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https://www.readbyqxmd.com/read/29888859/evaluation-of-the-trauma-triage-accuracy-in-a-level-1-australian-trauma-centre
#1
Matthew W Trinder, Samuel W Wellman, Sana Nasim, Dieter G Weber
OBJECTIVES: To assess the rate of undertriage of major trauma patients and to assess factors contributing to undertriage in a modern Australian Level 1 trauma centre. METHODS: A retrospective case series of 600 consecutive major trauma (injury severity score [ISS] >15) patients admitted to Royal Perth Hospital (RPH) during 2015 was performed. Data were compiled via the prospectively maintained hospital trauma registry for all patients admitted with a major trauma during the study period...
June 11, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29879979/regular-in-situ-team-based-training-in-trauma-resuscitation-with-video-debriefing-enhances-confidence-and-clinical-efficiency
#2
Alexander Knobel, Daniel Overheu, Matthias Gruessing, Ingke Juergensen, Johannes Struewer
BACKGROUND: To assess the clinical impact of a regular, multidisciplinary, video debriefed training intervention for trauma team members on real trauma resuscitations. In addition, attending personnel evaluated the training program via questionnaire. METHODS: The training intervention is a regular (monthly), video debriefed, team-based trauma simulation. Training takes place in the fully functional resuscitation bay (in-situ) of the Department of Traumatology at the Klinikum Oldenburg (Level 1, primary teaching hospital for the Carl von Ossietzky University Oldenburg) involving a complete trauma team...
June 7, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29851919/epidemiology-of-pediatric-traumatic-brain-injury-in-a-dense-urban-area-served-by-a-helicopter-trauma-service
#3
Ciaran S Hill, Aaron L McLean, Mark H Wilson
OBJECTIVE: Pediatric traumatic brain injury is the most common cause of death and a major cause of morbidity in children and young adults worldwide. Despite this, our understanding of epidemiological factors relating to this type of injury is incomplete. The objective of this study was to explore a variety of factors relating to these injuries including mechanism, timing of emergency response, prehospital management, radiological diagnosis, neurosurgical care, and final outcomes. METHODS: A retrospective review of all pediatric traumas attending a single large, densely populated urban area within a 2-year period was undertaken, and all cases with significant pediatric traumatic brain injury, as defined by a computed tomography scan showing an intracranial injury, were included for further analysis...
June 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29762335/correlation-of-level-of-trauma-activation-with-emergency-department-intervention
#4
Michael C Cooper, Geetanjali Srivastava
BACKGROUND: In-hospital trauma team activation criteria are formulated to identify severely injured patients requiring specialized multidisciplinary care. Efficacy of trauma activation (TA) criteria is commonly measured by emergency department (ED) disposition, injury severity score, and mortality. Necessity of critical ED interventions is another measure that has been proposed to evaluate the appropriateness of TA criteria. METHODS: Two-year retrospective cohort study of 1715 patients from our trauma registry at a Level 1 pediatric trauma center...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29742628/evaluation-of-dwell-time-for-peripheral-intravenous-catheters-started-in-the-field-for-geriatric-blunt-trauma-patients
#5
Darcy L Day, Francisco Conde
Replacement time for peripheral intravenous (PIV) catheters started in the field is unclear. The purpose of this study was to compare field-start PIV catheter dwell time of 2 days or less versus field-start PIV catheter dwell time of more than 2 days for the development of indicators of infection for geriatric blunt trauma patients. A retrospective case series was conducted at the state-designated trauma referral center. Activated trauma team patients with blunt injury were included if 65 years or older and if admitted from the field for 7 days or more with a PIV catheter placed prehospital...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29728151/development-and-validation-of-a-pre-hospital-red-flag-alert-for-activation-of-intra-hospital-haemorrhage-control-response-in-blunt-trauma
#6
Sophie Rym Hamada, Anne Rosa, Tobias Gauss, Jean-Philippe Desclefs, Mathieu Raux, Anatole Harrois, Arnaud Follin, Fabrice Cook, Mathieu Boutonnet, Arie Attias, Sylvain Ausset, Mathieu Boutonnet, Gilles Dhonneur, Jacques Duranteau, Olivier Langeron, Catherine Paugam-Burtz, Romain Pirracchio, Guillaume de St Maurice, Bernard Vigué, Alexandra Rouquette, Jacques Duranteau
BACKGROUND: Haemorrhagic shock is the leading cause of early preventable death in severe trauma. Delayed treatment is a recognized prognostic factor that can be prevented by efficient organization of care. This study aimed to develop and validate Red Flag, a binary alert identifying blunt trauma patients with high risk of severe haemorrhage (SH), to be used by the pre-hospital trauma team in order to trigger an adequate intra-hospital standardized haemorrhage control response: massive transfusion protocol and/or immediate haemostatic procedures...
May 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#7
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29703590/how-effective-is-trauma-simulation-as-an-educational-process-for-healthcare-providers-within-the-trauma-networks-a-systematic-review
#8
Donna Barleycorn, Geraldine A Lee
BACKGROUND: Major trauma is a significant public health problem and a leading cause of death for several age groups. To address this issue, Major Trauma Networks were introduced in the UK from 2010, consisting of Major Trauma Centres (MTCs) and a network of linked Trauma Units (TUs). OBJECTIVE: The aim is to undertake a systematic review to examine how effective is trauma simulation as an educational process for healthcare providers within trauma networks. METHODS: The databases searched included Medline, Embase and Cinahl from 2010 to 2016...
April 25, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29699720/getting-inside-the-expert-s-head-an-analysis-of-physician-cognitive-processes-during-trauma-resuscitations
#9
Matthew R White, Heather Braund, Daniel Howes, Rylan Egan, Andreas Gegenfurtner, Jeroen J G van Merrienboer, Adam Szulewski
STUDY OBJECTIVE: Crisis resource management skills are integral to leading the resuscitation of a critically ill patient. Despite their importance, crisis resource management skills (and their associated cognitive processes) have traditionally been difficult to study in the real world. The objective of this study was to derive key cognitive processes underpinning expert performance in resuscitation medicine, using a new eye-tracking-based video capture method during clinical cases. METHODS: During an 18-month period, a sample of 10 trauma resuscitations led by 4 expert trauma team leaders was analyzed...
April 23, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29690930/simple-modification-of-trauma-mechanism-alarm-criteria-published-for-the-traumanetwork-dgu-%C3%A2-may-significantly-improve-overtriage-a-cross-sectional-study
#10
Philipp Braken, Felix Amsler, Thomas Gross
BACKGROUND: No consensus exists in the literature on the use of uniform emergency room trauma team activation criteria (ERTTAC). Today excessive over- or undertriage rates continue to be a challenge for most trauma centres. Application of ERTTAC, published for use in the German TraumaNetwork DGU® , at a Swiss trauma centre resulted in a high overtriage rate. The aim of the investigation was to analyse the ERTTAC in detail with the intention of possible improvement. METHODS: The investigation included consecutive adult (age > 15 years) trauma patients treated at the emergency department of a level II trauma centre from 01...
April 24, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29685471/the-age-of-undertriage-current-trauma-triage-criteria-underestimate-the-role-of-age-and-comorbidities-in-early-mortality
#11
Elizabeth R Benjamin, Desmond Khor, Jayun Cho, Subarna Biswas, Kenji Inaba, Demetrios Demetriades
BACKGROUND: National guidelines recommend that prehospital and emergency department (ED) criteria identify patients who might benefit from trauma center triage and highest-level trauma team activation. However, some patients who are seemingly "stable" in the field and do not meet the standard criteria for trauma activation still die. OBJECTIVES: The purpose of this study was to identify these at-risk patients to potentially improve triage algorithms. METHODS: Patients enrolled in the National Trauma Data Bank (2007-2012) were included...
April 19, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29626247/commentary-on-a-consensus-based-criterion-standard-for-the-requirement-of-a-trauma-team-low-resource-setting-considerations
#12
Barclay T Stewart
No abstract text is available yet for this article.
April 6, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29622470/clinician-tasking-in-ambulance-control-improves-the-identification-of-major-trauma-patients-and-pre-hospital-critical-care-team-tasking
#13
Neil Sinclair, Paul A Swinton, Michael Donald, Lisa Curatolo, Peter Lindle, Steph Jones, Alasdair R Corfield
INTRODUCTION: Trauma remains the fourth leading cause of death in western countries and is the leading cause of death in the first four decades of life. NICE guidance in 2016 advocated the attendance of pre-hospital critical care trauma team (PHCCT) in the pre-hospital stage of the care of patients with major trauma. Previous publications support dispatch by clinicians who are also actively involved in the delivery of the PHCCT service; however there is a lack of objective outcome measures across the current reviewed evidence base...
May 2018: Injury
https://www.readbyqxmd.com/read/29587862/trauma-facilities-in-denmark-a-nationwide-cross-sectional-benchmark-study-of-facilities-and-trauma-care-organisation
#14
Jesper Weile, Klaus Nielsen, Stine C Primdahl, Christian A Frederiksen, Christian B Laursen, Erik Sloth, Ole Mølgaard, Lars Knudsen, Hans Kirkegaard
BACKGROUND: Trauma is a leading cause of death among adults aged < 44 years, and optimal care is a challenge. Evidence supports the centralization of trauma facilities and the use multidisciplinary trauma teams. Because knowledge is sparse on the existing distribution of trauma facilities and the organisation of trauma care in Denmark, the aim of this study was to identify all Danish facilities that care for traumatized patients and to investigate the diversity in organization of trauma management...
March 27, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29580349/efast-for-pneumothorax-real-life-application-in-an-urban-level-1-center-by-trauma-team-members
#15
Steven Maximus, Cesar Figueroa, Matthew Whealon, Jacqueline Pham, Eric Kuncir, Cristobal Barrios
The focused assessment with sonography for trauma (FAST) examination has become the standard of care for rapid evaluation of trauma patients. Extended FAST (eFAST) is the use of ultrasonography for the detection of pneumothorax (PTX). The exact sensitivity and specificity of eFAST detecting traumatic PTX during practical "real-life" application is yet to be investigated. This is a retrospective review of all trauma patients with a diagnosis of PTX, who were treated at a large level 1 urban trauma center from March 2013 through July 2014...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29569001/the-alcohol-intoxicated-trauma-patient-impact-on-imaging-and-radiation-exposure
#16
Christian David Weber, Jana Kristina Schmitz, Christina Garving, Klemens Horst, Hans-Christoph Pape, Frank Hildebrand, Philipp Kobbe
INTRODUCTION: The purpose of this study was to investigate the effects of alcohol intoxication in trauma patients in regard to its impact on application of computed tomography (CT) and associated radiation exposure. METHODS: We conducted a retrospective study from a continuous patient cohort. INCLUSION CRITERIA: admission to the emergency room of an urban Level 1 trauma center with trauma team activation during a 12-month period (Jan 1st-Dec 31st 2012)...
March 22, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29538237/proximal-penetrating-extremity-injuries-an-opportunity-to-decrease-overtriage
#17
Grace E Martin, Heng He, Amy T Makley, Timothy A Pritts, Joel B Elterman, Jay A Johannigman, Michael D Goodman
BACKGROUND: Penetrating injuries to the extremity proximal to the elbow or knee are anatomic criteria for full trauma team activation by the American College of Surgeon's Committee on Trauma standards. This criterion lacks objective evidence-based support. Overtriage of trauma team activation may result in excessive costs and resource burden at trauma centers. We hypothesized that full trauma team activation for penetrating injuries to the proximal extremities by anatomic criteria alone may lead to significant overtriage...
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29536940/simulation-and-the-diagnostic-process-a-pilot-study-of-trauma-and-rapid-response-teams
#18
Lindsay L Juriga, David J Murray, John R Boulet, James J Fehr
BACKGROUND: Simulation is frequently used to recreate many of the crises encountered in patient care settings. Teams learn to manage these crises in an environment that maximizes their learning experiences and eliminates the potential for patient harm. By designing simulation scenarios that include conditions associated with diagnostic errors, teams can experience how their decisions can lead to errors. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error...
November 27, 2017: Diagnosis
https://www.readbyqxmd.com/read/29521783/a-multicenter-performance-improvement-program-uses-rural-trauma-filters-for-benchmarking-an-evaluation-of-the-findings
#19
Ray Coniglio, Constance McGraw, Mike Archuleta, Heather Bentler, Leigh Keiter, Julie Ramstetter, Elizabeth Reis, Cristi Romans, Rachael Schell, Kelli Ross, Rachel Smith, Jodi Townsend, Alessandro Orlando, Charles W Mains
Colorado requires Level III and IV trauma centers to conduct a formal performance improvement program (PI), but provides limited support for program development. Trauma program managers and coordinators in rural facilities rarely have experience in the development or management of a PI program. As a result, rural trauma centers often face challenges in evaluating trauma outcomes adequately. Through a multidisciplinary outreach program, our Trauma System worked with a group of rural trauma centers to identify and define seven specific PI filters based on key program elements of rural trauma centers...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29521777/heads-up-describing-and-implementing-a-time-saving-head-strike-protocol-at-a-level-ii-trauma-center
#20
Sharon Wacht, Kristin Salottolo, Amy Atnip, Michelle Hooks, Mary Bailie, Matthew Carrick
Head strikes can be fatal for patients taking blood thinners (anticoagulants or antiplatelets). Our trauma center instituted the "head strike protocol" to provide uniform and expedited care for adult trauma patients taking preinjury anticoagulants and antiplatelet medications with suspected head injury. The purpose of this article is to describe the development and implementation of the head strike protocol and compare time metrics and outcomes before and after implementing the protocol. Per the head strike protocol, patients with suspected traumatic intracranial hemorrhage (tICH) were screened for anticoagulants or antiplatelet medications by emergency medical service personnel/at first contact, activated as a Level II trauma and received a computed tomographic scan of the head within 30 min of arrival, and started reversal of blood products within 30 min of tICH confirmation...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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