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https://www.readbyqxmd.com/read/29238847/which-pre-hospital-triage-parameters-indicate-a-need-for-immediate-evaluation-and-treatment-of-severely-injured-patients-in-the-resuscitation-area
#1
K O Jensen, R Heyard, D Schmitt, L Mica, C Ossendorf, H P Simmen, G A Wanner, C M L Werner, L Held, K Sprengel
PURPOSE: To find ways to reduce the rate of over-triage without drastically increasing the rate of under-triage, we applied a current guideline and identified relevant pre-hospital triage predictors that indicate the need for immediate evaluation and treatment of severely injured patients in the resuscitation area. METHODS: Data for adult trauma patients admitted to our level-1 trauma centre in a one year period were collected. Outpatients were excluded. Correct triage for trauma team activation was identified for patients with an ISS or NISS ≥ 16 or the need for ICU treatment due to trauma sequelae...
December 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29234819/-optimized-resource-mobilization-and-quality-of-treatment-of-severely-injured-patients-through-a%C3%A2-structured-trauma-room-alarm-system
#2
C Spering, M Roessler, T Kurlemann, K Dresing, K M Stürmer, W Lehmann, S Sehmisch
BACKGROUND: The treatment of severely injured patients in the trauma resuscitation unit (TRU) requires an interdisciplinary and highly professional trauma team approach. The complete team needs to be waiting for the patient in the TRU on arrival. Treating severely injured patients in the TRU, the trauma team connects the initial preclinical emergency stabilization with the subsequent sophisticated treatment. Thus, the trauma team depends on concise information from the emergency personnel at the scene to provide its leader with further information as well as an accurate alarm including all departments necessary to stabilize the patient in the TRU...
December 12, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#3
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29194318/non-compliance-with-acs-cot-recommended-criteria-for-full-trauma-team-activation-is-associated-with-undertriage-deaths
#4
Christopher J Tignanelli, Wayne E Vander Kolk, Judy N Mikhail, Matthew J Delano, Mark R Hemmila
BACKGROUND: The appropriate triage of acutely injured patients within a trauma system is associated with improved rates of mortality and optimal resource utilization. The American College of Surgeons Committee on Trauma (ACS-COT) put forward six minimum criteria (ACS-6) for full trauma team activation (TTA). We hypothesized that ACS-COT verified trauma center compliance with these criteria is associated with low under-triage rates and improved overall mortality. METHODS: Data from a state-wide collaborative quality initiative was utilized...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29189678/attempting-to-validate-the-overtriage-undertriage-matrix-at-a-level-i-trauma-center
#5
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the overtriage/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different, and Matrix does not discriminate the needs or outcomes of these different groups of patients...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29153980/why-saying-what-you-mean-matters-an-analysis-of-trauma-team-communication
#6
Hee Soo Jung, Charles Warner-Hillard, Ryan Thompson, Krista Haines, Brooke Moungey, Anne LeGare, David Williamson Shaffer, Carla Pugh, Suresh Agarwal, Sarah Sullivan
BACKGROUND: We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork. METHODS: Interdisciplinary trauma simulations were conducted. Team performance was rated using the TEAM tool. Team communication was coded for grammatical form and communicative intent. The rate of mixed mode communication (MMC) was calculated. MMC rates were compared to overall TEAM scores...
November 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29132571/the-human-factor-optimizing-trauma-team-performance-in-dynamic-clinical-environments
#7
REVIEW
Christopher Hicks, Andrew Petrosoniak
Resilience is built, not born, and there is no single strategy that reliably manufactures resilient performance in all circumstances. Optimizing team performance in dynamic environments involves the complex interplay of strategies that target individual preparation, team interaction, environmental optimization, and systems-level resilience engineering. To accomplish this, health care can draw influence from human factors research to inform tangible, practical, and measurable improvements in performance and outcomes, modified to suit local and domain-specific needs...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29127439/trauma-patients-centralization-for-the-mechanism-of-trauma-old-questions-without-answers
#8
S Magnone, A Ghirardi, M Ceresoli, L Ansaloni
INTRODUCTION: Centralization of trauma patients has become the standard of care. Unfortunately, overtriage can overcome the capability of Trauma Centres. This study aims to analyse the association of different mechanisms of injury with severe or major trauma defined as Injury Severity Score (ISS) greater than 15 and an estimation of overtriage upon our Trauma Centre. METHODS: A retrospective review of our prospective database was undertaken from March 2014 to August 2016...
November 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29126452/high-performing-trauma-teams-frequency-of-behavioral-markers-of-a-shared-mental-model-displayed-by-team-leaders-and-quality-of-medical-performance
#9
Bjørn Helge Johnsen, Heidi Kristina Westli, Roar Espevik, Torben Wisborg, Guttorm Brattebø
BACKGROUND: High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. METHOD: Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. RESULTS: The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior...
November 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29119562/validating-performance-of-triss-tarn-and-normit-survival-prediction-models-in-a-norwegian-trauma-population
#10
N O Skaga, T Eken, S Søvik
INTRODUCTION: Anatomic injury, physiological derangement, age, injury mechanism and pre-injury comorbidity are well-founded predictors of trauma outcome. Statistical prediction models may have poorer discrimination, calibration and accuracy when applied in new locations. We aimed to compare the TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population. METHODS: Consecutive patients admitted to Oslo University Hospital Ullevål within 24 h after injury, with Injury Severity Score ≥ 10, proximal penetrating injuries, or received by trauma team, were studied...
November 8, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29117055/improving-patient-experience-through-nursing-satisfaction
#11
Amanda McNicholas, Abby McCall, Alanna Werner, Ronda Wounderly, Erin Marinchak, Pamela Jones
Patient experience is a vital component of quality health care. In our institution we sought to improve both nursing satisfaction and collaboration, in conjunction with improving patient experience, predicting the two are directly proportional. We hypothesized that a more satisfied nursing team would result in an overall improvement in patient experience. To explore this hypothesis, we implemented multiple process changes to create an advanced practitioner-directed floor (APDF) on our 28-bed trauma, medical-surgical unit...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29117049/trauma-leadership-strategies-to-prevent-and-reduce-burnout-in-urban-academic-trauma-centers
#12
Melissa S Hockaday
The incidence of burnout syndrome is increasing among all health care disciplines. The core members of the trauma team in high-performing trauma centers are the greatest risk. It is the responsibility of trauma leadership to raise awareness of risk factors, implement standardized assessment tools, and develop strategies to mitigate burnout in employees. The consequences of burnout are devastating to providers' well-being as well as patient safety. Burnout can lead to increased risk of anxiety, depression, substance abuse, and suicide among team members...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29115207/self-evaluated-competence-in-trauma-reception
#13
Kristin Julia Steinthorsdottir, Peter Svenningsen, Rasmus Fabricius, Lars Bo Svendsen, Jens Hillingsø, Martin Sillesen
INTRODUCTION: No formal training requirements exist for trauma teams in Denmark. The aim of this study was to investigate the point prevalence level of training and the self-evaluated competence of doctors involved in trauma care. METHODS: On two nights, all doctors on call at departments involved in trauma care were interviewed and answered a structured questionnaire pertaining to their level of training and self-evaluated level of competence in relevant skills...
November 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29079066/anticoagulated-trauma-patients-a-level-i-trauma-center-s-response-to-a-growing-geriatric-population
#14
Mark D Mason, Sarah K Spilman, Elizabeth A Fuchsen, Sherry D Olson, Richard A Sidwell, James R Swegle, Sheryl M Sahr
BACKGROUND: Injured older adults often receive delayed care in the emergency department (ED) because they do not meet criteria for trauma team activation (TTA). This is particularly dangerous for the increasing number of patients taking anticoagulant or antiplatelet (AC/AP) medication at the time of injury. OBJECTIVES: The present study examined improvements in processes of care and triage accuracy when TTA criteria include an escalated response for older anticoagulated patients...
October 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29031173/an-unusual-case-of-transpelvic-impalement-injury-a-case-report
#15
Mushrek Alani, Saeed Mahmood, Ayman El-Menyar, Sajid Atique, Hassan Al-Thani, Ruben Peralta
INTRODUCTION: Impalement injury is a rare type of mechanical injury following forceful insertion of projecting object into the body. Careful planning for removal of the impaling object is essential to decrease the blood loss and preserve the function of the injured organ. PRESENTATION OF CASE: A 27 year-old male fell from 4m height over a U shaped projecting up metallic bar. The bar penetrated the left side of the pelvis and traversed through the left iliac bone causing a comminuted fracture in the supra-acetabular region extending to the left psoas muscle, injuring the viscera and causing fracture of the right femur...
October 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29023379/effect-of-early-pelvic-binder-use-in-the-emergency-management-of-suspected-pelvic-trauma-a-retrospective-cohort-study
#16
Sheng-Der Hsu, Cheng-Jueng Chen, Yu-Ching Chou, Sheng-Hao Wang, De-Chuan Chan
BACKGROUND: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. METHODS: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: a loss of consciousness or a Glasgow coma score (GCS) of <13; systolic blood pressure of <90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury...
October 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29017731/impact-of-geriatric-consultations-on-clinical-outcomes-of-elderly-trauma-patients-a-retrospective-analysis
#17
James P Dugan, Keith M Burns, Mustafa Baldawi, David G Heidt
INTRODUCTION: The elderly account for a large proportion of morbidity and mortality secondary to trauma, despite lower-energy mechanisms of injury and fewer trauma admissions. The benefit of geriatric trauma consultation services (GTCS) to this population remains unclear. METHODS: We performed a retrospective cohort analysis of a GTCS, which was established in January 2015. Patients over 60 admitted to the trauma service from January of 2014 to February 2016 were eligible...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28985089/examining-participant-perceptions-of-an-interprofessional-simulation-based-trauma-team-training-for-medical-and-nursing-students
#18
Rune Bruhn Jakobsen, Sarah Frandsen Gran, Bergsvein Grimsmo, Kari Arntzen, Erik Fosse, Jan C Frich, Per Hjortdahl
High quality care relies on interprofessional teamwork. We developed a short simulation-based course for final year medical, nursing and nursing anaesthesia students, using scenarios from emergency medicine. The aim of this paper is to describe the adaptation of an interprofessional simulation course in an undergraduate setting and to report participants' experiences with the course and students' learning outcomes. We evaluated the course collecting responses from students through questionnaires with both closed-ended and open-ended questions, supplemented by the facilitators' assessment of students' performance...
January 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28956414/interprofessional-collaboration-in-the-management-of-a-polytrauma-at-the-emergency-department-a-literature-review
#19
Alexandra Lapierre, Jérôme Gauvin-Lepage, Hélène Lefebvre
INTRODUCTION: interprofessional collaboration (IPC) in the context of trauma remains a challenge for health care professionals who must react quickly and prioritize interventions according to trauma practice standards. METHODS: a review of the literature was conducted by exploring the CINAHL, Scopus, Web of Science and Pubmed databases in relation to trauma and IPC in order to report on IPC knowledge in the context of traumatology. RESULTS: a significant number of articles related to traumatology (n = 14), to IPC (n = 38) and then related to these two themes (n = 15) were identified and analyzed...
August 17, 2017: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28944640/-unknown-title
#20
(no author information available yet)
Introduction : interprofessional collaboration (IPC) in the context of trauma remains a challenge for health care professionals who must react quickly and prioritize interventions according to trauma practice standards. Methods : a review of the literature was conducted by exploring the CINAHL, Scopus, Web of Science and Pubmed databases in relation to trauma and IPC in order to report on IPC knowledge in the context of traumatology. Results : a significant number of articles related to traumatology (n = 14), to IPC (n = 38) and then related to these two themes (n = 15) were identified and analyzed...
August 17, 2017: Recherche en Soins Infirmiers
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