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https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#1
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#2
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/28419017/the-evaluation-of-trauma-care-the-comparison-of-2-high-level-pediatric-emergency-departments-in-the-united-states-and-turkey
#3
Alkan Bal, Michael Cooper, Amanda Lee, Murat Anil, Halim Hennes
OBJECTIVE: The purpose of the study is to compare the outcomes of pediatric trauma patients with motor vehicle crashes (MVCs) and motor vehicle versus pedestrian crashes (MPCs) at a level 1 pediatric trauma center in the United States and a pediatric trauma center in Turkey. METHODS: The medical records of all pediatric MVC and MPC subjects presenting to the emergency departments (EDs) of a level 3 hospital in Turkey (Izmir Tepecik Training and Research Hospital [ITTRH]) and a level 1 pediatric trauma center in the United States (Children's Medical Center Dallas [CMCD]) over a 1-year period were reviewed...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28395982/cardiopulmonary-resuscitation-of-out-of-hospital-traumatic-cardiac-arrest-in-qatar-a-nationwide-population-based-study
#4
Furqan B Irfan, Rafael Consunji, Ayman El-Menyar, Pooja George, Ruben Peralta, Hassan Al-Thani, Stephen Hodges Thomas, Guillaume Alinier, Ashfaq Shuaib, Jassim Al-Suwaidi, Rajvir Singh, Maaret Castren, Peter A Cameron, Therese Djarv
BACKGROUND: Traumatic cardiac arrest studies have reported improved survival rates recently, ranging from 1.7-7.5%. This population-based nationwide study aims to describe the epidemiology, interventions and outcomes, and determine predictors of survival from out-of-hospital traumatic cardiac arrest (OHTCA) in Qatar. METHODS: An observational retrospective population-based study was conducted on OHTCA patients in Qatar, from January 2010 to December 2015. Traumatic cardiac arrest was redefined to include out-of-hospital traumatic cardiac arrest (OHTCA) and in-hospital traumatic cardiac arrest (IHTCA)...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28385178/epidemiology-and-outcomes-of-injuries-in-kenya-a-multisite-surveillance-study
#5
Isaac M Botchey, Yuen W Hung, Abdulgafoor M Bachani, Fatima Paruk, Amber Mehmood, Hassan Saidi, Adnan A Hyder
BACKGROUND: Injury is a leading cause of disability and death worldwide, accounting for over 5 million deaths each year. The injury burden is higher in low- and middle-income countries where more than 90% of injury-related deaths occur. Despite this burden, the use of prospective trauma registries to describe injury epidemiology and outcomes is limited in low- and middle-income countries. Kenya lacks robust data to describe injury epidemiology and care. The objective of this study was to investigate the epidemiology and outcomes of injuries at 4 referral hospitals in Kenya using hospital-based trauma registries...
April 3, 2017: Surgery
https://www.readbyqxmd.com/read/28363752/are-prehospital-deaths-from-trauma-and-accidental-injury-preventable-a-direct-historical-comparison-to-assess-what-has-changed-in-two-decades
#6
G J Oliver, D P Walter, A D Redmond
BACKGROUND & OBJECTIVES: In 1994, Hussain and Redmond revealed that up to 39% of prehospital deaths from accidental injury might have been preventable had basic first aid care been given. Since then there have been significant advances in trauma systems and care. The exclusion of prehospital deaths from the analysis of trauma registries, giv en the high rate of those, is a major limitation in prehospital research on preventable death. We have repeated the 1994 study to identify any changes over the years and potential developments to improve patient outcomes...
May 2017: Injury
https://www.readbyqxmd.com/read/28284400/-the-acute-phase-a-time-which-determines-the-outcome-of-a-patient-with-a-head-trauma
#7
Olivier Jeauneaux, Maylis Bony, Olivier Giroud, Flavien Chabert, Daniel Pagnier, Charlène Mansuy, Pauline Quélin, Héloïse Lemperrière, Caroline Grodecœur, Cécile Armonia
As soon as their prehospital care begins, patients with a serious head injury are given intensive care to offset the systemic failures observed and minimise secondary brain damage. In intensive care, monitoring is continuous and neuroprotection optimised. While the prognosis of the patient remains uncertain, their family are included and involved in their global care.
March 2017: Revue de L'infirmière
https://www.readbyqxmd.com/read/28262281/prehospital-deaths-from-trauma-are-injuries-survivable-and-do-bystanders-help
#8
G J Oliver, D P Walter, A D Redmond
BACKGROUND AND OBJECTIVES: Deaths from trauma occurring in the prehospital phase of care are typically excluded from analysis in trauma registries. A direct historical comparison with Hussain and Redmond's study on preventable prehospital trauma deaths has shown that, two decades on, the number of potentially preventable deaths remains high. Using updated methodology, we aimed to determine the current nature, injury severity and survivability of traumatic prehospital deaths and to ascertain the presence of bystanders and their role following the point of injury including the frequency of first-aid delivery...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28255632/population-based-autopsy-study-of-traumatic-fatalities
#9
S Saar, A Lomp, J Laos, V Mihnovitš, R Šalkauskas, T Lustenberger, M Väli, U Lepner, P Talving
BACKGROUND: Injuries result in 5.8 million global fatalities annually and are the leading cause of death in younger individuals. Nevertheless, population-based autopsy investigations on traumatic deaths are scarce. We set out to study all consecutive autopsies on traumatic fatalities performed in a 5-year time segment in Estonia. METHODS: After the ethics review board approval, all consecutive autopsies after blunt or penetrating deaths occurring in prehospital or in-hospital settings between January 1, 2009, and December 31, 2013, were retrospectively reviewed using the National Forensic Medicine Database...
March 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28238499/out-of-hospital-triage-of-older-adults-with-head-injury-a-retrospective-study-of-the-effect-of-adding-anticoagulation-or-antiplatelet-medication-use-as-a-criterion
#10
Daniel K Nishijima, Samuel D Gaona, Trent Waechter, Ric Maloney, Troy Bair, Adam Blitz, Andrew R Elms, Roel D Farrales, Calvin Howard, James Montoya, Jeneita M Bell, Mark Faul, David R Vinson, Hernando Garzon, James F Holmes, Dustin W Ballard
STUDY OBJECTIVE: Field triage guidelines recommend that emergency medical services (EMS) providers consider transport of head-injured older adults with anticoagulation use to trauma centers. However, the triage patterns and the incidence of intracranial hemorrhage or neurosurgery in these patients are unknown. Our objective is to describe the characteristics and outcomes of older adults with head trauma who are transported by EMS, particularly for patients who do not meet physiologic, anatomic, or mechanism-of-injury (steps 1 to 3) field triage criteria but are receiving anticoagulant or antiplatelet medications...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28169980/epidemiologic-characteristics-of-pediatric-trauma-patients-receiving-prehospital-care-in-kigali-rwanda
#11
Adam R Aluisio, Olivier Félix Umuhire, Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Jeanne DʼArc Nyinawankusi, Eric Uwitonze, Sam Enumah, John W Scott, Zeta Mutabazi, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Jean Claude Byiringiro, Adam C Levine
BACKGROUND: Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali by emergency medical services in Kigali, Rwanda. METHODS: This cohort study was conducted at the Centre Hospitalier Universitaire de Kigali from December 2012 to February 2015...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#12
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
March 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28157743/clinical-evaluation-of-the-patient-with-acute-stroke
#13
Andrew M Southerland
PURPOSE OF REVIEW: This article reviews the clinical evaluation of the patient with acute stroke, including key questions in the focused stroke history, important aspects of the National Institutes of Health Stroke Scale and focused neurologic examination, and the significance of the basic head CT scan in informing a timely treatment decision. RECENT FINDINGS: Advances in both stroke treatment and enhanced diagnostics support an evolving paradigm for acute stroke care, ranging from the prehospital setting to the rehabilitative setting...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#14
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28130577/radiological-evaluation-of-tube-depth-and-complications-of-prehospital-endotracheal-intubation-in-pediatric-trauma-a-descriptive-study
#15
T Simons, T Söderlund, L Handolin
PURPOSE: Pediatric prehospital endotracheal intubation (PHETI) is a difficult and rarely performed procedure that remains the gold standard for prehospital airway management when ventilation and/or anesthesia is required, but high complications rates, including malposition continue to concern. We reviewed the experience in our institution of pediatric intubations with particular emphasis on the position of the endotracheal tube (ETT) tip within the trachea and related complications. METHOD: Intubated pediatric patients presenting directly from the scene to our level 1 trauma center, between 2006 and 2014, were included in our study...
January 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28005912/benchmarking-prehospital-and-emergency-department-care-for-argentine-children-with-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#16
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Gustavo J Petroni, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Anthony Fabio, Michael J Bell
OBJECTIVE: There is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0)...
2016: PloS One
https://www.readbyqxmd.com/read/27938877/coagulopathy-and-transfusion-requirements-in-war-related-penetrating-traumatic-brain-injury-a-single-centre-study-in-a-french-role-3-medical-treatment-facility-in-afghanistan
#17
J Bordes, C Joubert, P Esnault, A Montcriol, C Nguyen, E Meaudre, R Dulou, A Dagain
INTRODUCTION: Traumatic brain injury associated coagulopathy is frequent, either in isolated traumatic brain injury in civilian practice and in combat traumatic brain injury. In war zone, it is a matter of concern because head and neck are the second most frequent site of wartime casualty burden. Data focusing on transfusion requirements in patients with war related TBI coagulopathy are limited. MATERIALS AND METHODS: A descriptive analysis was conducted of 77 penetrating traumatic brain injuries referred to a French role 3 medical treatment facility in Kabul, Afghanistan, deployed on the Kabul International Airport (KaIA), over a 30 months period...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/27926759/mortality-and-prehospital-blood-pressure-in-patients-with-major-traumatic-brain-injury-implications-for-the-hypotension-threshold
#18
Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Duane Sherrill, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, Chad Viscusi, Terry Mullins, P David Adelson
Importance: Current prehospital traumatic brain injury guidelines use a systolic blood pressure threshold of less than 90 mm Hg for treating hypotension for individuals 10 years and older based on studies showing higher mortality when blood pressure drops below this level. However, the guidelines also acknowledge the weakness of the supporting evidence. Objective: To evaluate whether any statistically supportable threshold between systolic pressure and mortality emerges from the data a priori, without assuming that a cut point exists...
April 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27903839/the-effect-of-brain-tomography-findings-on-mortality-in-sniper-shot-head-injuries
#19
Çağdaş Can, M Bolatkale, A Sarıhan, Y Savran, A Ç Acara, M Bulut
OBJECTIVES: Penetrating gunshot head injuries have a poor prognosis and require prompt care. Brain CT is a routine component of the standard evaluation of head wounds and suspected brain injury. We aimed to investigate the effect of brain CT findings on mortality in gunshot head injury patients who were admitted to our emergency department (ED) from the Syrian Civil War. METHODS: The study group comprised patients who were admitted to the ED with gunshot brain injury...
November 30, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#20
Yea-Chyi Lin, York Tien Lee, Jasmine Xun Yi Feng, Li Wei Chiang, Shireen Anne Nah
OBJECTIVES: We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome. METHODS: We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8...
November 29, 2016: Pediatric Emergency Care
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