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Trauma best practice

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https://www.readbyqxmd.com/read/28411934/tactical-combat-casualty-care-and-wilderness-medicine-advancing-trauma-care-in-austere-environments
#1
REVIEW
Frank K Butler, Brad Bennett, Colonel Ian Wedmore
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. Military units that have trained all of their unit members in TCCC have now documented the lowest incidence of preventable deaths in the history of modern warfare and TCCC is now the standard for battlefield trauma care in the US Military. TCCC and wilderness medicine share the goal of optimizing care for patients with trauma in austere environments that impose significant challenges in both equipment and evacuation capability...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28410572/incidence-of-infection-following-internal-fixation-of-open-and-closed-tibia-fractures-in-india-infiniti-a-multi-centre-observational-cohort-study
#2
Prakash Doshi, Hitesh Gopalan, Sheila Sprague, Chetan Pradhan, Sunil Kulkarni, Mohit Bhandari
BACKGROUND: Trauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India. METHODS: We conducted a multi-center, prospective cohort study...
April 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28403314/implementation-of-care-practices-to-prevent-and-repair-perineal-trauma-in-childbirth
#3
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/28372459/a-clinical-update-on-post-traumatic-stress-disorder-in-burn-injury-survivors
#4
Loyola McLean, Runsen Chen, Julia Kwiet, Jeffrey Streimer, John Vandervord, Rachel Kornhaber
OBJECTIVES: Burn injuries are complex traumatic events carrying high risks of acute physical and psychosocial morbidity. With greater survival, clinical and research attention has turned to psychosocial recovery outcomes and risk factors. It is timely to summarise current issues in post-traumatic disorders after burn injury for mental health and integrative care clinicians. Post-traumatic stress disorder (PTSD) is a common outcome of severe burn injury. There are difficulties in delivering current best practice treatments to many survivors especially those in rural and remote areas and those with comorbidities...
March 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#5
Laura C Lamb, Stephanie C Montgomery, Brian Wong Won, Siobhan Harder, Jeffrey Meter, James M Feeney
BACKGROUND: Fragility fractures have become a worldwide epidemic associated with significant morbidity and mortality. As the world population ages, the number of patients that experience these fractures is also expected to rise. A multidisciplinary team was assembled that was coordinated by the Acute Inpatient Medical Service and included orthopedic surgeons, geriatricians, anesthesiologists, cardiologists, nurses, trauma surgeons, emergency medicine physicians, physiatrists, and physical therapists...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28333837/leadership-lessons-learned-in-tactical-combat-casualty-care
#6
Frank K Butler
The US Military has achieved remarkable success in improving survival for our nation's combat wounded throughout the 14 years of conflict in Iraq and Afghanistan. For the prehospital phase of care, where most combat fatalities occur, these advances have been embodied in Tactical Combat Casualty Care (TCCC.) TCCC is a set of evidence-based, best-practice, prehospital trauma care guidelines that are customized for use on the battlefield. The TCCC Guidelines have been updated on an ongoing basis over the last 15 years through the work of the Committee on TCCC and the TCCC Working Group...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326161/the-underlying-dimensions-of-dsm-5-ptsd-symptoms-and-their-relations-with-anxiety-and-depression-in-a-sample-of-adolescents-exposed-to-an-explosion-accident
#7
Haibo Yang, Li Wang, Chengqi Cao, Xing Cao, Ruojiao Fang, Jianxin Zhang, Jon D Elhai
Background: A large number of empirical studies pertaining to the latent dimensions of DSM-5 PTSD symptoms have accumulated. However, there is still a lack of studies specific to youths. Objective: This study sought to investigate the latent dimensions of DSM-5 PTSD symptoms in a sample of adolescents exposed to an explosion accident. Method: Participants were 836 students (407 females and 428 males). Self-reported measures including the PTSD Checklist for DSM-5 and the anxiety and depression subscales of the 21-item Depression Anxiety Stress Scale were administered to participants...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#8
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290929/advanced-trauma-life-support-time-standards
#9
Andrew B Hall, Felix S Boecker, Joseph M Shipp, Dennis Hanseman
INTRODUCTION: Trauma readiness is critical to military medicine. Without medical centers that include persistent volumes of trauma, simulation has become the means to maintain and practice those skills. To create those simulations, standards for both design and metrics to evaluate practitioners are required. MATERIALS AND METHODS: Forty-four traumas were monitored and times to completion of the various steps of Advanced Trauma Life Support were recorded and tabulated...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#10
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28284483/tactical-combat-casualty-care-beginnings
#11
REVIEW
Frank K Butler
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. The origins of TCCC were nontraditional. The TCCC program began as a Naval Special Warfare biomedical research effort launched after the realization that extremity hemorrhage, a leading cause of preventable death on the battlefield, was not being treated with a readily available and highly effective intervention: the tourniquet. This insight prompted a systematic reevaluation of all aspects of battlefield trauma care that was conducted from 1993 to 1996 as a joint effort by special operations medical personnel and the Uniformed Services University of the Health Sciences...
March 8, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28272352/trauma-and-stem-cells-biology-and-potential-therapeutic-implications
#12
REVIEW
Kabilan Thurairajah, Matthew L Broadhead, Zsolt J Balogh
Trauma may cause irreversible tissue damage and loss of function despite current best practice. Healing is dependent both on the nature of the injury and the intrinsic biological capacity of those tissues for healing. Preclinical research has highlighted stem cell therapy as a potential avenue for improving outcomes for injuries with poor healing capacity. Additionally, trauma activates the immune system and alters stem cell behaviour. This paper reviews the current literature on stem cells and its relevance to trauma care...
March 7, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28267694/the-association-between-medicare-eligibility-and-gains-in-access-to-rehabilitative-care-a-national-regression-discontinuity-assessment-of-patients-ages-64-versus-65-years
#13
Cheryl K Zogg, John W Scott, David Metcalfe, Anupamaa J Seshadri, Thomas C Tsai, W Austin Davis, John A Rose, Olubode A Olufajo, Syed Nabeel Zafar, Ali Salim, Adil H Haider
OBJECTIVES: The aims of this study were to assess for changes in uninsured rates among trauma patients at age 64 versus 65 years and whether there are associated changes in post-discharge rehabilitation; determine whether changes are driven by rehabilitation provided at home, skilled nursing facilities (SNFs), or acute inpatient facilities; and determine whether changes vary among stratified subgroups of trauma-related "best-practice" factors. SUMMARY BACKGROUND DATA: Rehabilitation is an important component of high-quality trauma systems with access heavily influenced by insurance status...
April 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28243444/improving-consent-form-documentation-and-introduction-of-procedure-specific-labels-in-a-district-general-hospital
#14
Stefan Bajada, Samuel Dwamena, Zabihullah Abdul, Rhodri Williams, Owain Ennis
Informed consent is an important aspect in patient care. Failings in this area may result in patient dissatisfaction or litigation. The aim of this project was to assess our practice in consenting and institute changes to maintain best practice. A consecutive series of 140 patients undergoing elective and trauma procedures were randomly identified over a nine-month period. The consent forms were reviewed and the following information collected: patient/ consenter details, procedure, legibility, if copy was offered/ given to patient and adequacy of procedure-specific complications listed (scored 0-3)...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28225743/damage-control-resuscitation-in-patients-with-severe-traumatic-hemorrhage-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#15
Jeremy W Cannon, Mansoor A Khan, Ali S Raja, Mitchell J Cohen, John J Como, Bryan A Cotton, Joseph J Dubose, Erin E Fox, Kenji Inaba, Carlos J Rodriguez, John B Holcomb, Juan C Duchesne
BACKGROUND: The resuscitation of severely injured bleeding patients has evolved into a multi-modal strategy termed damage control resuscitation (DCR). This guideline evaluates several aspects of DCR including the role of massive transfusion (MT) protocols, the optimal target ratio of plasma (PLAS) and platelets (PLT) to red blood cells (RBC) during DCR, and the role of recombinant activated factor VII (rVIIa) and tranexamic acid (TXA). METHODS: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a subcommittee of the Practice Management Guidelines (PMG) Section of EAST conducted a systematic review using MEDLINE and EMBASE...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#16
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28210806/the-current-state-of-orthopaedic-residency-in-18-european-countries
#17
Rami Madanat, Tatu J Mäkinen, Daniel Ryan, Gazi Huri, Nikolaos Paschos, Joao Vide
PURPOSE: The aim of this study was to compare differences in current orthopaedic and trauma training programs across Europe. METHODS: A questionnaire was sent to the FORTE (Federation of Orthopaedic Trainees in Europe) representatives of 25 different European countries, of which 18 responded. The questionnaire included demographic information and information concerning the structure of the training programs, including duration, selection, and mandatory training requirements...
April 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28181214/aspirin-single-dose-for-perineal-pain-in-the-early-postpartum-period
#18
REVIEW
Sujana Molakatalla, Emily Shepherd, Rosalie M Grivell
BACKGROUND: Perineal trauma (due to spontaneous tears, surgical incision (episiotomy) or in association with operative vaginal birth) is common after vaginal birth, and is often associated with postpartum perineal pain. Birth over an intact perineum may also lead to perineal pain. There are adverse health consequences associated with perineal pain for the women and their babies in the short- and long-term, and the pain may interfere with newborn care and the establishment of breastfeeding...
February 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28158933/interventions-for-treating-simple-bone-cysts-in-the-long-bones-of-children
#19
REVIEW
Jia-Guo Zhao, Jia Wang, Wan-Jie Huang, Peng Zhang, Ning Ding, Jian Shang
BACKGROUND: Simple bone cysts, also known as a unicameral bone cysts or solitary bone cysts, are the most common type of benign bone lesion in growing children. Cysts may lead to repeated pathological fracture (fracture that occurs in an area of bone weakened by a disease process). Occasionally, these fractures may result in symptomatic malunion. The main goals of treatment are to decrease the risk of pathological fracture, enhance cyst healing and resolve pain. Despite the numerous treatment methods that have been used for simple bone cysts in long bones of children, there is no consensus on the best procedure...
February 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28138228/fracture-liaison-services-improving-outcomes-for-patients-with-osteoporosis
#20
REVIEW
Samuel Walters, Tanvir Khan, Terence Ong, Opinder Sahota
Fragility fractures are sentinels of osteoporosis, and as such all patients with low-trauma fractures should be considered for further investigation for osteoporosis and, if confirmed, started on osteoporosis medication. Fracture liaison services (FLSs) with varying models of care are in place to take responsibility for this investigative and treatment process. This review aims to describe outcomes for patients with osteoporotic fragility fractures as part of FLSs. The most intensive service that includes identification, assessment and treatment of patients appears to deliver the best outcomes...
2017: Clinical Interventions in Aging
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