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https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#1
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28721570/task-shifting-the-use-of-laypersons-for-acquisition-of-vital-signs-data-for-clinical-decision-making-in-the-emergency-room-following-traumatic-injury
#2
Bryce E Haac, Jared R Gallaher, Charles Mabedi, Andrew J Geyer, Anthony G Charles
IMPORTANCE: In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE: To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. DESIGN: We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28719604/research-questions-in-pre-hospital-trauma-care
#3
David J Lockey
Noting that a variety of pre-hospital interventions can now be applied to treat traumatic injury, David J Lockey calls for research to determine which of these actually improve survival and reduce morbidity.
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#4
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28715361/trauma-systems-around-the-world-a-systematic-overview
#5
Suzan Dijkink, Charlie Nederpelt, Pieta Krijnen, George C Velmahos, Inger B Schipper
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000-2016 was conducted following the PRISMA guidelines. Pre-hospital care, acute hospital care and quality assurance were classified using the WHO Trauma System Maturity Index in four levels from I (least mature) to IV (most mature)...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715359/attempting-to-validate-the-over-under-triage-matrix-at-a-level-i-trauma-center
#6
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different and Matrix does not discriminate the needs or outcomes of these different groups of patients...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28710974/predictors-of-recovery-in-cyclists-hospitalised-for-orthopaedic-trauma-following-an-on-road-crash
#7
Ben Beck, Christina L Ekegren, Peter Cameron, Elton R Edwards, Andrew Bucknill, Rodney Judson, Richard Page, Raphael Hau, Mark Stevenson, Belinda J Gabbe
BACKGROUND: As cycling-related injury rates are on the rise, there is a need to understand the long term outcomes of these patients in order to quantify the burden of injury and to inform injury prevention strategies. This study aimed to investigate predictors of return to work and functional recovery in a cohort of cyclists hospitalised for orthopaedic trauma from crashes occurring on-road. METHODS: A retrospective analysis of data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) was conducted for patients who were hospitalised for orthopaedic trauma following a cycling crash that occurred on-road between July 2007 and June 2015...
July 12, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28707131/posterior-locked-lateral-compression-injury-of-the-pelvis-in-geriatric-patients-an-infrequent-and-specific-variant-of-the-fragility-fracture-of-pelvis
#8
Se-Won Lee, Weon-Yoo Kim, Sung-Jun Koh, Young-Yul Kim
INTRODUCTION: Posterior locked lateral compression injury (PLLCI) of the pelvic ring is an infrequent variant of lateral compression injury, a condition described in only eight reported cases since 2000. Lateral compression injury usually results from high-energy trauma and is characterized by locking between the medially translated fractured ilium and the anterior border of the sacrum, regardless of whether the fractured ilium involves the sacroiliac joint. However, in our experience, lateral compression injury can also result from low-energy trauma as a manifestation of pelvic fragility fracture...
July 13, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28706106/detailed-assessment-of-benefits-and-risks-of-retrievable-inferior-vena-cava-filters-on-patients-with-complicated-injuries-the-da-vinci-multicentre-randomised-controlled-trial-study-protocol
#9
Kwok M Ho, Sudhakar Rao, Stephen Honeybul, Rene Zellweger, Bradley Wibrow, Jeffrey Lipman, Anthony Holley, Alan Kop, Elizabeth Geelhoed, Tomas Corcoran
INTRODUCTION: Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain. METHODS AND ANALYSIS: Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28701204/criteria-and-models-for-the-distribution-of-casualties-in-trauma-related-mass-casualty-incidents-a-systematic-literature-review-protocol
#10
Ali Ardalan, Mohammad Reza Khajehaminian, Sayed Mohsen Hosseini Boroujeni, Amir Nejati, Abbasali Keshtkar, Abbas Rahimi Foroushani, Omid Mahdi Ebadati E
BACKGROUND: One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents...
July 12, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28693491/hypoxia-and-hypotension-in-patients-intubated-by-physician-staffed-helicopter-emergency-medical-services-a-prospective-observational-multi-centre-study
#11
Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne, Stephen J M Sollid
BACKGROUND: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Several studies describe the impact of pre-hospital hypoxia or hypotension on trauma patients, but few studies compare this in trauma and non-trauma patients...
July 11, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28689194/risk-factors-and-outcomes-associated-with-post-traumatic-headache-after-mild-traumatic-brain-injury
#12
Yilmaz Tansel, Gerwin Roks, Myrthe de Koning, Myrthe Scheenen, Harm van der Horn, Gerben Plas, Gerard Hageman, Guus Schoonman, Jacoba Spikman, Joukje van der Naalt
OBJECTIVES: To determine the prevalence and potential risk factors of acute and chronic post-traumatic headache (PTH) in patients with mild to moderate traumatic brain injury (TBI) in a prospective longitudinal observational multicentre study. Acute PTH (aPTH) is defined by new or worsening of pre-existing headache occurring within 7 days after trauma, whereas chronic PTH (cPTH) is defined as persisting aPTH >3 months after trauma. An additional goal was to study the impact of aPTH and cPTH in terms of return to work (RTW), anxiety and depression...
July 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28685899/prevention-and-recognition-of-abusive-head-trauma-training-for-healthcare-professionals-in-vietnam
#13
Jennifer A Fraser, Tara Flemington, Thi Ngoc Diep Doan, Minh Tu Van Hoang, Thi Le Binh Doan, Manh Tuan Ha
AIM: This paper presents results from an intervention designed to improve identification and response to abusive head trauma in a tertiary paediatric hospital in Vietnam. METHODS: One hundred and sixteen healthcare professionals (paediatric medical and nursing staff) completed a clinical training programme and participated in its evaluation. A pre-post-test and follow-up design was used to evaluate the outcomes. Questionnaires were used to collect data prior to training, at six-weeks and at six-months...
July 7, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28673321/open-chest-versus-closed-chest-cardiopulmonary-resuscitation-in-blunt-trauma-analysis-of-a-nationwide-trauma-registry
#14
Akira Endo, Atsushi Shiraishi, Yasuhiro Otomo, Makoto Tomita, Hiroki Matsui, Kiyoshi Murata
BACKGROUND: Although open-chest cardiopulmonary resuscitation (OCCPR) is often considered as the last salvage maneuver in critically injured patients, evidence on the effectiveness of OCCPR has been based only on the descriptive studies of limited numbers of cases or expert opinions. This study aimed to compare the effectiveness of OCCPR with that of closed-chest cardiopulmonary resuscitation (CCCPR) in an emergency department (ED). METHODS: A nationwide registry-based, retrospective cohort study was conducted...
July 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28668659/morbidity-and-mortality-amongst-indian-hajj-pilgrims-a-3-year-experience-of-indian-hajj-medical-mission-in-mass-gathering-medicine
#15
Inam D Khan, Shahbaz A Khan, Bushra Asima, Syed B Hussaini, M Zakiuddin, F A Faisal
The Hajj, a mass-gathering of over 3.5-million pilgrims, faces challenges to global health-security, housing, food, water, transportation, communication, sanitation, crowd-control and security. The Indian Medical Mission extended health-security to approximately 140,000 pilgrims, through outreach medical teams, primary-care clinics, tent-clinics, secondary-care hospitals and evacuation capabilities. Data on medical attendance, bed-occupancy, investigations, referrals, medication usage and deaths was compared...
June 28, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28666918/urinary-tract-infection-after-retrograde-urethrogram-in-children-a-multicenter-study
#16
Neha R Malhotra, Jared R Green, Cynthia K Rigsby, Jane L Holl, Earl Y Cheng, Emilie K Johnson
INTRODUCTION: The risk of post-procedural urinary tract infection (ppUTI) after retrograde urethrogram (RUG) has not been well quantified. Prophylactic antibiotics may reduce the risk, but must be weighed against the risks of antibiotic resistance. Prior research has shown that this risk is variable after voiding cystourethrogram (0-42% reported ppUTI rate) and appears to be low after urodynamics (0-4.8%) but this risk has not been well documented for patients undergoing RUG. OBJECTIVE: We aimed to (1) describe the rate of ppUTI after RUG, and (2) examine factors associated with use of antibiotics at the time of RUG...
June 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28656318/efficiency-of-fragment-specific-fixation-plates-in-the-treatment-of-comminuted-distal-radial-fractures
#17
Elhadi Musaab Elhadi Babikir, Eyad Daood Al-Maqdassy, Khalid Hasan, Shamsi Abdul Hameed, Abduljabbar Alhammoud, Mohammed Mubarak Al-Ateeq Al-Dosari
PURPOSE: The purpose of this study was to assess the clinical, radiologic and functional outcome of treating comminuted intra-articular distal radius fractures with fragment specific fixation. METHODS: This was a retrospective chart review of 25 unstable intra-articular distal radius fractures (type C2 AO) that had fragment specific fixation done in the orthopaedic department of the Hamad General Hospital (level 1 trauma center) over three years (2010-2013), with a follow up of one year post-operatively...
June 27, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28653646/early-predictors-of-outcome-after-mild-traumatic-brain-injury-upfront-an-observational-cohort-study
#18
Joukje van der Naalt, Marieke E Timmerman, Myrthe E de Koning, Harm J van der Horn, Myrthe E Scheenen, Bram Jacobs, Gerard Hageman, Tansel Yilmaz, Gerwin Roks, Jacoba M Spikman
BACKGROUND: Mild traumatic brain injury (mTBI) accounts for most cases of TBI, and many patients show incomplete long-term functional recovery. We aimed to create a prognostic model for functional outcome by combining demographics, injury severity, and psychological factors to identify patients at risk for incomplete recovery at 6 months. In particular, we investigated additional indicators of emotional distress and coping style at 2 weeks above early predictors measured at the emergency department...
July 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28653434/injury-from-falls-in-infants-under-one-year
#19
Christopher S Mulligan, Susan Adams, Dimitra Tzioumi, Julie Brown
AIM: Falls in infants are a common cause of injury. Compared to older children, infants under age one are likely to have distinctive causation and injury patterns, as they are pre-mobile or have limited independent mobility and falls are more directly the responsibility of the care giver. There is little known about the mechanistic factors, predictors of injury and injury patterns in this age group. METHODS: We conducted a retrospective review of infants under age one who presented after a fall to a paediatric trauma centre in Sydney, Australia...
June 26, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28653327/are-severely-injured-trauma-victims-in-norway-offered-advanced-pre-hospital-care-national-retrospective-observational-cohort
#20
T Wisborg, E N Ellensen, I Svege, T Dehli
BACKGROUND: Studies of severely injured patients suggest that advanced pre-hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale...
June 26, 2017: Acta Anaesthesiologica Scandinavica
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