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Pre hospital trauma

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https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#1
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430721/outcomes-of-reverse-total-shoulder-arthroplasty-for-proximal-humeral-fractures-primary-arthroplasty-versus-secondary-arthroplasty-following-failed-proximal-humeral-locking-plate-fixation
#2
Emilio Sebastia-Forcada, Alejandro Lizaur-Utrilla, Román Cebrian-Gomez, Francisco A Miralles-Muñoz, Fernando A Lopez-Prats
OBJECTIVE: To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures. DESIGN: Matched case-control study. SETTING: University hospital, level I trauma center. PATIENTS: 30 consecutive patients with fracture sequelae due to failed PHLP fixation (mean age 73) were age- and gender-matched to 30 patients with acute fracture (mean age 75)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28424137/improvement-of-treatment-outcomes-after-implementation-of-a-massive-transfusion-protocol-a-level-i-trauma-center-experience
#3
Andrew Nunn, Peter Fischer, Ronald Sing, Megan Templin, Michael Avery, A Britton Christmas
We assessed the effectiveness of the implementation of an institutional massive transfusion protocol (MTP) for resuscitation with a 1:1:1 transfusion ratio of packed red blood cell (PRBC), fresh frozen plasma, and platelet units. In a Level I trauma center database, all trauma admissions (2004-2012) that received massive transfusions (≥10 units PRBCs in the first 24 hours) were reviewed retrospectively. Demographic data, transfusion ratios, and outcomes were compared before (PRE) and after (POST) MTP implementation in May 2008...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423435/-pathogen-spectrum-of-complex-wounds-in-germany-from-war-zones
#4
Hans Joachim Riesner, Benedikt Friemert, Patricia Lang, Hans Georg Palm, Arnold J Suda
Background Treatment of the injured from war zones with wounds with multi-resistant pathogens is becoming more common in Germany, especially in German Armed Forces Hospitals. In most cases, the pre-treatment of these patients has been inadequate and they have a high load of rare pathogens. In Germany, hospitals have to evaluate these pathogens by law. The aim of this study was to review current German guidelines and data on the array of pathogens of complex trauma wounds in Germany and to compare patients with wounds and multi-resistant pathogens from war zones treated in Germany...
April 19, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28422541/evaluation-of-the-implementation-of-the-trauma-triage-and-destination-plan-on-the-field-triage-of-injured-patients-in-north-carolina
#5
Jane H Brice, Frances S Shofer, Christopher Cowden, E Brooke Lerner, Matthew Psioda, Meredith Arasaratanam, N Clay Mann, Antonio R Fernandez, Anna Waller, Chailee Moss, Michael Mian
OBJECTIVE: Timely triage and appropriate destination decision making for injured patients are central challenges faced by emergency medical services (EMS) systems. In 2010, North Carolina (NC) adopted a statewide Trauma Triage and Destination Plan (TTDP) based on the CDC's Field Triage Guidelines to better address these challenges. We sought to characterize the implementation of these guidelines by quantifying their effect on multiple metrics of patient care. METHODS: We employed a retrospective pre-post study design utilizing a statewide EMS medical record database...
April 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#6
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28416927/cataract-surgery-and-possible-complications-in-patients-with-pseudoexfoliation-syndrome
#7
Gulsum Egemen Erkayhan, Semih Dogan
OBJECTIVE: The aim of this study was to evaluate the demographic characteristics and intraoperative complications of cataract surgery in patients with pseudoexfoliation syndrome (PEX). MATERIALS AND METHODS: Cases of 225 eyes (80 eyes with pseudoexfoliation and 145 eyes without pseudoexfoliation as the control group) that underwent phacoemulsification cataract surgery and IOL implantation at the Silifke State Hospital Ophthalmology Clinic between April 2011 and April 2013 were analysed retrospectively...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28416852/-first-aid-system-for-trauma-development-and-status
#8
D K Chen, W C Lin, P Zhang, S J Kuang, W Huang, T B Wang
With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28403314/implementation-of-care-practices-to-prevent-and-repair-perineal-trauma-in-childbirth
#9
Rafael Cleison Silva Dos Santos, Maria Luiza Gonzalez Riesco
Objective: To implement care practices for perineal trauma prevention and repairing in normal birth. Method: Quasi-experimental study conducted at Hospital da Mulher Mãe-Luzia, in Macapá, AP, Brazil. Seventy-four (74) nurses and obstetricians and 70 post-partum women were interviewed and the records of 555 patients were analyzed. The study was conducted in three stages: pre-audit and baseline audit (phase 1); educational intervention and implementation of best practices (phase 2); post-implementation audit (phase 3)...
April 6, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28400887/antibiotic-prophylaxis-in-orbital-fractures
#10
Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
PURPOSE: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. MAIN OUTCOME MEASURES: Development of orbital infection. RESULTS: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28400033/pre-hospital-policies-for-the-care-of-patients-with-acute-coronary-syndromes-in-india-a-policy-document-analysis
#11
Amisha Patel, Dorairaj Prabhakaran, Mark Berendsen, P P Mohanan, Mark D Huffman
BACKGROUND AND OBJECTIVE: Ischemic heart disease is the leading cause of death in India. In high-income countries, pre-hospital systems of care have been developed to manage acute manifestations of ischemic heart disease, such as acute coronary syndrome (ACS). However, it is unknown whether guidelines, policies, regulations, or laws exist to guide pre-hospital ACS care in India. We undertook a nation-wide document analysis to address this gap in knowledge. METHODS AND RESULTS: From November 2014 to May 2016, we searched for publicly available emergency care guidelines and legislation addressing pre-hospital ACS care in all 29 Indian states and 7 Union Territories via Internet search and direct correspondence...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28396900/multidisciplinary-team-approach-to-traumatic-spinal-cord-injuries-a-single-institution-s-quality-improvement-project
#12
Georgina Alizo, Jason D Sciarretta, Stefanie Gibson, Keely Muertos, Sharon Holmes, Felicia Denittis, Joseph Cheatle, John Davis, Antonio Pepe
BACKGROUND: A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. METHODS: The trauma center registry was retrospectively queried, from January 2011 through December 2015, for patients presenting with a spinal cord injury...
April 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28392075/pre-hospital-thoracotomy-and-the-evolution-of-pre-hospital-critical-care-for-victims-of-trauma
#13
EDITORIAL
D J Lockey, K Brohi
No abstract text is available yet for this article.
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28389109/problem-solving-following-traumatic-brain-injury-in-adolescence-associations-with-functional-outcomes
#14
Shari L Wade, Amy E Cassedy, Lauren E Fulks, H Gerry Taylor, Terry Stancin, Michael W Kirkwood, Keith O Yeates, Brad G Kurowski
OBJECTIVE: To examine the association of problem solving with functioning in youth with traumatic brain injury (TBI). DESIGN: Cross-sectional evaluation of pre-treatment data from a randomized clinical trial. SETTING: Four children's hospitals and one general hospital, with level 1 trauma units. PARTICIPANTS: Youth, ages 11 to 18, who sustained moderate or severe TBI in the past 18 months (n = 133). MAIN OUTCOME AND MEASURES: Problem-solving skills were assessed using the Social Problem Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories (SIP-SR)...
April 4, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28356197/risk-factors-for-depression-following-traumatic-injury-an-epidemiological-study-from-a-scandinavian-trauma-center
#15
Rebecka Ahl, Rickard Lindgren, Yang Cao, Louis Riddez, Shahin Mohseni
INTRODUCTION: A significant proportion of patients suffer depression following traumatic injuries. Once manifested, major depression is challenging to overcome and its presence risks impairing the potential for physical rehabilitation and functional recovery. Risk stratification for early detection and intervention in these instances is important. This study aims to investigate patient and injury characteristics associated with an increased risk for depression. METHODS: All patients with traumatic injuries were recruited from the trauma registry of an urban university hospital between 2007 and 2012...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28342652/effective-hospital-wide-education-in-hemorrhage-control
#16
James R Hegvik, Sarah K Spilman, Sherry D Olson, Carrie A Gilchrist, Richard A Sidwell
BACKGROUND: Uncontrolled hemorrhage is the leading cause of potentially preventable traumatic death. Bleeding victims must receive immediate medical attention to save lives, and the first opportunity to control bleeding after trauma often comes from bystanders. Educating the general public is important for improving outcomes for hemorrhaging victims, and it is imperative for all people, including those with no clinical training, to have the knowledge to respond until trained medical specialists arrive...
March 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28326162/trauma-informed-care-for-children-in-the-ambulance-international-survey-among-pre-hospital-providers
#17
Eva Alisic, Mark P Tyler, Melita J Giummarra, Rahim Kassam-Adams, Juul Gouweloos, Markus A Landolt, Nancy Kassam-Adams
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28324353/the-fast-d-protocol-a-simple-method-to-rule-out-traumatic-vascular-injuries-of-the-lower-extremities
#18
Miguel Angel Montorfano, Lisandro Miguel Montorfano, Federico Perez Quirante, Federico Rodríguez, Leonardo Vera, Luca Neri
BACKGROUND: The aim of this study is to assess the accuracy of a Fast Doppler protocol for the examination of an injured lower limb, namely 2-Point Fast Doppler (2PFD), in order to rapidly triage arterial lesions after penetrating trauma. METHODS: The presence of flow and the aspects of the Doppler waveform of the dorsalis pedis artery (DPA) and posterior tibial artery (PTA) of the injured lower limb (2PFD) were evaluated immediately before the execution of a standardized Color Duplex Doppler (SD) evaluation in 149 limbs of 140 patients with gunshot penetrating injuries...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28315812/onset-of-coagulation-function-recovery-is-delayed-in-severely-injured-trauma-patients-with-venous-thromboembolism
#19
Belinda H McCully, Christopher R Connelly, Kelly A Fair, John B Holcomb, Erin E Fox, Charles E Wade, Eileen M Bulger, Martin A Schreiber
BACKGROUND: Altered coagulation function after trauma may contribute to venous thromboembolism (VTE) development. Severe trauma impairs coagulation function, but the trajectory for recovery is not known. We hypothesized that enhanced, early recovery of coagulation function increases VTE risk in severely-injured trauma patients. STUDY DESIGN: Secondary analysis was performed on data from The Pragmatic Randomized Optimal Platelet and Plasma Ratio (PROPPR) trial, excluding patients who died within 24 hours and/or were on pre-injury anticoagulants...
March 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28314465/data-capture-and-communication-during-transfers-to-definitive-care-in-an-inclusive-trauma-system
#20
Nori L Bradley, Naisan Garraway, Nathaniel Bell, Nasira Lakha, S Morad Hameed
INTRODUCTION: Background trauma survivors in rural areas transferred to urban centers have higher mortality than trauma patients admitted directly to urban centers. Transfer data in trauma registries is important for injury control. Prehospital and early physiologic data may reflect processes of pre-hospital care. British Columbia currently has no standardized process for trauma patient data transfer. PATIENTS AND METHODS: We performed a retrospective data analysis for major trauma patients (ISS>15) transferred to a Level I trauma center over a 1year period (n=243)...
November 5, 2016: Injury
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