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Pre hospital trauma

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https://www.readbyqxmd.com/read/28899316/road-safety-serious-injuries-remain-a-major-unsolved-problem
#1
Ben Beck, Peter A Cameron, Mark C Fitzgerald, Rodney T Judson, Warwick Teague, Ronan A Lyons, Belinda J Gabbe
OBJECTIVE: To investigate temporal trends in the incidence, mortality, disability-adjusted life-years (DALYs), and costs of health loss caused by serious road traffic injury. DESIGN, SETTING AND PARTICIPANTS: A retrospective review of data from the population-based Victorian State Trauma Registry and the National Coronial Information System on road traffic-related deaths (pre- and in-hospital) and major trauma (Injury Severity Score > 12) during 2007-2015.Main outcomes and measures: Temporal trends in the incidence of road traffic-related major trauma, mortality, DALYs, and costs of health loss, by road user type...
September 18, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28894892/using-emergency-trauma-team-activations-to-measure-trauma-activity-and-injury-severity-10%C3%A2-years-of-experience-using-an-australian-major-trauma-centre-registry
#2
M M Dinh, S Roncal, K Curtis, R Ivers
OBJECTIVES: To describe the outcomes of Emergency Department trauma team activations over a 10-year period with respect to injury severity and hospital length of stay. METHODS: This was a retrospective study using trauma registry data at a single Major Trauma Centre in Australia. All trauma team activations and arrivals on pre-hospital major trauma (T1) protocol recorded in the trauma registry between June 2006 and July 2016 were included. The outcome of interest was major trauma, defined as an Injury Severity Score (ISS) >12 or length of stay >3 days or requiring urgent operative intervention or admission to the Intensive Care Unit following trauma...
September 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28888692/canadian-study-of-health-and-aging-clinical-frailty-scale-does-it-predict-adverse-outcomes-among-geriatric-trauma-patients
#3
Annie Cheung, Barbara Haas, Thom J Ringer, Amanda McFarlan, Camilla L Wong
BACKGROUND: The Canadian Study of Health and Aging Clinical Frailty Scale (CFS) and the laboratory Frailty Index (FI-lab) are validated tools based on clinical and laboratory data, respectively. Their utility as predictors of geriatric trauma outcomes is unknown. Our primary objective was to determine whether pre-admission CFS is associated with adverse discharge destination. Secondary objectives were to evaluate the relationships between CFS and in-hospital complications and between admission FI-lab and discharge destination...
September 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#4
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28883869/ataxia-in-childhood-epidemiological-clinical-and-neuroradiologic-features-and-the-risk-of-recurrence
#5
REVIEW
Mohsen Javadzadeh, Masoud Hassanvand Amouzadeh, Shaghayegh Sadat Esmail Nejad, Ezatollah Abasi, Abbas Alipour, Mohsen Mollamohammadi
OBJECTIVE: This study was conducted on the demographic data, clinical characteristics, electroencephalography, neuroradiological findings, and their impact on the recurrence of ataxia. MATERIALS & METHODS: A 3-yr retrospective review of 49 children with ataxia in Mofid Children Hospital, Tehran, Iran was conducted from Apr 2013 to Apr 2016. The demographic, clinical and paraclinical data were recorded in pre-prepared questionnaires. The patients were also classified in two groups of with or without recurrence and the results were compared...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28881517/-thoracoscopy-in-diagnosis-and-treatment-of-pleural-diseases-in-children
#6
M Chen, L L Zhong, H Huang, L Lin, H Y Deng, X F Ding, X Hu
Objective: To investigate the value of thoracoscopy in diagnosis and treatment of pleural diseases in children. Method: Clinical manifestations and treatment outcomes of 19 patients who had refractory pleural diseases treated with thoracosocy during May 2011 to August 2016 in Hunan Provincial People's Hospital were retrospectively analyzed. In 19 cases, 15 were male and 4 were female, with an average age of (4.8±2.0) years. Thirteen patients had left pleural lesion, while 5 patients had right lesion, and 1 had bilateral lesions...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28878533/the-importance-of-pelvic-ring-stabilization-as-a-life-saving-measure-in-pre-hospital-a-case-report-commented-by-autopsy
#7
Carlos Durão, Magda Alves, André Barros, Frederico Pedrosa
Hip fractures with unstable pelvic ring have great morbidity and mortality rates. These fractures result from high energy trauma such as falls from heights, road accidents and collapsing structures or other similar mechanisms of action. We report the case of a 63 years old man, construction worker, who stood inside a ditch during a wall construction when he was surprised by this collapse, which resulted in direct trauma to the right thigh and pelvis. The autopsy revealed diaphysis fracture of the right femur with an open book pelvic fracture with severe hemorrhagic infiltration and hematoma of the pelvic muscles without arterial injury...
August 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28876664/access-to-tertiary-trauma-care-challenges-within-a-developing-health-care-system
#8
C Mbanje, G Muguti
BACKGROUND: Trauma is a leading cause of mortality the world over, with an increasing impact in low and middle income countries. Oneof the key challenges in tackling the morbidity and mortality associated with the growing trauma epidemic includes the ability to provide timely access to appropriate trauma care. METHOD: A prospective cross-sectional study of 385 consecutive trauma patients admitted at Parirenyatwa Group of Hospitals (PGH) following injury. Data inclusive of demographics, Methods of transfer, time to care and referral patterns was analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28874930/prevalence-of-intracranial-hemorrhage-after-blunt-head-trauma-in-patients-on-pre-injury-dabigatran
#9
James A Chenoweth, M Austin Johnson, Laura Shook, Mark E Sutter, Daniel K Nishijima, James F Holmes
INTRODUCTION: Dabigatran etexilate was the first direct-acting oral anticoagulant approved in the United States. The prevalence of intracranial hemorrhage after blunt head trauma in patients on dabigatran is currently unknown, complicating adequate ability to accurately compare the risks and benefits of dabigatran to alternative anticoagulants. We aimed to determine the prevalence of intracranial hemorrhage for patients on dabigatran presenting to a Level I trauma center. METHODS: This is a retrospective observational study of adult patients on dabigatran who presented to a Level I trauma center and received cranial computed tomography (CT) following blunt head trauma...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28859918/vital-sign-based-shock-scores-are-poor-at-triaging-south-african-trauma-patients
#10
Robert Barnes, Damian Clarke, Zane Farina, Benn Sartorius, Petra Brysiewicz, Grant Laing, John Bruce, Victor Kong
BACKGROUND: Traumatic shock cannot be diagnosed by a single physiological measurement and a number of vital sign based combined shock scores (CSS) have been proposed to identify and triage trauma patients with shock. This audit uses data from a prospectively entered electronic trauma registry to compare the ability of these CSS to predict in-hospital mortality, need for surgery, need for blood transfusion and ICU admission. MATERIALS AND METHODS: The data used in the study was obtained from the Hybrid Electronic Medical Record (HEMR) in Pietermaritzburg from January 2012-September 2015...
August 28, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28857647/ems-dispatches-during-hurricanes-irene-and-sandy-in-new-jersey
#11
Joshua Bucher, Jonathan McCoy, Colleen Donovan, Snehal Patel, Pamela Ohman-Strickland, Asa Dewan
BACKGROUND: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters. OBJECTIVES: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period. METHODS: This retrospective study was conducted at a large EMS dispatch center that provides first responders, Basic Life Support (BLS), Advanced Life Support (ALS), and critical care transport services to an area with approximately 20 receiving hospitals including a Level I Trauma Center...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#12
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28846501/rapid-source-control-laparotomy-is-there-a-mortality-benefit
#13
James Vogler, Laura Bagwell, Leslie Hart, Sharon Holmes, Jason Sciaretta, John Mihran Davis
BACKGROUND: The purpose of this study was to determine the influence rapid source-control laparotomy (RSCL) has on the mortality rate in non-trauma patients with intra-abdominal infection. The hypothesis was that RSCL reduces deaths and hospital lengths of stay (LOS) in patients compared with definitive repair and primary fascial closure (PFC). METHODS: The International Classification of Diseases-10 codes for sepsis, gastric and duodenal ulcer perforation or hemorrhage, incisional or ventral hernia with obstruction, intestinal volvulus, ileus with obstruction, diverticulitis with perforation or abscess, vascular disorder of intestine, non-traumatic intestinal perforation, peritoneal abscess, and unspecified peritonitis were used to query the 2015 National Surgical Quality Improvement Project (NSQIP) database for all patients treated with either RSCL or PFC...
August 28, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28845372/guillain-barr%C3%A3-syndrome-after-revision-lumbar-surgery-a-case-report
#14
Aymen Rashid, Swamy Kurra, William Lavelle
Guillain-Barré syndrome (GBS) is a term that is used to describe a group of immune-mediated peripheral neuropathies, with the most common feature being rapid polyradiculoneuropathy. The exact etiology of this syndrome is unknown. In the field of orthopedics, GBS has been reported to occur after total hip arthroplasty, orthopedic trauma, and spine surgery. We report a unique case of GBS after elective revision lumbar spine surgery. A 62-year-old female presented with persistent low back pain and radiculopathy and elected to have revision lumbar spine surgery...
June 26, 2017: Curēus
https://www.readbyqxmd.com/read/28837293/-%C3%A2-golden-hour-%C3%A2-and-the-sellick-manoeuvre-in-emergency-care-we-must-not-throw-out-the-baby-with-the-bathwater
#15
Lukas Bürki, Bertrand Yersin
This article evaluates 3 controversial subjects of pre-hospital emergency care : 1) The concept of the « Golden hour » predicates an increased morbidity and mortality for injured patients, if pre-hospital care exceeds 1 hour. In the subgroup of patients presenting with severe hemorrhagic injuries or penetrating trauma to the torso, a transport of 60 minutes or less decreases mortality ; 2) The Sellick manoeuvre is used to decrease the risk of bronchoaspiration in patients undergoing an emergency intubation...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28835283/identifying-pre-hospital-factors-associated-with-outcome-for-major-trauma-patients-in-a-regional-trauma-network-an-exploratory-study
#16
Lee Thompson, Michael Hill, Caroline Davies, Gary Shaw, Matthew D Kiernan
BACKGROUND: Major trauma is often life threatening and the leading cause of death in the United Kingdom (UK) for adults aged less than 45 years old. This study aimed to identify pre-hospital factors associated with patient outcomes for major trauma within one Regional Trauma Network. METHOD: Secondary analysis of pre-hospital audit data and patient outcome data from the Trauma Audit Research Network (TARN) was undertaken. The primary outcome used in analysis was 'Status at Discharge' (alive/deceased)...
August 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28822391/the-impact-of-hemodynamic-transesophageal-echocardiography-on-the-use-of-continuous-renal-replacement-therapy-in-trauma
#17
Madison Griffin, Brett Howard, Sam Devictor, Josh Ferenczy, Frances Cobb, D Benjamin Christie
Post-traumatic fluid management is a widely debated topic. No best-practice consensus exists. Adverse outcomes such as acute kidney injury or volume overload are common. Continuous renal replacement therapy (CRRT) is an adjunct therapy for severe acute renal failure and volume overload, but is costly and not without risk. Hemodynamic transesophageal echocardiography (hTEE) is widely accepted as a reliable way to monitor volume status of intensive care unit (ICU) patients. Although data exist evaluating hTEE and CRRT independently, there is a lack of research mutually inclusive of the two...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#18
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(®)), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28809636/-arthroscopic-finding-of-knee-joint-in-relation-to-age-and-its-comparison-with-pre-operative-clinical-finding-a-retrospective-study
#19
P Látal, K Šimeček, M Kloub
PURPOSE OF THE STUDY In the retrospective study of two South Bohemian centres we present the comparison of pre-operative anamnestic clinical signs in relation to the arthroscopic intraoperative finding. The obtained data is used also to evaluate the arthroscopic finding in relation to age and sex. MATERIAL AND METHODS The arthroscopic findings of patients who underwent surgery in 2013-2014 period (1.1.2013-31.12.2014) at the Department of Trauma Surgery of České Budějovice Hospital, a.s. and in 2014 (1.1...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28801837/blunt-injuries-related-to-equestrian-sports-results-from-an-international-prospective-trauma-database-analysis
#20
Christian D Weber, Anthony R Nguyen, Rolf Lefering, Martijn Hofman, Frank Hildebrand, Hans-Christoph Pape
INTRODUCTION: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries. METHODS: We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012)...
August 11, 2017: International Orthopaedics
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