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Trauma best practice

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https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#1
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
#2
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...
February 16, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28181214/aspirin-single-dose-for-perineal-pain-in-the-early-postpartum-period
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28135807/special-population-child-and-adolescent-psychotherapy
#6
George Halasz
OBJECTIVES: First, to outline the paradigm change of the past 20 years that has transformed the theory and practice of child and adolescent psychodynamic psychotherapy; second, to update aspects of the current Practice Parameters for Psychodynamic Psychotherapy with Children to align with the paradigm change driven by the principles of regulation theory, relational trauma and repair, and the critical need for clinicians' self-care in trauma informed psychotherapy. CONCLUSION: The emerging neuroscience-driven paradigm of psychotherapy poses challenges for the child and adolescent psychotherapist: to embrace the new conceptual reference points as organising principles leads to an urgent need to rethink traditional diagnostic formulations and time-honoured techniques for intervention...
January 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#7
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28096009/perceptions-of-dying-well-and-distressing-death-by-acute-care-nurses
#8
Christine A Becker, Greg Wright, Kristen Schmit
AIM: This study aims to identify perceptions of nurses practicing in four adult inpatient units regarding their actions to provide quality end of life care for dying patients, their definitions of dying well, and their symptoms of distress and actions they took for relief. BACKGROUND: Nurses caring for patients who are dying want them to have the best death possible; however, many nurses are not prepared for every death which may occur. METHODS: Qualitative questionnaire data were collected from 49 nurses on four adult inpatient nursing units to analyze nurse perceptions of distressing death and dying well...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28018761/improving-donor-conversion-rates-at-a-level-one-trauma-center-impact-of-best-practice-guidelines
#9
Rodrigo F Alban, Bobby L Gibbons, Vanessa L Bershad
BACKGROUND: Organ availability is a consistently limiting factor in transplant surgery. A primary driver of this limitation is donor conversion rate, which is defined as the percentage of eligible donors for whom procurement is actually performed. An alternative way to increase organ availability is through improved utilization of organs from donors after cardiac death (DCD). Recently, a concerted, multidisciplinary effort has been made within our system to improve conversion rates and DCD utilization, thus increasing organ availability...
November 22, 2016: Curēus
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
#10
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/27938650/-the-search-for-balance-in-the-therapeutic-decision-making-process-the-example-of-class-ii-malocclusion-treatments-in-children-and-adolescents
#11
Philippe Amat
INTRODUCTION: Therapeutic decision-making is essentially the key to our clinical practice, and its most medical feature. The history of orthodontics is studded with multiple intellectual debates and stand-offs between conflicting treatment philosophies, the authors of which all aspire to a balance guaranteeing optimal treatment for their patients. Among the wealth of published data, which items should we select to ensure balanced treatment decisions in our daily practice and how can we remain serene in the face of the uncertainty and loneliness engendered by therapeutic decision-making process? MATERIALS AND METHODS: Evidence-based orthodontics is an aid to clinical decisionmaking...
December 2016: L' Orthodontie Française
https://www.readbyqxmd.com/read/27916016/penetrating-neck-trauma-and-the-need-for-surgical-exploration-six-year-experience-within-a-regional-trauma-centre
#12
A V Kasbekar, E J Combellack, S G Derbyshire, A C Swift
BACKGROUND: There has been a shift towards conservative management of penetrating neck trauma in selected patients. METHODS: A retrospective case note review of the management of penetrating neck trauma (2007-2013) was undertaken at our large teaching hospital and compared against best-evidenced practice. RESULTS: Sixty-three patients were admitted over six years. The incidence of penetrating neck trauma is reducing, contrary to our belief...
January 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#13
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909067/concept-and-evaluation-of-the-german-war-surgery-course-einsatzchirurgie-kurs-der-bundeswehr
#14
David A Back, K Waldmann, T Hauer, N Huschitt, M W Bowyer, U Wesemann, A Lieber, C Willy
INTRODUCTION: Military surgeons must be prepared to care for severe and complex life-threatening injuries rarely seen in the civilian setting. Typical civilian training and practice do not provide adequate exposure to the broad set of surgical skills required. The German Bundeswehr Medical Service has developed and refined the War Surgery Course (WSC) to meet this training gap. This article describes the recent experience with this readiness curriculum. METHODS: Run annually since 1998, WSC consists nowadays of 5 days with 20 theoretical modules...
December 1, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#15
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27891037/revisiting-cruciate-paralysis-a-case-report-and-systematic-review
#16
Benjamin Hopkins, Ryan Khanna, Nader S Dahdaleh
OBJECTIVE: Cruciate paralysis is a rare, poorly understood condition of the upper craniovertebral junction that allows for selective paralysis of the upper extremities while sparing the lower extremities. Reported cases are few and best treatment practices remain up for debate. The purpose of this study was to conduct a systemic literature review in an attempt to identify prognostic predictors and outcome trends associated with cases previously reported in the literature. MATERIALS AND METHODS: We conducted a systematic literature review for all cases using the term "Cruciate Paralysis," reviewing a total of 37 reported cases...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27875057/national-athletic-trainers-association-position-statement-preventing-and-managing-sport-related-dental-and-oral-injuries
#17
Trenton E Gould, Scott G Piland, Shane V Caswell, Dennis Ranalli, Stephen Mills, Michael S Ferrara, Ron Courson
OBJECTIVE: To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. BACKGROUND: Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports...
October 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/27870669/operating-room-efficiency-benefits-of-an-orthopaedic-traumatologist-at-a-level-ii-trauma-center
#18
Peter L Althausen, Justin R Kauk, Steven Shannon, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. DESIGN: Retrospective review...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27868431/tracking-changes-in-glenohumeral-joint-position-in-acute-post-stroke-hemiparetic-patients-an-observational-study
#19
Praline Choolun, Suzanne Kuys, Leanne Bisset
AIMS: The majority of people develop hemiparetic shoulder inferior subluxation following stroke, but the timing of onset is unknown. This study aimed to assess changes in glenohumeral joint centre of rotation (GHJC) during the first six weeks following stroke. METHODS: Thirty patients with confirmed diagnosis of stroke (age 65 ± 19 years, 60% female, 40% right side affected) were assessed within 14 days of admission and at six weeks along with matched controls...
November 20, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27825662/talk-the-talk-implementing-a-communication-curriculum-for-surgical-residents
#20
Anna B Newcomb, Amber W Trickey, Melissa Porrey, Jeffrey Wright, Franco Piscitani, Paula Graling, Jonathan Dort
OBJECTIVES: The Accreditation Council for Graduate Medical Education milestones provide a framework of specific interpersonal and communication skills that surgical trainees should aim to master. However, training and assessment of resident nontechnical skills remains challenging. We aimed to develop and implement a curriculum incorporating interactive learning principles such as group discussion and simulation-based scenarios to formalize instruction in patient-centered communication skills, and to identify best practices when building such a program...
November 4, 2016: Journal of Surgical Education
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