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https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#1
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29020951/paramedic-literature-search-filters-optimised-for-clinicians-and-academics
#2
Alexander Olaussen, William Semple, Alaa Oteir, Paula Todd, Brett Williams
BACKGROUND: Search filters aid clinicians and academics to accurately locate literature. Despite this, there is no search filter or Medical Subject Headings (MeSH) term pertaining to paramedics. Therefore, the aim of this study was to create two filters to meet to different needs of paramedic clinicians and academics. METHODS: We created a gold standard from a reference set, which we measured against single terms and search filters. The words and phrases used stemmed from selective exclusion of terms from the previously published Prehospital Search Filter 2...
October 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28975883/prehospital-interventions-before-and-after-implementation-of-a-physician-staffed-helicopter
#3
Asger Sonne, Sandra Wulffeld, Jacob Steinmetz, Lars S Rasmussen, Rasmus Hesselfeldt
INTRODUCTION: Implementation of a physician-staffed helicopter emergency medical service (HEMS) in eastern Denmark was associated with increased survival for severely injured patients. This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion of patients who received those interventions before and after the HEMS implementation. METHODS: A post-hoc analysis of a prospective before-after study. We included trauma patients with Injury Severity Scores above three who had been admitted to seven emergency departments or one level 1 trauma centre in the course of a five-month period before and a 12-month period after the HEMS implementation...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28962953/arachnoid-cyst-associated-chronic-subdural-hematoma-report-of-14-cases-and-a-systematic-literature-review
#4
Xuanxuan Wu, Guichen Li, Jinchuan Zhao, Xiaobo Zhu, Yang Zhang, Kun Hou
BACKGROUND: Arachnoid cyst (AC) associated chronic subdural hematoma (CSDH) differs a lot from its counterparts without AC in epidemiological, demographic, and clinical characteristics, management, and prognosis. To further illustrate the epidemiological, demographic, and clinical characteristics, diagnosis, treatment, and prognosis of AC associated CSDH. METHODS: A retrospective study of the medical records at the neurosurgical departments of two institutions was performed combined with a systematic PubMed search of the published studies written in English and Chinese...
September 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28910462/prehospital-cricothyrotomy-kits-used-in-combat
#5
Steven G Schauer, Michael D April, Cord W Cunningham, Adrianna N Long, Robert Carter
BACKGROUND: Surgical cricothyrotomy remains the only definitive airway management modality for the tactical setting recommended by Tactical Combat Casualty Care guidelines. Some units have fielded commercial cricothyrotomy kits to assist Combat Medics with surgical cricothyrotomy. To our knowledge, no previous publications report data on the use of these kits in combat settings. This series reports the the use of two kits in four patients in the prehospital combat setting. METHODS: Using the Department of Defense Trauma Registry and the Prehospital Trauma Registry, we identified four cases of patients who underwent prehospital cricothyrotomy with the use of commercial kits...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28886790/hemodynamic-deterioration-in-lateral-compression-pelvic-fracture%C3%A2-after-prehospital-pelvic-circumferential-compression%C3%A2-device%C3%A2-application
#6
Alan A Garner, Jeremy Hsu, Anne McShane, Adam Sroor
Increased fracture displacement has previously been described with the application of pelvic circumferential compression devices (PCCDs) in patients with lateral compression-type pelvic fracture. We describe the first reported case of hemodynamic deterioration temporally associated with the prehospital application of a PCCD in a patient with a complex acetabular fracture with medial displacement of the femoral head. Active hemorrhage from a site adjacent to the acetabular fracture was subsequently demonstrated on angiography...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28880984/association-of-a-perioperative-education-program-with-unplanned-readmission-following-total-laryngectomy
#7
Evan M Graboyes, Dorina Kallogjeri, Jan Zerega, Sara Kukuljan, Linda Neal, Kelsey M Rosenquist, Brian Nussenbaum
Importance: Patients undergoing total laryngectomy (TL) are at high risk for 30-day hospital readmission. Strategies to decrease the readmission rate remain unknown. Objectives: To assess the association of a comprehensive perioperative TL education program with unplanned readmissions; to determine the program's association with the rate of readmissions for stomal or tracheoesophageal puncture (TEP) complications and patient and caregiver knowledge of and preparedness for TL...
September 7, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28835284/maintaining-immobilisation-devices-on-trauma-patients-during-ct-a-feasibility-study
#8
Pål Johan Stokkeland, Erlend Andersen, Maria Myhre Bjørndal, Arne Morten Mikalsen, Sindre Aslaksen, Per Kristian Hyldmo
BACKGROUND: To reduce the possibility of secondary deterioration of spinal injuries, it is desirable to maintain the spinal immobilisation that is applied in the prehospital setting throughout computed tomography (CT) scanning. A previous study found that metallic components within the inflation valve of the vacuum mattresses caused CT artefacts. The aim of our study was to investigate the effect of vacuum mattresses with plastic valves on CT artefacts, the radiation dose, and noise compared to a trauma transfer board and the spine boards currently used in our trauma system...
August 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28752349/citicoline-in-severe-traumatic-brain-injury-indications-for-improved-outcome-a%C3%A2-retrospective-matched-pair-analysis-from-14%C3%A2-austrian-trauma-centers
#9
Helmut Trimmel, Marek Majdan, Andrea Wodak, Guenther Herzer, Daniel Csomor, Alexandra Brazinova
Goal-oriented management of traumatic brain injury (TBI) can save the lives and/or improve the long-term outcome of millions of affected patients worldwide. Additionally, enhancing quality of life will save enormous socio-economic costs; however, promising TBI treatment strategies with neuroprotective agents, such as citicoline (CDP-choline), lacked evidence or produced contradictory results in clinical trials. During a prehospital TBI project to optimize early TBI care within 14 Austrian trauma centers, data on 778 TBI patients were prospectively collected...
July 27, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28671060/retrospective-analysis-of-mosh-pit-related-injuries
#10
Andrew M Milsten, Joseph Tennyson, Stacy Weisberg
OBJECTIVES: Moshing is a violent form of dancing found world-wide at rock concerts, festivals, and electronic dance music events. It involves crowd surfing, shoving, and moving in a circular rotation. Moshing is a source of increased morbidity and mortality. The goal of this study was to report epidemiologic information on patient presentation rate (PPR), transport to hospital rate (TTHR), and injury patterns from patients who participated in mosh-pits. Materials and Methods Subjects were patrons from mosh-pits seeking medical care at a single venue...
July 3, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#11
MULTICENTER STUDY
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28596923/unilateral-dilated-pupil-and-spontaneous-cardiac-arrest-with-successful-bystander-resuscitation
#12
James M Hancox, Julian Spiers, Nicholas Crombie, David N Naumann
A 75-year-old man collapsed on a golf course and received cardiopulmonary resuscitation from a bystander, including the use of a public automated external defibrillator (AED). The AED was discharged once, with return of spontaneous circulation. An air ambulance crew found the patient haemodynamically stable, with no acute abnormalities on a 12-lead ECG. He had reduced consciousness and a dilated left pupil. On contacting the patient's wife by telephone, she said that he had fallen and hit his head earlier that day...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28538641/prehospital-plasma-resuscitation-associated-with-improved-neurologic-outcomes-after-traumatic-brain-injury
#13
Matthew C Hernandez, Cornelius A Thiels, Johnathon M Aho, Elizabeth B Habermann, Martin D Zielinski, James A Stubbs, Donald H Jenkins, Scott P Zietlow
BACKGROUND: Trauma-related hypotension and coagulopathy worsen secondary brain injury in patients with traumatic brain injuries (TBIs). Early damage control resuscitation with blood products may mitigate hypotension and coagulopathy. Preliminary data suggest resuscitation with plasma in large animals improves neurologic function after TBI; however, data in humans are lacking. METHODS: We retrospectively identified all patients with multiple injuries age >15 years with head injuries undergoing prehospital resuscitation with blood products at a single Level I trauma center from January 2002 to December 2013...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28493893/comparison-of-influencing-factors-on-outcomes-of-single-and-multiple-road-traffic-injuries-a-regional-study-in-shanghai-china-2011-2014
#14
COMPARATIVE STUDY
Wenya Yu, Haiping Chen, Yipeng Lv, Qiangyu Deng, Peng Kang, Lulu Zhang
INTRODUCTION: To identify key intervention factors and reduce road traffic injury (RTI)-associated mortality, this study compared outcomes and influencing factors of single and multiple road traffic injuries (RTIs) in Shanghai. METHODS: Based on the design of National Trauma Data Bank, this study collected demographic, injury, and outcome data from RTI patients treated at the four largest trauma centers in Shanghai from January 2011 to January 2015. Data were analyzed with descriptive statistics, univariate analysis, and hierarchical logistic regression analysis...
2017: PloS One
https://www.readbyqxmd.com/read/28481669/prehospital-fluid-administration-in-trauma-patients-a-survey-of-state-protocols
#15
Sahil Dadoo, Joseph M Grover, Lukas G Keil, Kay S Hwang, Jane H Brice, Timothy F Platts-Mills
OBJECTIVE: The optimal resuscitation approach during the initial treatment of hypotensive trauma patients remains unknown, but some clinical trials have observed a survival benefit from restricting fluid administration prior to definitive hemorrhage control. We sought to characterize emergency medical services (EMS) protocols for the administration of intravenous fluids in this setting. METHODS: Publicly accessible statewide EMS protocols for the treatment of hypotensive trauma patients were included and characterized by: 1) goal of fluid administration, 2) dosing strategy, 3) maximum dose, 4) type of fluid, and 5) specific protocols for head trauma, if present...
September 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28463098/when-is-a-cardiac-arrest-non-cardiac
#16
Ryan M Carter, David C Cone
Introduction While the overall survival rate for out-of-hospital cardiac arrest (OHCA) is low, ranging from 5%-10%, several characteristics have been shown to decrease mortality, such as presence of bystander cardiopulmonary resuscitation (CPR), witnessed vs unwitnessed events, and favorable initial rhythm (VF/VT). More recently, studies have shown that modified CPR algorithms, such as chest-compression only or cardio-cerebral resuscitation, can further increase survival rates in OHCA. Most of these studies have included only OHCA patients with "presumed cardiac etiology," on the assumption that airway management is of lesser impact than chest compressions in these patients...
October 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28463097/road-traffic-injury-in-lagos-nigeria-assessing-prehospital-care
#17
Nasiru A Ibrahim, Abdul Wahab O Ajani, Ibrahim A Mustafa, Rufai A Balogun, Mobolaji A Oludara, Olufemi E Idowu, Babatunde A Solagberu
Introduction Injuries are the third most important cause of overall deaths globally with one-quarter resulting from road traffic crashes. Majority of these deaths occur before arrival in the hospital and can be reduced with prompt and efficient prehospital care. The aim of this study was to highlight the burden of road traffic injury (RTI) in Lagos, Nigeria and assess the effectiveness of prehospital care, especially the role of Lagos State Ambulance Service (LASAMBUS) in providing initial care and transportation of the injured to the hospital...
August 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28455815/perfusion-abnormalities-are-frequently-detected-by-early-ct-perfusion-and-predict-unfavourable-outcome-following-severe-traumatic-brain-injury
#18
Cino Bendinelli, Shannon Cooper, Tiffany Evans, Andrew Bivard, Dianne Pacey, Mark Parson, Zsolt J Balogh
BACKGROUND: In patients with severe traumatic brain injury (TBI), early CT perfusion (CTP) provides additional information beyond the non-contrast CT (NCCT) and may alter clinical management. We hypothesized that this information may prognosticate functional outcome. METHODS: Five-year prospective observational study was performed in a level-1 trauma centre on consecutive severe TBI patients. CTP (obtained in conjunction with first routine NCCT) was interpreted as: abnormal, area of altered perfusion more extensive than on NCCT, and the presence of ischaemia...
April 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28452887/multicenter-retrospective-study-of-non-compressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#19
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
OBJECTIVE: Rational development of technology for rapid control of non-compressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) versus open (OPEN) management. METHODS: Retrospective study of adult trauma patients with NCTH admitted to 4 urban level 1 trauma centers in the Houston and San Antonio metropolitan areas in 2008-2012...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28440675/near-infrared-spectroscopy-nirs-to-detect-traumatic-intracranial-haematoma-a-systematic-review-and-meta-analysis
#20
Robert J Brogan, Vassilios Kontojannis, Bhavin Garara, Hani J Marcus, Mark H Wilson
OBJECTIVES AND METHODS: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine...
April 25, 2017: Brain Injury: [BI]
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