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"Acute care surgery"

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https://www.readbyqxmd.com/read/29421694/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-resuscitative-thoracotomy-in-select-patients-with-hemorrhagic-shock-early-results-from-the-american-association-for-the-surgery-of-trauma-aortic-occlusion-in-resuscitation-for-trauma-and-acute-care
#1
Megan Brenner, Kenji Inaba, Alberto Aiolfi, Joseph DuBose, Timothy Fabian, Tiffany Bee, John B Holcomb, Laura Moore, David Skarupa, Thomas M Scalea
BACKGROUND: Aortic occlusion (AO) is a potentially valuable tool for early resuscitation in patients nearing extremis or in arrest from severe hemorrhage. STUDY DESIGN: AAST AORTA registry identified trauma patients without penetrating thoracic injury undergoing AO at the level of the descending thoracic aorta (RT or Zone 1 REBOA) in the Emergency Department (ED). Survival outcomes relative to the timing of CPR need and admission hemodynamic status were examined...
February 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29356604/procalcitonin-usefulness-in-acute-care-surgery-and-trauma
#2
Sara E Parli, Grishma Trivedi, Alison Woodworth, Phillip K Chang
BACKGROUND: Procalcitonin (PCT) is a serum biomarker currently suggested by the Surviving Sepsis Campaign to aid in determination of the appropriate duration of therapy in sepsis patients. We review the use of procalcitonin in patients after trauma or acute care surgery. METHOD: A MEDLINE search via PubMed was performed using the combination of "procalcitonin" and "humans" and "injuries, trauma," "wounds and injuries," or "wounds." Studies of burn patients, children, other biomarkers, and non-acute care surgery were excluded...
January 22, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29352339/effect-of-time-to-operation-on-value-of-care-in-acute-care-surgery
#3
Tyler J Loftus, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: As reimbursement models evolve, there is increasing emphasis on maximizing value-based care for inpatient conditions. We hypothesized that longer intervals between admission and surgery would be associated with worse outcomes and increased costs for acute care surgery patients, and that these associations would be strongest among patients with high-risk conditions. METHODS: We performed a 5-year retrospective analysis of three risk cohorts: appendectomy (low-risk for morbidity and mortality, n = 618), urgent hernia repair (intermediate-risk, n = 80), and laparotomy for intra-abdominal sepsis with temporary abdominal closure (sTAC; high-risk, n = 102)...
January 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#4
DeGirolamo Kristin, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336766/the-implications-of-transfer-to-an-acute-care-surgical-tertiary-service
#5
Rebecca Britt, Pamela Davis, Anjali Gresens, Leonard Weireter, T J Novosel, Jay Collins, L D Britt
Tertiary hospitals are increasingly called on by smaller hospitals and free-standing emergency rooms (ERs) to provide surgical care for complex patients. This study assesses patients transferred to an acute care surgery service. The ER and transfer center logs, as well as billing data, were reviewed for 12 months for all cases evaluated by acute care surgery. The charts were reviewed for demographics, comorbidities, and outcomes. A total of 111 transferred patients with complete data were identified, with 59 transferred from another hospital and 52 from a free-standing ER...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29280925/ontemporary-utilization-of-resuscitative-thoracotomy-results-from-the-aast-aortic-occlusion-for-resuscitation-in-trauma-and-acute-care-surgery-aorta-multicenter-registry
#6
Joseph DuBose, Timothy Fabian, Tiffany Bee, Laura J Moore, John B Holcomb, Megan Brenner, David Skarupa, Kenji Inaba, Todd E Rasmussen, David Turay, Thomas M Scalea
INTRODUCTION: Several reviews of Resuscitative thoracotomy (RT) use over the last 5 decades have been conducted, most recently the evidence-based practice management guideline (PMG) of the Eastern Association for the Surgery of Trauma (EAST). The present study was designed to examine contemporary RT utilization and outcomes compared to historical data (n = 10,238) from the EAST PMG review from published series 1974 - 2013. METHODS: The AAST AORTA registry was utilized to identify patients undergoing RT in the ED from Nov 2013 to Dec 2016...
December 26, 2017: Shock
https://www.readbyqxmd.com/read/29274376/trauma-still-the-cornerstone-of-acute-care-surgery-specialty
#7
L D Britt
No abstract text is available yet for this article.
December 20, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29251703/a-pilot-registry-of-trauma-surgeons-willing-and-ready-to-respond-to-disasters
#8
Daniel Grabo, Aaron Strumwasser, Kyle Remick, Susan Briggs
BACKGROUND: A well-defined means of organizing surgeons based on functional capabilities in disaster response has been lacking. We sought to create a pilot registry of surgeons, organized by functional capacities, available to respond to disasters in conjunction with the American College of Surgeons Operation Giving Back and to better understand their participation in disaster medicine training. METHODS: The authors conducted a survey of the members of the American Association for the Surgery of Trauma and the Eastern Association for the Surgery of Trauma aimed at establishing a pilot registry of qualified trauma surgeons available to respond to disasters...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29229317/team-based-simulations-for-new-surgeons-does-early-and-often-make-a-difference
#9
Kareem R AbdelFattah, M Chance Spalding, David Leshikar, Aimee K Gardner
BACKGROUND: Current work hour restrictions and the expansion of requirements for surgery residents has led to decreased time on high-acuity rotations such as trauma and acute care surgery. In an effort to improve resident competency, we examined the efficacy of a new team-based trauma curriculum for postgraduate year 1 (PGY1) residents. METHODS: After completing required Advanced Trauma Life Support certification, PGY1s participated in a series of trauma simulations in 3-person teams from June to August...
December 8, 2017: Surgery
https://www.readbyqxmd.com/read/29180188/statewide-assessment-of-surgical-outcomes-and-the-acute-care-surgery-model
#10
COMPARATIVE STUDY
Nicholas L Bandy, Sarah C DeShields, Tina D Cunningham, Rebecca C Britt
BACKGROUND: The acute care surgery (ACS) model has been widely implemented with single institution studies demonstrating improved outcomes. Recent multicenter studies have raised questions about the economics and efficacy of ACS. This study compares traditional and ACS outcomes across an entire state. METHODS: A retrospective review of Virginia's Health Information administrative database was completed. Adults admitted with appendicitis or cholecystitis between 2008 and 2014 were included...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-after-emergent-laparotomy-and-temporary-abdominal-closure
#11
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n = 36) to patients with standard resuscitation (n = 153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and Kidney Disease: Improving Global Outcomes stages of acute kidney injury...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28979986/geographic-diffusion-and-implementation-of-acute-care-surgery-an-uneven-solution-to-the-national-emergency-general-surgery-crisis
#12
Jasmine A Khubchandani, Angela M Ingraham, Vijaya T Daniel, Didem Ayturk, Catarina I Kiefe, Heena P Santry
Importance: Owing to lack of adequate emergency care infrastructure and decline in general surgery workforce, the United States faces a crisis in access to emergency general surgery (EGS) care. Acute care surgery (ACS), an organized system of trauma, general surgery, and critical care, is a proposed solution; however, ACS diffusion remains poorly understood. Objective: To investigate geographic diffusion of ACS models of care and characterize the communities in which ACS implementation is lagging...
October 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28958272/inclusion-of-the-acute-care-surgeon-in-the-difficult-airway-protocol-a-nine-year-experience
#13
Seong K Lee, Andrew A Rosenthal, Dafney L Davare, Chauniqua Kiffin, Rafael Sanchez, Michael Hurtado, Eddy H Carrillo
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28930946/evaluating-the-traditional-day-and-night-shift-in-an-acute-care-surgery-fellowship-is-the-swing-shift-a-better-choice
#14
Paul J Chestovich, Christopher F McNicoll, Nichole K Ingalls, Deborah A Kuhls, Douglas R Fraser, Shawna L Morrissey, John J Fildes
BACKGROUND: Fellowship trainees in Acute Care Surgery require experience in the management of complex and operative trauma cases. Trauma center staffing usually follows standard 12 or 24 hour shifts, with resident and fellow trainees following a similar schedule. Although trauma admissions can be generally unpredictable, we analyzed temporal trends of trauma patient arrival times to determine the best time frame to maximize trainee experience during each day. METHODS: We reviewed ten years (2007-2016) of trauma registry data for blunt and penetrating trauma activations...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930045/antibiotic-use-among-older-adults-on-an-acute-care-general-surgery-service
#15
André S Pollmann, Jon G Bailey, Philip J B Davis, Paul M Johnson
BACKGROUND: Antibiotics play an important role in the treatment of many surgical diseases that affect older adults, and the potential for inappropriate use of these drugs is high. Our objective was to describe antibiotic use among older adults admitted to an acute care surgical service at a tertiary care teaching hospital. METHODS: Detailed data regarding diagnosis, comorbidities, surgery and antibiotic use were retrospectively collected for patients 70 years and older admitted to an acute care surgical service...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929283/expanding-the-field-of-acute-care-surgery-a-systematic-review-of-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-cases-of-morbidly-adherent-placenta
#16
R Manzano-Nunez, M F Escobar-Vidarte, M P Naranjo, F Rodriguez, P Ferrada, J D Casallas, C A Ordoñez
PURPOSE: Prophylactic placement of endovascular balloon occlusion catheters has grown to be part of the surgical plans to control intraoperative hemorrhage in cases of abnormal placentation. We performed a systematic literature review to investigate the safety and effectiveness of the use of REBOA during cesarean delivery in pregnant woman with morbidly adherent placenta. METHODS: A systematic review was performed. Relevant case reports and nonrandomized studies were identified by the literature search in MEDLINE...
September 19, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28918345/meta-analysis-on-the-impact-of-the-acute-care-surgery-model-of-disease-and-patient-specific-outcomes-in-appendicitis-and-biliary-disease
#17
Patrick B Murphy, Kristin DeGirolamo, Theunis Jean Van Zyl, Laura Allen, Elliott Haut, W Robert Leeper, Ken Leslie, Neil Parry, Morad Hameed, Kelly N Vogt
BACKGROUND: The acute care surgery (ACS) model was developed to acknowledge the complexity of a traditionally fractured emergency general surgery patient population, however, there are variations in the design of ACS service models. This meta-analysis analyzes the impact of implementation of different ACS models on the outcomes for appendicitis and biliary disease. STUDY DESIGN: A systematic, English-language search of major databases was conducted. From 1,827 papers, 2 independent reviewers identified 25 studies that reported on outcomes for patients with appendicitis (n = 13), biliary disease (n = 7), or both (n = 5), before and after implementation of an ACS service...
December 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28899559/emergency-general-surgery-and-trauma-outcomes-from-the-first-consultant-led-service-in-singapore
#18
Sachin Mathur, Woan Wui Lim, Tiong Thye Goo
INTRODUCTION: There is a significant burden on public health systems from emergency surgical and trauma (ESAT) patients. In Western countries, the response has been to separate acute and elective surgery with the creation of a new sub-specialty: acute care surgery. Dedicated acute units have shown improvements in efficiency and clinical outcomes for patients. The aim of this study was to assess the results of the first such unit in Singapore. MATERIALS AND METHODS: A retrospective analysis was performed of a 12-month period of acute admissions between May 2014 and April 2015, with comparison of 6-months before and after the creation of the ESAT service...
September 5, 2017: Injury
https://www.readbyqxmd.com/read/28892324/2016-acs-governors-survey-will-acute-care-surgery-change-the-surgical-landscape
#19
Juan C Paramo, Mark W Puls, David J Welsh, Peter Andreone
No abstract text is available yet for this article.
May 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28882357/evaluation-of-negative-pressure-wound-therapy-to-closed-laparotomy-incisions-in-acute-care-surgery
#20
COMPARATIVE STUDY
Elleson Schurtz, Jerome Differding, Eric Jacobson, Christopher Maki, Mentor Ahmeti
BACKGROUND: Surgical site complications in the form of wound infections are a major burden to the healthcare system. Negative pressure wound therapy (NPWT) as delivered by a surgical incision management system (SIMS) is a novel approach to improve wound healing when applied to closed incisions. However, data is limited in its application to laparotomy incisions in the acute care surgery setting. METHODS: A retrospective case-control study was performed to evaluate the outcomes of SIMS with regard to surgical site infections in a series of 48 consecutive patients in which SIMS was applied to closed laparotomy incisions in the acute care surgery setting...
January 2018: American Journal of Surgery
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