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Trauma best practice

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https://www.readbyqxmd.com/read/28816873/the-need-of-validated-disease-specific-outcome-instruments-for-spine-trauma
#1
Cumhur Oner, Said Sadiqi, Anne Mechteld Lehr, Gregory D Schroeder, Alexander R Vaccaro
This article focuses on patient-reported and clinician-reported outcome measures in spine trauma care. The measurement of the quality of care and functional and health-related quality of life outcomes of spine trauma patients has become increasingly important. However, no outcome instrument is specifically designed, validated, or universally adapted for this specific patient population. Issues specific to spinal trauma patients may not be adequately addressed by the instruments that are currently used in the literature and the daily clinical practice...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28808951/what-is-the-diagnostic-accuracy-of-the-duck-walk-test-in-detecting-meniscal-tears
#2
A Van der Post, J C A Noorduyn, V A B Scholtes, E L A R Mutsaerts
BACKGROUND: Clinical weightbearing provocation tests, like the duck walk test, may be of value in diagnosing or screening for medial meniscal tears. However, evidence of the diagnostic accuracy of the duck walk test is lacking. QUESTIONS/PURPOSES: (1) To determine the sensitivity and specificity of the duck walk test in diagnosing medial meniscal tears. (2) To determine whether tear location, tear cause (traumatic versus degenerative), and ACL insufficiency were associated with differences in the sensitivity and specificity of the test...
August 14, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28792281/pan-asian-trauma-outcomes-study-patos-rationale-and-methodology-of-an-international-and-multicenter-trauma-registry
#3
So Yeon Kong, Sang Do Shin, Hideharu Tanaka, Akio Kimura, Kyoung Jun Song, Goh E Shaun, Wen-Chu Chiang, Kentaro Kajino, Sabariah Faizah Jamaluddin, Dae Han Wi, Ju Ok Park, Sung Woo Moon, Young Sun Ro, David C Cone, James F Holmes
BACKGROUND: Trauma is a major health burden and a time-dependent critical emergency condition among developing and developed countries. In Asia, trauma has become a rapidly expanding epidemic and has spread out to many underdeveloped and developing countries through rapid urbanization and industrialization. Most casualties of severe trauma, which results in significant mortality and disability are assessed and transported by prehospital providers including physicians, professional providers, and volunteer providers...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28767491/medical-student-perceptions-of-global-surgery-at-an-academic-institution-identifying-gaps-in-global-health-education
#4
Ambar Mehta, Tim Xu, Matthew Murray, Kathleen M Casey
PURPOSE: Robust global health demands access to safe, affordable, timely surgical care for all. The long-term success of global surgery requires medical students to understand and engage with this emerging field. The authors characterized medical students' perceptions of surgical care relative to other fields within global health. METHOD: An optional, anonymous survey was given to all Johns Hopkins medical students from February to March 2016 to assess perceptions of surgical care and its role in global health...
August 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28765479/early-intracardiac-thrombus-and-pulmonary-embolus-after-trauma
#5
Neel Desai, Julia Heid, Andrew Leitch
Here, we present the case of a patient with the findings of an early intracardiac thrombus and a pulmonary embolus after major trauma. A large clot was identified extending from the inferior vena cava into the right atrium and ventricle in the setting of preserved right ventricular function. Post-traumatic intracardiac thrombus is extremely rare and no comparable cases have previously been described in the absence of a congenital heart defect and obvious myocardial injury. Best practice afterpost-traumatic intracardiac thrombus is not well established but we found that early inferior vena cava filter placement and treatment with therapeutic coagulation resulted in clinical improvement, resolution of the thrombus and no further emboli...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28762032/-surgical-positioning-techniques-in-urology-tips-and-tricks
#6
A Miernik, K-D Sievert, T R W Herrmann, C Netsch, J J Rassweiler, H Leyh, J Westphal, A Bachmann, A Häcker, R Homberg, J-T Klein, P J Olbert, D S Schoeb, A J Gross
Correct positioning of patients during preoperative preparations is essential for success of the intervention to avoid any positioning trauma and to provide the best access to the targeted structures. The appropriate positioning (and optimal performance) means that complications are avoided and also makes an essential contribution to the smooth course of the surgical intervention. A correct position is essential particularly in urology because the organs assigned to the discipline of urology are anatomically mostly difficult to reach...
July 31, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28740974/wound-closure-and-wound-healing-suture-techniques-in-contemporary-periodontal-and-implant-surgery-interactions-requirements-and-practical-considerations
#7
Otto Zuhr, Dodji Lukas Akakpo, Markus Hürzeler
In contemporary reconstructive periodontal and implant surgery, attaining uncomplicated wound healing in the early postoperative healing phase is the key to achieving a successful treatment outcome and is of central interest, from the clinical as well as the scientific perspective. The realization of primary wound healing is the central challenge in most cases. Two of the evidence-based factors that affect postoperative wound healing can be influenced by the surgeon: the blood supply to the surgical site and postoperative wound stability...
July 20, 2017: Quintessence International
https://www.readbyqxmd.com/read/28736840/issop-position-statement-on-migrant-child-health
#8
REVIEW
(no author information available yet)
Greater numbers of children are on the move than ever before. In 2015, the number of forcibly displaced people across the globe reached 65.3 million. Of the more than 1 million migrants, asylum seekers, and refugees who arrived in Europe in 2015, nearly one third were children, and 90,000 of these children were unaccompanied. Child migrants are among the most vulnerable, even after arriving at their destination. The health of migrant children is related to their health status before their journey, the conditions during their journey and at their destination, and the physical and mental health of their caregivers...
July 23, 2017: Child: Care, Health and Development
https://www.readbyqxmd.com/read/28719647/morbidity-outcomes-and-cost-benefit-analysis-of-wildlife-rehabilitation-in-catalonia-spain
#9
Rafael Angel Molina-López, Santi Mañosa, Alex Torres-Riera, Manel Pomarol, Laila Darwich
BACKGROUND: There are few studies of careful examination of wildlife casualties in Wildlife Rehabilitation Centers. These studies are essential for detecting menaces to wild species and providing objective criteria about cost-benefit of treatments in those centers. The release rate is considered the main outcome indicator, but other parameters such as length of stay at the center and a cost-benefit index expressed as number of released animals per euro and day, could be used as reliable estimators of the rehabilitation costs...
2017: PloS One
https://www.readbyqxmd.com/read/28718614/emergency-management-of-renal-and-genitourinary-trauma-best-practices-update
#10
Whitney K. Bryant, Sanjay Shewakramani
In up to 10% of patients who experience abdominal trauma, renal and urogenital systems will be involved. In polytrauma patients with other potentially life-threatening injuries, renal and genitourinary trauma may be overlooked initially, but a delayed or missed diagnosis of these injuries may result in preventable complications. This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy...
August 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#11
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28701204/criteria-and-models-for-the-distribution-of-casualties-in-trauma-related-mass-casualty-incidents-a-systematic-literature-review-protocol
#12
Ali Ardalan, Mohammad Reza Khajehaminian, Sayed Mohsen Hosseini Boroujeni, Amir Nejati, Abbasali Keshtkar, Abbas Rahimi Foroushani, Omid Mahdi Ebadati E
BACKGROUND: One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents...
July 12, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28693654/cut-and-rip-and-cut-alone-techniques-versus-usual-practice-in-the-removal-of-trauma-patient-clothing
#13
Aaron K Sibley, Trevor N Jain, Brent Nicholson, Paul Atkinson
Introduction Rapid exposure of a trauma patient is an essential component of the primary survey. No gold standard exists regarding the best technique to remove clothing from a trauma patient. The purpose of this study is to compare two techniques of clothing removal versus usual practice using standard trauma shears. METHODS: Advanced Care Paramedic (ACP) students were randomized to either the Cut and Rip (CAR) or Cut Alone (CAL) techniques to remove clothing from a standardized trauma mannequin...
July 11, 2017: CJEM
https://www.readbyqxmd.com/read/28692624/improving-trauma-care-in-africa
#14
Deborah Tuggle, Niki Rasnake, Theresa Day
Bringing the first Advanced Trauma Care for Nurses (ATCN) provider and instructor courses to Zimbabwe was the initial step in an educational partnership spanning more than 8,000 miles. Zimbabwe is a South African country with limited health care services, severe financial restraints, and a shortage of health care professionals. All of these barriers made our goal of bringing an organized and systematic approach to trauma care even more important. The nurses of Zimbabwe were aware that their patients were not receiving "best practice" care, which made them passionate for education, with strict enforcement of standardized delivery of care...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692619/effects-of-a-systematic-quality-improvement-process-to-decrease-complications-in-trauma-patients-with-prehospital-peripheral-intravenous-access
#15
Angie Garrett, Stacy A Drake, John B Holcomb
Peripheral intravenous (PIV) catheterization is commonly performed, and its complications are costly, may result in serious health issues, and may adversely affect patient satisfaction. At our large urban Level I trauma center, we identified a cluster of 7 PIV complications from prehospital insertions in a 5-month period. Several of the patients developed noninfectious as well as infectious, limb-threatening complications requiring aggressive operative intervention. A performance improvement project was chartered to identify the cause of PIV complications and review current nursing practice...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28678793/timing-of-femoral-shaft-fracture-fixation-following-major-trauma-a-retrospective-cohort-study-of-united-states-trauma-centers
#16
James P Byrne, Avery B Nathens, David Gomez, Daniel Pincus, Richard J Jenkinson
BACKGROUND: Femoral shaft fractures are common in major trauma. Early definitive fixation, within 24 hours, is feasible in most patients and is associated with improved outcomes. Nonetheless, variability might exist between trauma centers in timeliness of fixation. Such variability could impact outcomes and would therefore represent a target for quality improvement. We evaluated variability in delayed fixation (≥24 hours) between trauma centers participating in the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) and measured the resultant association with important clinical outcomes at the hospital level...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28611170/go-karting-injury-a-case-of-laryngeal-trauma
#17
Marina Brimioulle, Matthew King, Philippe Bowles, Nicholas Saunders
We report a case of accidental strangulation and crush injury to the anterior neck resulting in laryngeal trauma. This extremely uncommon mechanism of injury provides a safety warning regarding precautions with neck wear, and the unusual resulting injury represents an opportunity to review best practice in management of laryngeal trauma.
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28601206/prolonged-field-care-beyond-the-golden-hour
#18
REVIEW
Sean Keenan, Jamie C Riesberg
Prolonged field care (PFC) has emerged as a recent area of focus for US military Special Operations Forces (SOF) medical experts. Focused on the current reality of providing medical care to military forces often deployed in remote and austere locations far from medical support or a robust casualty evacuation chain, PFC encompasses evolving operational situations not unlike many wilderness medicine practice environments. SOF currently operates in all areas of the world and on a variety of different missions, which finds these small teams far from the accustomed practice environment of robust deployed medical infrastructure commonly seen during the last 15 years of military conflicts...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#19
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 bestpractice 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 US 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...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28597478/safety-of-the-use-of-group-a-plasma-in-trauma-the-stat-study
#20
Nancy M Dunbar, Mark H Yazer
BACKGROUND: Use of universally ABO-compatible group AB plasma for trauma resuscitation can be challenging due to supply limitations. Many centers are now using group A plasma during the initial resuscitation of traumatically injured patients. This study was undertaken to evaluate the impact of this practice on mortality and hospital length of stay (LOS). STUDY DESIGN AND METHODS: Seventeen trauma centers using group A plasma in trauma patients of unknown ABO group participated in this study...
August 2017: Transfusion
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