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Trauma & critical care

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https://www.readbyqxmd.com/read/29232173/tele-pediatric-intensive-care-for-critically-ill-children-in-syria
#1
Muhammad Bakr Ghbeis, Katherine M Steffen, Elizabeth A Braunlin, Gregory J Beilman, Jay Dahman, Waseem Ostwani, Marie E Steiner
BACKGROUND: Armed conflicts can result in humanitarian crises and have major impacts on civilians, of whom children represent a significant proportion. Usual pediatric medical care is often disrupted and trauma resulting from war-related injuries is often devastating. High pediatric mortality rates are thus experienced in these ravaged medical environments. INTRODUCTION: Using simple communication technology to provide real-time management recommendations from highly trained pediatric personnel can provide substantive clinical support and have a significant impact on pediatric morbidity and mortality...
December 12, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29224906/horse-related-injuries-in-children-unmounted-injuries-are-more-severe-a-retrospective-review
#2
Grace E L Wolyncewicz, Cameron S Palmer, Helen E Jowett, John M Hutson, Sebastian K King, Warwick J Teague
INTRODUCTION: Horse-related injuries account for one quarter of all paediatric sports fatalities. It is not known whether the pattern of injury spectrum and severity differ between children injured whilst mounted, compared with those injured unmounted around horses. We aimed to identify any distinctions between the demographic features, spectrum and severity of injuries for mounted versus unmounted patients. PATIENTS AND METHODS: Trauma registry data were reviewed for 505 consecutive paediatric patients (aged<16years) admitted to a large paediatric trauma centre with horse-related injuries over a 16-year period...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29224655/evaluation-and-treatment-of-blunt-pelvic-trauma
#3
Jonathan G Martin, Michael Kassin, Peter Park, R Mitchell Ermentrout, Sean Dariushnia
Trauma is a significant contributor to mortality, especially in the young. Pelvic trauma with pelvic ring fractures may result in associated arterial injury, necessitating endovascular intervention. As a result, interventional radiology plays a critical role in partnering with trauma providers in the care of these patients. Management is determined by the acuity of the patient's clinical status, radiographs, ultrasound, and the results of computed tomography imaging when available. Numerous embolic agents are available for treatment of arterial hemorrhage...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29221482/rejection-acceptance-and-the-spectrum-between-understanding-male-attitudes-and-experiences-towards-conflict-related-sexual-violence-in-eastern-democratic-republic-of-congo
#4
Jocelyn Kelly, Katherine Albutt, Justin Kabanga, Kimberley Anderson, Michael VanRooyen
BACKGROUND: Female survivors of sexual violence in conflict experience not only physical and psychological sequelae from the event itself, but often many negative social outcomes, such as rejection and ostracisation from their families and community. Male relatives - whether husbands, fathers, brothers - play a key role in determining how the family and community respond to a survivor of sexual violence. Understanding these perspectives could help improve services for survivors of sexual violence, as well as their families and communities...
December 8, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/29218819/a-conceptual-model-of-the-risk-of-elder-abuse-posed-by-incontinence-and-care-dependence
#5
Joan Ostaszkiewicz
AIMS AND OBJECTIVES: To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. BACKGROUND: Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care...
December 8, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/29214899/paid-staff-or-volunteers-does-it-make-a-difference-the-impact-of-staffing-on-child-outcomes-for-children-attending-community-based-programmes-in-south-africa-and-malawi
#6
Mark Tomlinson, Lorraine Sherr, Ana Macedo, Xanthe Hunt, Sarah Skeen
BACKGROUND: Globally, and in low and middle income countries (LMIC) specifically, there is a critical shortage of workers. The use of volunteers to support such care delivery systems has been examined, there is scant literature on the impact of volunteers on child outcome in high human immunodeficiency virus (HIV)-affected communities. OBJECTIVES: To examine the differential impact of paid versus volunteer workforce in Community Based Organisations (CBOs) providing care to children and families affected by the HIV epidemic in South Africa and Malawi on child outcomes over time...
2017: Global Health Action
https://www.readbyqxmd.com/read/29212692/the-impact-of-age-on-major-orthopaedic-trauma-an-analysis-of-the-united-kingdom-trauma-audit-research-network-database
#7
J Herron, R Hutchinson, F Lecky, O Bouamra, A Edwards, M Woodford, W G P Eardley
AIMS: To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that of a younger population with similar injuries. PATIENTS AND METHODS: The Trauma Audit Research Network database was reviewed to identify eligible patients admitted between April 2012 and June 2015. Distribution and severity of injury, interventions, comorbidity, critical care episodes and mortality were recorded. The population was divided into young (64 years or younger) and older (65 years and older) patients...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29212642/compassion-fatigue-and-the-healthy-work-environment
#8
Lesly Kelly, Michael Todd
BACKGROUND: Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited. OBJECTIVE: To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction. METHODS: Nurses (n = 105) in 3 intensive care units at an academic medical center completed a survey including the Professional Quality of Life and the American Association of Critical-Care Nurses' Healthy Work Environment standards...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29209509/realtime-ultrasound-guided-percutaneous-tracheostomy-in-emergency-setting-the-glass-ceiling-has-been-broken
#9
Parli Raghavan Ravi, M N Vijai, Sachin Shouche
Background: In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature...
2017: Disaster and Military Medicine
https://www.readbyqxmd.com/read/29208320/efficacy-of-a-massive-transfusion-protocol-for-hemorrhagic-trauma-resuscitation
#10
George Lim, Katrina Harper-Kirksey, Ram Parekh, Alex F Manini
OBJECTIVES: New paradigm shifts in trauma resuscitation recommend that early reconstitution of whole blood ratios with massive transfusion protocols (MTP) may be associated with improved survival. We performed a preliminary study on the efficacy of MTP at an urban, Level 1 trauma center and its impact on resuscitation goals. METHODS: A case-control study was performed on consecutive critically-ill trauma patients over the course of 1 year. The trauma captain designated patients as either MTP activation (cases) or routine care without MTP (controls) in matched, non-randomized fashion...
November 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29202259/bedside-lung-ultrasound-in-the-care-of-the-critically-ill
#11
Máté Rudas, Sam Orde, Marek Nalos
OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care. SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29200065/cardiac-arrest-in-the-operating-room-part-2-special-situations-in-the-perioperative-period
#12
Matthew D McEvoy, Karl-Christian Thies, Sharon Einav, Kurt Ruetzler, Vivek K Moitra, Mark E Nunnally, Arna Banerjee, Guy Weinberg, Andrea Gabrielli, Gerald A Maccioli, Gregory Dobson, Michael F O'Connor
As noted in part 1 of this series, periprocedural cardiac arrest (PPCA) can differ greatly in etiology and treatment from what is described by the American Heart Association advanced cardiac life support algorithms, which were largely developed for use in out-of-hospital cardiac arrest and in-hospital cardiac arrest outside of the perioperative space. Specifically, there are several life-threatening causes of PPCA of which the management should be within the skill set of all anesthesiologists. However, previous research has demonstrated that continued review and training in the management of these scenarios is greatly needed and is also associated with improved delivery of care and outcomes during PPCA...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29199476/sexual-violence-victimization-among-youth-presenting-to-an-urban-emergency-department-the-role-of-violence-exposure-in-predicting-risk
#13
Andria B Eisman, Quyen M Ngo, Yasamin Y Kusunoki, Erin E Bonar, Marc A Zimmerman PhD, Rebecca M Cunningham Md, Maureen A Walton PhD Mph
Sexual violence (SV) is a widespread public health problem among adolescents and emerging adults with significant short- and long-term consequences. Young people living in urban, disadvantaged communities with high rates of violence may be especially at risk for SV victimization. Understanding interconnections between different forms of violence is critical to reducing SV risk among youth. Participants were youth ( N = 599) ages 14 to 24 years ( M = 20.05, SD = 2.42) presenting to an urban emergency department with a Level 1 trauma designation as part of a prospective cohort study and followed-up for 24 months...
December 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/29197316/developing-a-mass-casualty-surge-capacity-protocol-for-emergency-medical-services-to-use-for-patient-distribution
#14
Samuel E Shartar, Brooks L Moore, Lori M Wood
OBJECTIVES: Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care...
December 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29194491/healthcare-providers-perceptions-of-a-situational-awareness-display-for-emergency-department-resuscitation-a-simulation-qualitative-study
#15
Lisa A Calder, Abhi Bhandari, George Mastoras, Kathleen Day, Kathryn Momtahan, Matthew Falconer, Brian Weitzman, Benjamin Sohmer, A Adam Cwinn, Stanley J Hamstra, Avi Parush
Importance: Emergency resuscitation of critically ill patients can challenge team communication and situational awareness. Tools facilitating team performance may enhance patient safety. Objectives: To determine resuscitation team members' perceptions of the Situational Awareness Display's utility. Design: We conducted focus groups with healthcare providers during Situational Awareness Display development. After simulations assessing the display, we conducted debriefs with participants...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29194321/variability-in-management-of-blunt-liver-trauma-and-contribution-of-level-of-acs-cot-verification-status-on-mortality
#16
Christopher J Tignanelli, Bellal Joseph, Jill L Jakubus, Gaby A Iskander, Lena M Napolitano, Mark R Hemmila
BACKGROUND: Patients who sustain blunt liver trauma and are treated at an ACS-COT verified level 1 trauma center have an overall lower risk of mortality compared with patients admitted to a level 2 trauma center. However, elements contributing to these differences are unknown. We hypothesize that practice variation exists between trauma centers in management of blunt liver injury. Our objective is to identify practice variations and their effect on clinical outcomes. METHODS: Data from a statewide collaborative quality initiative for trauma was utilized...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29177438/evaluating-quality-indicators-of-tertiary-care-hospitals-for-trauma-care-in-japan
#17
Shinji Nakahara, Tetsuya Sakamoto, Takashi Fujita, Yasuyuki Uchida, Yoichi Katayama, Seizan Tanabe, Yasuhiro Yamamoto
Objective: This study examined the associations between trauma mortality and quality of care indicators currently used in Japan. Design: This is a retrospective two-level discrete-time survival analysis. Quality indicators were derived from the 2012-2013 annual hospital survey conducted by the Ministry of Health, Labour and Welfare. Trauma mortality data were derived from the Japan Trauma Data Bank for the period of April 2012 to March 2013. Setting: Tertiary care centers designated as emergency and critical care centers (ECCCs) in Japan...
November 21, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29173286/an-airway-rapid-response-system-implementation-and-utilization-in-a-large-academic-trauma-center
#18
Joshua H Atkins, Christopher H Rassekh, Ara A Chalian, Jing Zhao
BACKGROUND: Rapid response teams mobilize resources to patients experiencing acute deterioration. Failed airway management results in death or anoxic brain injury. A codified, systems-based approach to bring personnel and equipment to the bedside for multidisciplinary airway assessment and rescue was reflected in the initial implementation of an airway rapid response (ARR) team. METHODS: A retrospective review of records of 117 ARR events in a 40-month period (August 2011-November 2014) was undertaken at the Hospital of the University of Pennsylvania, a 789-bed, academic, urban, tertiary care, Level 1 trauma center...
December 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29171247/care-of-patients-undergoing-weaning-from-mechanical-ventilation-in-critical-care
#19
Susan Elliott, Nicola Morrell-Scott
There are several reasons why mechanical ventilation - the use of an artificial device to assist a patient to breathe - may be initiated, for example to enable general anaesthesia for patients undergoing surgery, and for those with a compromised airway or respiratory failure. It is important that critical care nurses have the skills and knowledge to care for patients who are undergoing weaning from mechanical ventilation. This is to ensure that patients are weaned safely and as soon as possible, to improve their outcomes and avoid an increase in patient mortality and morbidity through complications that can arise such as airway trauma and ventilator-associated pneumonia...
November 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29170342/45%C3%A2-patient-evaluation-of-trauma-service
#20
Balraj Jagdev, Hannah Gardiner, Chris Turner
: Patient Experience of the Trauma System (PETS)Trauma care is highly organised, time critical medicine. Changes to patient management in trauma care are often the result of Random Control Trials, and expert opinion following rigorous evaluation of the evidence. Highly efficient, injury focused care is required to achieve the best outcomes for patients. One area that has not been researched so thoroughly however, is the patient experience of trauma care. As evidence already suggests that patients with high stress levels have poorer outcomes, we wanted to investigate the patient perception of the trauma system...
December 2017: Emergency Medicine Journal: EMJ
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