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Trauma best practice

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https://www.readbyqxmd.com/read/29333889/risking-it-anyway-an-adolescent-case-study-of-trauma-sexual-and-gender-identities-and-relationality
#1
Elizabeth A McConnell
This article presents the case of a Chinese-American adolescent with a significant trauma history who was questioning her sexual and gender identities. The implications of the client's intersecting identities for case conceptualization and treatment are considered within the framework of affirmative practices for sexual and gender minority (SGM) clients. The impacts of stress and trauma on this client's experiences-and SGM clients more broadly-are also considered, particularly with respect to how this client understood and negotiated her experiences of relational trauma...
January 15, 2018: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/29321637/detection-of-american-football-head-impacts-using-biomechanical-features-and-support-vector-machine-classification
#2
Lyndia C Wu, Calvin Kuo, Jesus Loza, Mehmet Kurt, Kaveh Laksari, Livia Z Yanez, Daniel Senif, Scott C Anderson, Logan E Miller, Jillian E Urban, Joel D Stitzel, David B Camarillo
Accumulation of head impacts may contribute to acute and long-term brain trauma. Wearable sensors can measure impact exposure, yet current sensors do not have validated impact detection methods for accurate exposure monitoring. Here we demonstrate a head impact detection method that can be implemented on a wearable sensor for detecting field football head impacts. Our method incorporates a support vector machine classifier that uses biomechanical features from the time domain and frequency domain, as well as model predictions of head-neck motions...
December 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29319647/transition-to-critical-care-practice-within-an-academic-service-partnership-a-case-report-of-the-first-3-years-of-clinical-immersion-in-trauma-burn-and-neuroscience-critical-care
#3
Esther Bay, Andrea Sherzer, Emily Darnbrook
In response to regulators of nursing education and the Institute of Medicine, an academic-service partnership was formed between a research-intensive school of nursing and a tertiary health care facility. In that partnership, clinical experiences occurred mostly within 1 organization. This case report showcases the development, implementation, and revisions within our capstone immersion course, designed to ease the new graduates' transition into practice, including transitions to critical care nursing. Herein, we highlight our successes and challenges of implementing the clinical component within 2 critical care units focused on trauma and neurosurgical care of complex patients...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29319644/improving-thermoregulation-for-trauma-patients-in-the-emergency-department-an-evidence-based-practice-project
#4
Ada Saqe-Rockoff, Finn D Schubert, Amanda Ciardiello, Elizabeth Douglas
Extensive evidence exists on the association between hypothermia and increased morbidity and mortality in trauma patients. Gaps in practice related to temperature assessment have been identified in literature, along with limited personnel knowledge regarding management of patients with accidental hypothermia. An interdisciplinary team identified gaps in practice in our institution regarding temperature assessment and documentation of rewarming and initiated an evidence-based practice project to change practice at our institution...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29312748/acute-respiratory-distress-syndrome-in-traumatic-brain-injury-how-do-we-manage-it
#5
REVIEW
Valentina Della Torre, Rafael Badenes, Francesco Corradi, Fabrizio Racca, Andrea Lavinio, Basil Matta, Federico Bilotta, Chiara Robba
Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29287058/activities-of-the-thor-aabb-working-party
#6
Mark H Yazer, Philip C Spinella
The AABB (formerly the American Association of Blood Banks) is an international authority on transfusion medicine and tissue banking. The Trauma, Hemostasis and Oxygenation Research (THOR) Network is an international multidisciplinary network of civilian and military providers ranging from first responders and medics to critical care physicians, and from basic scientists to clinical trialists. The THOR Network's vision is to improve outcomes from traumatic hemorrhagic shock by optimizing the acute phase of resuscitation...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29285613/are-large-fracture-trials-really-possible-what-we-have-learned-from-the-randomized-controlled-damage-control-study
#7
Eva Steinhausen, Bertil Bouillon, Dieter Rixen
PURPOSE: Although they are considered the 'gold standard' of evidence-based medicine, randomized controlled trials are still a rarity in orthopedic surgery. In the management of patients with multiple trauma, there is a current trend toward 'damage control orthopedics', but to date, there is no proof of the superiority of this concept in terms of evidence-based medicine. The purpose of this article is to present unexpected difficulties we encountered in successfully completing our randomized controlled trial and to discuss the problematic differences between theoretically planning a trial and real-life practical experience of implementing the plan, with attention to published strategies...
December 28, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29259831/sport-related-portal-vein-thrombosis-an-unusual-complication
#8
Igor Dumic, Nikola Tankosic, Milica Stojkovic Lalosevic, Tamara Alempijevic
Portal vein thrombosis (PVT) is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ) is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ) in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT...
2017: Case Reports in Hepatology
https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#9
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29212880/standardizing-the-evaluation-of-nonaccidental-trauma-in-a-large-pediatric-emergency-department
#10
Lauren C Riney, Theresa M Frey, Emily T Fain, Elena M Duma, Berkeley L Bennett, Eileen Murtagh Kurowski
BACKGROUND AND OBJECTIVES: Variability exists in the evaluation of nonaccidental trauma (NAT) in the pediatric emergency department because of misconceptions and individual bias of clinicians. Further maltreatment, injury, and death can ensue if these children are not evaluated appropriately. The implementation of guidelines for NAT evaluation has been successful in decreasing differences in care as influenced by race and ethnicity of the patient and their family. Our Specific, Measurable, Achievable, Realistic, and Timely aim was to increase the percent of patients evaluated in the emergency department for NAT who receive guideline-adherent evaluation from 47% to 80% by December 31, 2016...
December 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/29208046/short-form-version-of-the-quality-of-trauma-care-patient-reported-experience-measure-sf-qtac-prem
#11
Niklas Bobrovitz, Maria J Santana, Jamie Boyd, Theresa Kline, John Kortbeek, Sandy Widder, Kevin Martin, Henry T Stelfox
OBJECTIVE: To enable the valid and reliable measurement of patient experiences we previously published a multicenter multi-center validation of the Quality of Trauma Care Patient-Reported Experience Measure (QTAC-PREM). The purpose of this study was to derive a simplified, short form version of the QTAC-PREM to further enhance the feasibility of measuring patient experiences in injury care. To identify candidate items for the short form we reviewed the results of the original multi-center long form validation cohort study, which included 400 injury care patients and their family members recruited from three trauma centers...
December 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29205275/antenatal-maternal-education-for-improving-postnatal-perineal-healing-for-women-who-have-birthed-in-a-hospital-setting
#12
REVIEW
Sonia M O'Kelly, Zena Eh Moore
BACKGROUND: The female perineum becomes suffused and stretched during pregnancy, and further strain during vaginal childbirth contributes to approximately 85% of women experiencing some degree of trauma to the perineal region. Multiple factors play a role in the type and severity of trauma experienced, including parity, delivery method, and local practices. There is ongoing debate about best midwifery practice to reduce perineal trauma. Once perineal trauma has occurred, treatment also varies greatly, depending on its degree and severity, local practice and customs, and personal preference...
December 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29193516/the-effectiveness-of-clinical-pathway-directed-care-on-hospitalisation-related-outcomes-in-patients-with-severe-traumatic-brain-injury-a-quasi-experimental-study
#13
Warda Ramadan Abouzeid Mohamed, Matthew J Leach, Nagwa Ahmad Reda, Mohammad Mohamed Abd-Ellatif, Mona Aly Mohammed, Mervat Anwar Abdel Aziz
BACKGROUND: Severe traumatic brain injury (STBI) is a major cause of disability and mortality in young adults. Clinical pathways endeavour to bring evidence and clinical practice closer together to foster the delivery of best practice and to improve patient outcomes. OBJECTIVE: To compare the effectiveness of clinical pathway directed care to usual care on hospitalisation-related outcomes in patients with STBI. DESIGN: Quasi-experimental study...
November 29, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29183635/hypothermia-indices-among-severely-injured-trauma-patients-undergoing-urgent-surgery-a-single-centred-retrospective-quality-review-and-analysis
#14
A Alam, Rafael Olarte, Jeannie Callum, Arsham Fatahi, B Nascimento, Claude Laflamme, Robert Cohen, Avery B Nathens, Homer Tien
BACKGROUND: Hypothermia (<36°C) exacerbates trauma-induced coagulopathy and worsens morbidity and mortality among severely injured trauma patients; there is a paucity of published data describing how well trauma centres adhere to standards regarding measurement of temperature, and best practices for preventing and treating hypothermia. METHODS: We completed a retrospective quality audit of all severely injured trauma patients (Injury Severity Score (ISS≥20)) who had urgent surgery at Sunnybrook Health Sciences Centre (SHSC) between 2010 and 2014...
January 2018: Injury
https://www.readbyqxmd.com/read/29183532/descriptive-analysis-of-venous-thromboembolism-in-georgia-trauma-centers-compared-with-national-trauma-centers-participating-in-the-trauma-quality-improvement-program
#15
MULTICENTER STUDY
Randi L Lassiter, Dennis W Ashley, Regina S Medeiros, Bao-Ling Adam, Elizabeth G NeSmith, Tracy J Johns, Elizabeth V Atkins, Christopher J Dente, Colville H Ferdinand
This study was designed to compare the incidence of venous thromboembolism (VTE) in Georgia trauma centers with other national trauma centers participating in the Trauma Quality Improvement Program (TQIP). The use of chemoprophylaxis and characteristics of patients who developed VTE were also examined. We conducted a retrospective observational study of 325,703 trauma admissions to 245 trauma centers from 2013 to 2014. Patient demographics, rate of VTE, as well as the use, type, and timing of chemoprophylaxis were compared between patients admitted to Georgia and non-Georgia trauma centers...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29181549/treating-open-lower-limb-fractures-successfully-thoughts-and-current-practice-on-therapy-and-centralization-in-the-netherlands
#16
K Oflazoglu, J M Hoogendoorn, P van der Zwaal, E T Walbeehm, W A van Enst, H R Holtslag, D Hofstee, P Plantinga, M Elzinga, H Rakhorst
INTRODUCTION: The British Orthopedic Association (BOA) and British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) updated the evidence-based guidelines for the treatment and care of open lower limb fractures (BOAST 4). Following this, a Dutch version has been developed. The main points are multidisciplinary care, planning, and treatment of these injuries. Early osteosynthesis (within 7-14 days) combined with soft-tissue coverage results in more efficient care and less complications...
November 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29172352/complications-of-an-ageing-dentition-part-1-occlusal-trauma-and-cracked-teeth
#17
Bryan Daniel Murchie
A growing problem in dentistry is complications associated with failing amalgam restorations that have been in place for many years. At present, there is a wide variety of treatment options available in the clinician’s armamentarium when this situation arises, however, without the correct diagnosis, the prognosis for the tooth may quickly diminish, despite the clinician’s best efforts. A confusing array of symptoms and failures may confound even the most experienced dentist, which will inevitably lead to invasive and time consuming approaches in a desperate attempt to rectify the initial problem...
April 2017: Dental Update
https://www.readbyqxmd.com/read/29161385/are-we-close-to-the-ideal-intravenous-fluid
#18
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29158647/performance-of-physiology-scoring-systems-in-prediction-of-in-hospital-mortality-of-traumatic-children-a-prospective-observational-study
#19
Babak Nakhjavan-Shahraki, Mahmoud Yousefifard, Gholamreza Faridaalaee, Kavous Shahsavari, Alireza Oraii, Mohammad Javad Hajighanbari, Parviz Karimi, Fatemeh Mahdizadeh, Samaneh Abiri, Mostafa Hosseini
Background: This study is designed to compare the value of four physiologic scoring systems of rapid acute physiology score (RAPS), rapid emergency medicine score (REMS), Worthing physiology scoring system (WPSS) and revised trauma score (RTS) in predicting the in-hospital mortality of traumatic children brought to the emergency department. Method: We used the data gathered from six healthcare centers across Iran between the April-October 2016. Included patients were all children with trauma...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29155312/designing-clinical-studies-in-orthopedic-traumatology
#20
REVIEW
D M Rouleau
The design of clinical studies in orthopedic traumatology is challenging in several respects. In this era of evidence-based medicine, the pressure is high to choose our treatments solely based on randomized controlled studies. This type of study, when well-constructed, makes it possible to discern the best treatment for a specific fracture in a given group of patients and in connection with a specific outcome. Randomized controlled trials require a lot of resources and are not designed to answer all research questions...
November 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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