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https://www.readbyqxmd.com/read/29352616/assessing-advanced-airway-management-performance-in-a-national-cohort-of-emergency-medical-services-agencies
#1
Henry E Wang, John P Donnelly, Dustin Barton, Jeffrey L Jarvis
STUDY OBJECTIVE: Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. METHODS: We used EMS data from ESO Solutions, a national EMS electronic health record system...
January 15, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29351927/bet-2-is-early-chemical-thromboprophylaxis-safe-in-patients-with-blunt-trauma-solid-organ-injury-soi-undergoing-non-operative-management-nom
#2
Craig Ferguson, Jonathan Lewin
A short cut review was carried out to establish whether chemical thromboprophylaxis was a safe early intervention in patients with solid organ injury that is being managed non-operatively. Eight papers presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that there is inadequate evidence assessing safety of low molecular weight heparin (LMWH) within 24 hours of trauma...
February 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29351182/the-management-of-partial-zone-ii-intrasynovial-flexor-tendon-lacerations-a-literature-review-of-biomechanics-clinical-outcomes-and-complications
#3
Kyle D Lineberry, Shirley Shue, Kyle J Chepla
BACKGROUND: Penetrating trauma or lacerations within zone II of the flexor sheath may result in partial tendon injury. The proper management of this injury is controversial; the literature contains differing indications for surgical treatment and post-operative rehabilitation. METHODS: A literature review of the Cochrane, Medline and Pubmed databases was performed using the following search criteria: partial, flexor, tendon, laceration. All English language studies that evaluated biomechanical strength, complications, and outcomes after partial tendon injury in human and animal studies were included and reviewed by two of the authors...
January 12, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29350642/acute-and-overuse-elbow-trauma-radio-orthopaedics-overview
#4
Elisabetta Antonia Nocerino, Davide Cucchi, Paolo Arrigoni, Marco Brioschi, Cristiano Fusi, Eugenio A Genovese, Carmelo Messina, Pietro Randelli, Carlo Masciocchi, Alberto Aliprandi
The correct management of acute, subacute and overuse-related elbow pathologies represents a challenging diagnostic and therapeutic problem. While major trauma frequently requires a rapid surgical intervention, subluxation and minor trauma allow taking more time for diagnostics and planning the correct elective treatment after careful clinical and radiological investigation. In these conditions, communication between orthopaedic surgeon and radiologist allow to create a detailed radiology report, tailored to the patient's and surgeon's needs and optimal to plan proper management...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#5
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29349487/lay-first-responder-training-in-eastern-uganda-leveraging-transportation-infrastructure-to-build-an-effective-prehospital-emergency-care-training-program
#6
Peter G Delaney, Richard Bamuleke, Yang Jae Lee
BACKGROUND: Though road traffic injuries (RTIs) are a major cause of mortality in East Africa, few countries have emergency medical services. The aim was to create a sustainable and efficient prehospital lay first responder program, creating a system with lay first responders spread through the 53 motorcycle taxi stages of Iganga Municipality. METHODS: One hundred and fifty-four motorcycle taxi riders were taught a first aid curriculum in partnership with a local Red Cross first aid trainer and provided with a first aid kit following WHO guidelines for basic first aid...
January 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29347913/an-unusual-case-of-infective-pneumocephalus-case-report-of-pneumocephalus-exacerbated-by-continuous-positive-airway-pressure
#7
Abdus Samad Ansari, Brittany B Dennis, Dilip Shah, Winfred Baah
BACKGROUND: Pneumocephalus, illustrated by air in the cranial vault is relatively infrequent and generally associated with neurosurgery, trauma, meningitis and barotrauma. However cases of spontaneous non-traumatic pneumocephalus remain rare. While the relationship between continuous positive airway pressure (CPAP) and atraumatic pneumocephalus has been previously reported, to our knowledge the rare presentation associated with sinus wall osteomyelitis has never been described. We summarize here the case of a 67-year-old woman's acute presentation of Streptococcus salvarius infection after a sudden drop in her consciousness...
January 18, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29346237/pediatric-pelvic-fractures-and-differences-compared-with-the-adult-population
#8
Carolina de la Calva, Nadia Jover, Jaime Alonso, Marta Salom
INTRODUCTION: Although pelvic fractures in children are rare, because of anatomical differences between an adult's skeleton and a child's skeleton, these lesions in the pediatric population have specific characteristics that need to be borne in mind when dealing with them. MATERIALS AND METHODS: A retrospective chart review was performed on the pelvic fractures in skeletally immature patients treated in our hospital in the last 20 years. RESULTS: Eighty-one pelvic fractures in children were treated between 1993 and 2013...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346233/video-recordings-to-analyze-preventable-management-errors-in-pediatric-resuscitation-bay
#9
Julia Borns, Jörg Ersch, Milana Dobrovoljac, Georg Staubli, Barbara Brotschi
OBJECTIVE: In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings. METHODS: Video recording of all patients admitted to the pediatric resuscitation bay at University Children's Hospital Zurich during a 13-month period was performed...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346229/anatomical-variations-of-the-vertebral-artery-in-the-upper-cervical-spine-clinical-relevance-for-procedures-targeting-the-c1-c2-and-c2-c3-joints
#10
Maria Francisca Elgueta, Johanna Ortiz Jimenez, Nina Nan Wang, Almudena Pérez Lara, Jeffrey Chankowsky, Roshanak Charghi, De Q Tran, Roderick J Finlayson
BACKGROUND AND OBJECTIVES: Accidental breach of the vertebral artery (VA) during the performance of cervical pain blocks can result in significant morbidity. Whereas anatomical variations have been described for the foraminal (V2) segment of the VA, those involving its V3 portion (between the C2 transverse process and dura) have not been investigated and may be of importance for procedures targeting the third occipital nerve or the lateral atlantoaxial joint. METHODS: Five hundred computed tomography angiograms of the neck performed in patients older than 50 years for the management of cerebrovascular accident or cervical trauma (between January 2010 and May 2016) were retrospectively and independently reviewed by 2 neuroradiologists...
January 16, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29344055/non-organic-vision-loss-in-the-afghanistan-and-iraq-conflicts
#11
Kevin M Broderick, Thomas B Ableman, Eric D Weber, Robert W Enzenauer, Harold J Wain, Keith J Wroblewski
Non-organic visual loss (NOVL), defined as a decrease in visual acuity or field without an identifiable organic cause, can be challenging to diagnose, especially in patients whose NOVL is superimposed on some component of true organic pathology. Exposure to combat puts soldiers at risk of emotional distress and physical trauma, which can contribute to the development of NOVL with conversion disorder or malingering. This case series describes six patients with NOVL who sustained ocular or non-ocular injuries while serving in combat operations in Iraq and Afghanistan, and highlights diagnostic pearls and components of inter-disciplinary management in the unique military context...
August 2017: Neuro-ophthalmology
https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#12
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29341840/surgical-site-infections-after-open-reduction-internal-fixation-for-trauma-in-low-and-middle-human-development-index-countries-a-systematic-review
#13
Thomas J McQuillan, Lawrence Z Cai, Ian Corcoran-Schwartz, Thomas G Weiser, Joseph D Forrester
BACKGROUND: Musculoskeletal trauma represents a large source of morbidity in low and middle human development index countries (LMHDICs). Open reduction and internal fixation (ORIF) of traumatic long bone fractures definitively manages these injuries and restores function when conducted safely and effectively. Surgical site infections (SSIs) are a common complication of operative fracture fixation, although the risks of infection are ill-defined in LMHDIC. PATIENTS AND METHODS: This study reviewed systematically all studies describing SSI after ORIF in LMDHICs...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29341131/a-retrospective-study-of-feline-trauma-patients-admitted-to-a-referral-centre
#14
T Hernon, M Gurney, S Gibson
OBJECTIVE: To identify prognostic information and provide recommendations for management of feline trauma patients. METHODS: Retrospective analysis of case records for 185 cats presented as emergency trauma cases to a referral hospital between February 2009 and December 2013. Each case was assigned a severity score from 1 (very minor injuries) to 6 (moribund, dying). The data were analysed using Mann-Whitney U and Spearman's rank correlation tests. Logistic regression was used to calculate odds ratios...
January 17, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29340725/decision-making-in-management-of-the-complex-trauma-patient-changing-the-mindset-of-the-non-trauma-surgeon
#15
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
BACKGROUND: European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29338912/-surgical-outcomes-of-traumatic-cervical-fractures-in-patients-with-ankylosing-spondylitis
#16
Alberto Isla Guerrero, Beatriz Mansilla Fernández, Borja Hernández Garcia, Álvaro Gómez de la Riva, María Luisa Gandía González, Elena Isla Paredes
OBJECTIVE: Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. METHODS: Between January 2004 and December 2014, 6 patients with ankylosing spondylitis and neurological complications after injuries were treated...
January 12, 2018: Neurocirugía
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#17
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29337920/acute-traumatic-endotheliopathy-in-isolated-severe-brain-injury-and-its-impact-on-clinical-outcome
#18
Venencia Albert, Arulselvi Subramanian, Deepak Agrawal, Hara Prasad Pati, Siddhartha Datta Gupta, Asok Kumar Mukhopadhyay
STUDY DESIGN: Prospective observational cohort. OBJECTIVE: To investigate the difference in plasma levels of syndecan-1 (due to glycocalyx degradation) and soluble thrombomodulin (due to endothelial damage) in isolated severe traumatic brain injury (TBI) patients with/without early coagulopathy. A secondary objective was to compare the effects of the degree of TBI endotheliopathy on hospital mortality among patients with TBI-associated coagulopathy (TBI-AC). METHODS: Data was prospectively collected on isolated severe TBI (sTBI) patients with Glasgow Coma Scale (GCS) ≤8 less than 12 h after injury admitted to a level I trauma centre...
January 16, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29335752/diagnosis-and-management-of-long-bone-nonunions-a-nationwide-survey
#19
Sezai Özkan, Peter A Nolte, Michel P J van den Bekerom, Frank W Bloemers
PURPOSE: There is variability among surgeons on definitions regarding the degree of bone healing of long-bone fractures. A lack of consensus may negatively affect communication between surgeons, and lead to unintended and unwanted variability in treatment of patients suffering from abnormal healing of long-bone fractures. We aimed to identify differences between surgeons regarding their views on the degree of union of long-bone fractures. METHODS: We performed a survey among 114 surgeons who worked at 11 level I trauma centers and 68 level II/III hospitals in the Netherlands...
January 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29334996/italian-guidelines-on-the-assessment-and-management-of-pediatric-head-injury-in-the-emergency-department
#20
REVIEW
Liviana Da Dalt, Niccolo' Parri, Angela Amigoni, Agostino Nocerino, Francesca Selmin, Renzo Manara, Paola Perretta, Maria Paola Vardeu, Silvia Bressan
OBJECTIVE: We aim to formulate evidence-based recommendations to assist physicians decision-making in the assessment and management of children younger than 16 years presenting to the emergency department (ED) following a blunt head trauma with no suspicion of non-accidental injury. METHODS: These guidelines were commissioned by the Italian Society of Pediatric Emergency Medicine and include a systematic review and analysis of the literature published since 2005...
January 15, 2018: Italian Journal of Pediatrics
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