptive statistics to include total number of patients transported, percentages of Advanced Life Support versus Basic Life Support transports, time of transport, and type of ERC provider for the transport were collected...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290929/advanced-trauma-life-support-time-standards
#6
Andrew B Hall, Felix S Boecker, Joseph M Shipp, Dennis Hanseman
INTRODUCTION: Trauma readiness is critical to military medicine. Without medical centers that include persistent volumes of trauma, simulation has become the means to maintain and practice those skills. To create those simulations, standards for both design and metrics to evaluate practitioners are required. MATERIALS AND METHODS: Forty-four traumas were monitored and times to completion of the various steps of Advanced Trauma Life Support were recorded and tabulated...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#7
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28262592/bilateral-asymmetrical-hip-dislocation-with-one-side-obturator-intra-pelvic-dislocation-case-report
#8
Abdullah Saad Abdulfattah Abdullah, Ayman Abdelhady, Abduljabbar Alhammoud
INTRODUCTION: Hip dislocations usually occur as a result of motor vehicle accidents and require high energy trauma. Bilateral hip dislocations are rare compared to unilateral ones. Most reported cases are asymmetrical simultaneous bilateral anterior and posterior dislocations. CASE PRESENTATION: This case report describes a 32years female passenger who was involved in road traffic accident and had bilateral asymmetrical hip dislocations with one side posterior and the other side obturator intra-pelvic dislocation...
February 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28262283/demand-for-specialised-training-for-the-obese-trauma-patient-national-atls-expert-group-survey-results
#9
Philip H Pucher, Lulu Tanno, Kalon Hewage, N Mark Bagnall
BACKGROUND: The growing incidence of obesity in Western populations continues to place new stressors on health systems. Obese trauma patients present particular challenges across the entirety of the patient care pathway, and are at risk of higher lengths of stay, morbidity, and mortality. This study sought to assess a national group of trauma experts' opinions and knowledge regarding the management of obese trauma. METHODS: A questionnaire was circulated to a trauma training providers and national steering committee members at a UK national Advance Trauma Life Support meeting...
February 24, 2017: Injury
https://www.readbyqxmd.com/read/28262203/development-and-evaluation-of-a-trauma-decision-making-simulator-in-oculus-virtual-reality
#10
Cuan M Harrington, Dara O Kavanagh, John F Quinlan, Donncha Ryan, Patrick Dicker, Dara O'Keeffe, Oscar Traynor, Sean Tierney
BACKGROUND: Consumer-available virtual-reality technology was launched in 2016 with strong foundations in the entertainment-industry. We developed an innovative medical-training simulator on the Oculus™ Gear-VR platform. This novel application was developed utilising internationally recognised Advanced Trauma Life Support (ATLS) principles, requiring decision-making skills for critically-injured virtual-patients. METHODS: Participants were recruited in June, 2016 at a single-centre trauma-course (ATLS, Leinster, Ireland) and trialled the platform...
February 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28248804/standardizing-the-initial-resuscitation-of-the-trauma-patient-with-the-primary-assessment-completion-tool-pact-using-video-review
#11
Lee Ann Wurster, Rajan K Thakkar, Kathy J Haley, Krista K Wheeler, Jeremy Larson, Michael Stoner, Yaffa Gewirtz, Todd Holman, Don Buckingham, Jonathan I Groner
BACKGROUND: Major trauma resuscitations at pediatric trauma centers have an elevated risk for error due to their high acuity and relatively low frequency. The Advanced Trauma Life Support® (ATLS®) treatment paradigm was established to improve the management of trauma patients during the initial resuscitation phase and has been shown to improve outcomes through a standardized approach. The goal of this quality improvement project was to decrease assessment physician variability and improve the compliance with the ATLS® primary assessment for major resuscitations...
February 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28242408/a-rare-entity-traumatic-thoracic-aortic-injury-in-a-patient-with-aberrant-right-subclavian-artery
#12
Hiten Mohanbhai Patel, Shubhabrata Banerjee, Shahzad Bulsara, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: Aberrant right subclavian artery is an uncommon entity incidence ranging from 0.5-2.5%. Management of thoracic aortic injury in the presence of such anomalies can be a challenge. We present here a case of traumatic aortic injury which was incidentally found to have an asymptomatic aberrant right subclavian artery. The patient was managed by an endovascular repair of thoracic aortic injury with an endograft and a right carotid to subclavian artery bypass as a hybrid procedure...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28193544/current-approach-to-liver-traumas
#13
Levent Kaptanoglu, Necmi Kurt, Hasan Ediz Sikar
INTRODUCTION: Liver injuries remain major obstacle for successful treatment, due to size and location of the liver. Requirement for surgery should be determined by clinical factors, most notably hemodynamical state. In this present study we tried to declare our approach to liver traumas. We also tried to emphasize the importance of conservative treatment, since surgeries for liver traumas carry high mortality rates. PRESENTATION OF CASE: Patients admitted to the Department of Emergency Surgery at Kartal Research and Education Hospital, due to liver trauma were retrospectively analyzed between 2003 and 2013...
March 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28180121/hemodynamic-changes-following-routine-fluid-resuscitation-in-patients-with-blunt-trauma
#14
Shahram Paydar, Hamed Kabiri, Maryam Barhaghtalab, Fariborz Ghaffarpasand, Saeed Safari, Alireza Baratloo
BACKGROUND: The management of trauma patients is often difficult. The American college of surgeons suggests using advanced trauma life support (ATLS) measures. ATLS is regarded as the gold standard for the resuscitation of cases with acute life threatening injuries. OBJECTIVES: To assess the change in base excess (BE) values and central venous pressure (CVP) one and six hours after injection of 1000 cc normal saline in trauma patients admitted to the ICU. PATIENTS AND METHODS: According to the inclusion and exclusion criteria, patients were randomly selected to participate in the project...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28070472/utilizing-the-veraflo%C3%A2-instillation-negative-pressure-wound-therapy-system-with-advanced-care-for-a-case-study
#15
Rita K Driver
BACKGROUND:  Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen...
November 30, 2016: Curēus
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#16
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27940682/definitions-and-assessment-approaches-for-emergency-medical-services-for-children
#17
Susan Fuchs, Mark Terry, Kathleen Adelgais, Marlene Bokholdt, Jane Brice, Kathleen M Brown, Arthur Cooper, Mary E Fallat, Katherine E Remick, Keith Widmeier, Wendy Simon, Melissa Marx
Pediatric Life Support (PLS) courses and instructional programs are educational tools developed to teach resuscitation and stabilization of children who are critically ill or injured. A number of PLS courses have been developed by national professional organizations for different health care providers (eg, pediatricians, emergency physicians, other physicians, prehospital professionals, pediatric and emergency advanced practice nurses, physician assistants). PLS courses and programs have attempted to clarify and standardize assessment and treatment approaches for clinical practice in emergency, trauma, and critical care...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#18
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...
January 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/27913262/neurosurgeons-in-japan-are-exclusively-brain-surgeons
#19
REVIEW
Shunji Asamoto
BACKGROUND: In Japan, neurosurgeons have traditionally mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is 1 of the many subspecialties in the neurosurgical field in Japan. METHODS: Most patients with neurological deficits or suspected neurological diseases see board-certified neurosurgeons directly in Japan, not through referrals from family physicians or specialists in other fields...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27906867/external-validation-of-the-air-medical-prehospital-triage-score-for-identifying-trauma-patients-likely-to-benefit-from-scene-helicopter-transport
#20
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different data set is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study registry. METHODS: Patients 16 years or older undergoing scene HEMS or ground EMS (GEMS) transport in the Pennsylvania Trauma Outcomes Study registry 2000-2013 were included...
February 2017: Journal of Trauma and Acute Care Surgery
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