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Trauma, critical Care

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https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#1
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28625245/-effects-of-different-sedation-regimens-on-sedation-and-inflammatory-response-in-critically-ill-children-with-multiple-trauma
#2
Wenjia Tong, Conglei Song, Danqun Jin, Jingmin Sun, Yating Wang, Daliang Xu
OBJECTIVE: To compare the sedation and anti-inflammatory effects of dexmedetomidine and midazolam on critical ill children with multiple trauma. METHODS: A prospective randomized controlled trial was conducted. Sixty-five critical ill children with multiple trauma admitted to pediatric intensive care unit (PICU) of Anhui Province Children's Hospital from January 2014 to September 2016 were enrolled, who were randomly divided into dexmedetomidine group (33 cases) and midazolam group (32 cases)...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624030/emergency-department-length-of-stay-in-critical-nonoperative-trauma
#3
Anaar Siletz, Kexin Jin, Marilyn Cohen, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
BACKGROUND: Prolonged emergency department (ED) stays correlate with negative outcomes in critically ill nontrauma patients. This study sought to determine the effect of ED length of stay (LOS) on trauma patients. MATERIALS AND METHODS: Two hundred forty-one trauma patients requiring direct intensive care unit (ICU) admission were identified. Patients requiring immediate operative intervention were excluded. Odds ratios (ORs) of outcomes for patients transferred to ICU in ≤90 min were compared with patients transferred in >90 min, adjusting for Injury Severity Score (ISS)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28620594/hypokalemia-at-the-time-of-admission-to-the-intensive-care-unit-icu-increases-the-need-for-mechanical-ventilation-and-time-of-ventilation-in-critically-ill-trauma-patients
#4
Mohammadreza Safavi, Azim Honarmand, Mozhgan Karbalayi Mehrizi, Mansour Siavash Dastjerdi, Mohammad Emami Ardestani
No abstract text is available yet for this article.
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28614442/skin-and-soft-tissue-infections-in-the-intensive-care-unit-a-retrospective-study-in-a-tertiary-care-center
#5
Luís Filipe Malheiro, Rita Magano, Alcina Ferreira, António Sarmento, Lurdes Santos
Objective: To identify factors that may influence outcomes in patients with severe skin and soft tissue infections in the intensive care unit. Methods: A retrospective observational study was conducted in a cohort of 1,123 critically ill patients admitted to an intensive care unit with a primary or secondary diagnosis of severe skin and soft tissues infection between January 2006 and December 2014. Results: Thirty patients were included, 20 (66...
June 12, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28602224/general-surgeon-management-of-complex-hepatopancreatobiliary-trauma-at-a-level-i-trauma-center
#6
Peter Kilen, Alissa Greenbaum, Richard Miskimins, Manuel Rojo, Razvan Preda, Thomas Howdieshell, Stephen Lu, Sonlee West
BACKGROUND: The impact of general surgeons (GS) taking trauma call on patient outcomes has been debated. Complex hepatopancreatobiliary (HPB) injuries present a particular challenge and often require specialized care. We predicted no difference in the initial management or outcomes of complex HPB trauma between GS and trauma/critical care (TCC) specialists. MATERIALS AND METHODS: A retrospective review of patients who underwent operative intervention for complex HPB trauma from 2008 to 2015 at an ACS-verified level I trauma center was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601477/family-perspectives-of-traumatically-brain-injured-patient-pain-behaviors-in-the-intensive-care-unit
#7
Brandy L Vanderbyl, Céline Gélinas
Behavioral scales allow for the pain assessment of vulnerable critically ill patients who are unable to self-report. However, validity of the use of such scales is limited in traumatic brain injury patients with an altered level of consciousness as a result of the different way that these patients express pain. Family participation is considered as an important component of pain assessment for those unable to self-report, but research in this area is minimal so far. This study aimed to describe what behaviors family caregivers deemed relevant to pain for patients with a traumatic brain injury with an altered level of consciousness in the intensive care unit...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28601206/prolonged-field-care-beyond-the-golden-hour
#8
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/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#9
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28598904/deaths-and-high-risk-trauma-patients-missed-by-standard-trauma-data-sources
#10
Craig D Newgard, Rochelle Fu, E Brooke Lerner, Mohamud Daya, Dagan Wright, Jonathan Jui, N Clay Mann, Eileen Bulger, Jerris Hedges, Lynn Wittwer, David Lehrfeld, Thomas Rea
BACKGROUND: Trauma registries are used to evaluate and improve trauma care, yet potentially miss certain trauma deaths and high-risk patients. We estimated the number of missed deaths and high-risk trauma patients using commonly-available sources of trauma data, and bias in quality metrics for field trauma triage. METHODS: This was a pre-planned secondary analysis of a population-based prospective cohort of injured patients transported by 44 EMS agencies to 28 hospitals in 7 Northwest counties from 1/1/2011 to 12/31/2011 and followed through hospitalization...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28580776/do-we-have-enough-evidence-for-minimally-invasive-cardiac-surgery-a-critical-review-of-scientific-and-non-scientific-information
#11
REVIEW
Torsten Doenst, Joseph Lamelas
Reducing surgical trauma by minimizing skin incisions has transformed abdominal surgery resulting in significant improvements in outcome. In cardiac surgery, such efforts have also been made, but similar benefits could not be demonstrated. In addition, any potential benefit comes at the cost of increased cardiopulmonary bypass and clamp times, leading to questions regarding the safety of minimally invasive cardiac surgery (MICS). Nevertheless, outcomes have been equivalent to matched sternotomy cases and there is no doubt that the number of patients undergoing minimally-invasive mitral or aortic procedures is slowly increasing...
August 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28567280/solar-powered-oxygen-systems-in-remote-health-centers-in-papua-new-guinea-a-large-scale-implementation-effectiveness-trial
#12
Trevor Duke, Ilomo Hwaihwanje, Magdalynn Kaupa, Jonah Karubi, Doreen Panauwe, Martin Sa'avu, Francis Pulsan, Peter Prasad, Freddy Maru, Henry Tenambo, Ambrose Kwaramb, Eleanor Neal, Hamish Graham, Rasa Izadnegahdar
BACKGROUND: Pneumonia is the largest cause of child deaths in Papua New Guinea (PNG), and hypoxaemia is the major complication causing death in childhood pneumonia, and hypoxaemia is a major factor in deaths from many other common conditions, including bronchiolitis, asthma, sepsis, malaria, trauma, perinatal problems, and obstetric emergencies. A reliable source of oxygen therapy can reduce mortality from pneumonia by up to 35%. However, in low and middle income countries throughout the world, improved oxygen systems have not been implemented at large scale in remote, difficult to access health care settings, and oxygen is often unavailable at smaller rural hospitals or district health centers which serve as the first point of referral for childhood illnesses...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28557070/color-and-power-doppler-sonography-for-pneumothorax-detection
#13
John R Richards, Julianne M Awrey, Sarah E Medeiros, John P McGahan
The use of B- and M-mode sonography for detection of pneumothorax has been well described and studied. It is now widely incorporated by sonographers, emergency physicians, trauma surgeons, radiologists, and critical care specialists worldwide. Lung sonography can be performed rapidly at the bedside or in the prehospital setting. It is more sensitive, specific, and accurate than plain chest radiography. The use of color and power Doppler sonography as an adjunct to B- and M-mode imaging for detection of pneumothorax has been described in a small number of studies and case reports but is much less widely known or used...
May 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28550970/thoracotomy-in-the-emergency-department-for-resuscitation-of-the-mortally-injured
#14
J Christopher DiGiacomo, L D George Angus
PURPOSE: Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room...
May 10, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28545548/circulating-microparticle-levels-are-reduced-in-patients-with-ards
#15
Ciara M Shaver, Justin Woods, Jennifer K Clune, Brandon S Grove, Nancy E Wickersham, J Brennan McNeil, Gregory Shemancik, Lorraine B Ware, Julie A Bastarache
BACKGROUND: It is unclear how to identify which patients at risk for acute respiratory distress syndrome (ARDS) will develop this condition during critical illness. Elevated microparticle (MP) concentrations in the airspace during ARDS are associated with activation of coagulation and in vitro studies have demonstrated that MPs contribute to acute lung injury, but the significance of MPs in the circulation during ARDS has not been well studied. The goal of the present study was to test the hypothesis that elevated levels of circulating MPs could prospectively identify critically ill patients who will develop ARDS and that elevated circulating MPs are associated with poor clinical outcomes...
May 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#16
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#17
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28506455/trauma-morning-report-is-the-ideal-environment-to-teach-and-evaluate-resident-communication-and-sign-outs-in-the-80-hour-work-week
#18
Mary E Ottinger, Sean F Monaghan, Shea C Gregg, Andrew H Stephen, Michael D Connolly, David T Harrington, Charles A Adams, William G Cioffi, Daithi S Heffernan
BACKGROUND: The 80h work week has raised concerns that complications may increase due to multiple sign-outs or poor communication. Trauma Surgery manages complex trauma and acute care surgical patients with rapidly changing physiology, clinical demands and a large volume of data that must be communicated to render safe, effective patient care. Trauma Morning Report format may offer the ideal situation to study and teach sign-outs and resident communication. MATERIALS AND METHODS: Surgery Residents were assessed on a 1-5 scale for their ability to communicate to their fellow residents...
May 1, 2017: Injury
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#19
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28486327/tourniquets-in-trauma-care-a-review-of-application
#20
Brian Cornelius, Ryan Campbell, Pat McGauly
Traumatic hemorrhage has been identified as the leading cause of battlefield death in recent conflicts. Although injury patterns are not directly reproducible to the civilian world, treatment advancements can be used to provide care to patients worldwide. Long-standing dogma regarding the use of tourniquets has been disproved, and there is now recognition of the critical role that tourniquets play in trauma care. The history and evolution of tourniquets, including the identification of previous faults in application, will lead to an examination of the current devices in use along with evidence-based recommendations for use...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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