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P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Melvin E Stone, Stanley Kalata, Anna Liveris, Zachary Adorno, Shira Yellin, Edward Chao, Srinivas H Reddy, Michael Jones, Carlos Vargas, Sheldon Teperman
BACKGROUND: Critical administration threshold (≥3 units of packed red blood cells/h or CAT+) has been proposed as a new definition for massive transfusion (MT) that includes volume and rate of blood transfusion. CAT+ has been shown to eliminate survivor bias and be a better predictor of mortality than the traditional MT (>10 units/24h). End-tidal CO2 (ET CO2) negatively correlates with lactate and is an early predictor of shock in trauma patients. We conducted a pilot study to test the hypothesis that low ET CO2 on admission predicts CAT+...
July 5, 2016: Injury
Magnus Hultin, Maritha Jacobsson, Christine Brulin, Maria Härgestam
Leadership in acute care teams based on knowledge and communication - an interdisciplinary analysis of a serie of in-situ trauma team trainings Efficient communication is one of the key features of good teamwork. Call-outs (CO) and Closed-loop communication (CLC), as a component of secure and efficient communication, has been extensively taught in the team training context. This paper reports results from a thesis exploring how trauma teams communicate while working. Eighteen in-situ trauma team training sessions were documented with surveys, audio and video for later analysis...
2016: Läkartidningen
Michel Taylor, Wilma Hopman, Jeff Yach
BACKGROUND: In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures. METHODS: Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Zhi-Jie Hong, Cheng-Jueng Chen, Jyh-Cherng Yu, De-Chuan Chan, Yu-Ching Chou, Chia-Ming Liang, Sheng-Der Hsu
We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT.Totally, 144 unconscious patients with high-energy multiple trauma from single level I trauma center in North Taiwan were enrolled from January 2009 to December 2013. All patients were managed by a well-trained trauma team and were suitable for CT examination. The enrolled patients are all transferred directly from the scene of an accident, not from other medical institutions with a definitive diagnosis...
September 2016: Medicine (Baltimore)
A M K Harmsen, G F Giannakopoulos, M Terra, E S M de Lange de Klerk, F W Bloemers
PURPOSE: Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation. METHODS: A cohort comparison, between June 2004-July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome...
September 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Andrew Dickinson, S Dalal, L Beales
During Herrick 19, Main Operating Base Price Role 1 treatment facility saw one of the busiest periods of Role 1 trauma care within the British Afghanistan campaign. Within 5 months 73 trauma casualties were treated, 48 of whom were category A. This article shares the experiences of this Role 1 and its unusual context, and discusses the relevance with regard to future medical planning. The focus is on the human element; a fundamental of all military operations yet one that is often overlooked. We consider the team construct and the team members of Role 1 and suggest how this team and its leaders can be optimally prepared, supported and maintained, and then safely disassembled...
September 13, 2016: Journal of the Royal Army Medical Corps
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...
September 9, 2016: Pediatric Emergency Care
Mary Ellen Zimmermann, Zachary Brown, Praise Matemavi, Gloria Melnic, Jason Sample
At many institutions, it is common practice for trauma patients with traumatic intracranial hemorrhage (ICH) to receive routine repeat head computed tomographic (CT) scans after the initial CT scan, regardless of symptoms, to evaluate progression of the injury. The purpose of this study was to assess quantifiable risk factors (age, anticoagulation, gender) that could place patients at greater risk for progression of injury, thus requiring surgical intervention (craniotomy, craniectomy) for which serial CT scanning would be useful...
September 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Stefano Magnone, Andrea Allegri, Eugenia Belotti, Claudio Carlo Castelli, Marco Ceresoli, Federico Coccolini, Roberto Manfredi, Cecilia Merli, Fabrizio Palamara, Dario Piazzalunga, Tino Martino Valetti, Luca Ansaloni
BACKGROUND: Advanced Trauma Life Support (ATLS) guidelines are widely accepted for use in initial management of trauma patients. The application of ATLS guidelines and introduction of management by means of trauma team (TT) both took place in April 2011. The aim of the present study was to evaluate related effects on mortality in the shock room (SR) and at 24 hours after admission. METHODS: Data were retrieved by administrative software based on patient admission for trauma of at least 48 hours...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Gaspar Alberto Motta-Ramírez
BACKGROUND: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team. OBJECTIVE: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography...
July 2016: Gaceta Médica de México
Mahdi Malekpour, Nina Neuhaus, David Martin, Kenneth Widom, Megan Rapp, Diane Leonard, Susan Baro, James Dove, Marie Hunsinger, Joseph Blansfield, Mohsen Shabahang, Denise Torres, Jeffrey Wild
BACKGROUND: The majority of the US population live in urban areas, yet more than half of all trauma deaths occur in rural areas. The Rural Trauma Team Development Course (RTTDC) is developed to improve the outcomes of rural trauma and we aimed to study its effect on patient transfer. METHODS: Trauma referrals 2 years before the RTTDC training were compared with referrals 2 years after the course. RESULTS: Of the 276 studied patients, 97 were referred before the RTTDC training and 179 patients were referred after the course...
July 28, 2016: American Journal of Surgery
David I Bruner
No abstract text is available yet for this article.
September 2016: Annals of Emergency Medicine
S J Mercer, C P Jones, M Bridge, E Clitheroe, B Morton, P Groom
INTRODUCTION: Non-iatrogenic trauma to the airway is rare and presents a significant challenge to the anaesthetist. Although guidelines for the management of the unanticipated difficult airway have been published, these do not make provision for the 'anticipated' difficult airway. This systematic review aims to inform best practice and suggest management options for different injury patterns. METHODS: A literature search was conducted using Embase, Medline, and Google Scholar for papers after the year 2000 reporting on the acute airway management of adult patients who suffered airway trauma...
September 2016: British Journal of Anaesthesia
Trond Dehli, Svein Arne Monsen, Knut Fredriksen, Kristian Bartnes
BACKGROUND: Correct triage based on prehospital information contributes to a better outcome for potentially seriously injured patients. In 2011 we changed the trauma team activation (TTA) criteria in our center in order to improve the high over- and undertriage properties of the protocol. Five criteria that were unable to predict severe injury were removed. In the present study, we evaluated the protocol revision by comparing over- and undertriage in the former and present set of criteria...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Meghan Garnett, Tanya Charyk Stewart, Michael R Miller, Rodrick Lim, Kristine Van Aarsen, Wanda Millard
OBJECTIVES: To determine if changes to the Ontario Highway Traffic Act (OHTA) in 2009 and 2010 had an effect on the proportion of alcohol-related motor vehicle collisions (MVCs) presenting to a trauma centre over a 10-year period. METHODS: A retrospective review of the trauma registry at a Level I trauma centre in southwestern Ontario was undertaken. The trauma registry is a database of all trauma patients with an injury severity score (ISS) ≥12 and/or who had trauma team activation...
August 10, 2016: CJEM
Devendra Lakhotia, Kavin Khatri, Vijay Sharma, Kamran Farooque, Swati Sharma
Bilateral clavicle fractures are uncommonly reported in the literature with the incidence being less than 0.5% of all the clavicle fractures. Bilateral clavicle fractures are caused either by high-energy transfer of compression forces across both shoulder girdles or by a direct trauma to one clavicle followed by that to the other clavicle. These fractures could be missed due to their association with more severe chest injuries or a more symptomatically displaced fracture on one side or due to inadequate chest radiographs...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Sayyed Ehtesham Hussain Naqvi, Eram Ali, Mohammed Haneef Beg, Saurav Varshney
Carotid artery injuries constitute a specific and relatively small group of vascular trauma among the traumatic injuries to neck. They have the potential of killing the patients within minutes to hours due to haemodynamic instability if not managed by the specialist team within time. Central Neurologic deficit from cerebral hypoxia either resulting primarily from trauma or secondarily from surgery is a major concern. We hereby present a case of a 22-year-old man who presented to emergency department with alleged assault and vascular trauma to neck in a state of cardiac arrest...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Shea C Gregg, Daithi S Heffernan, Michael D Connolly, Andrew H Stephen, Stephanie N Leuckel, David T Harrington, Jason T Machan, Charles A Adams, William G Cioffi
BACKGROUND: Limited data exist on how to develop resident leadership and communication skills during actual trauma resuscitations. METHODS: An evaluation tool was developed to grade senior resident performance as the team leader during full-trauma-team activations. Thirty actions that demonstrated the Accreditation Council for Graduate Medical Education core competencies were graded on a Likert scale of 1 (poor) to 5 (exceptional). These actions were grouped by their respective core competencies on 5 × 7-inch index cards...
October 2016: Journal of Trauma and Acute Care Surgery
Lavinia Melania Bratu, Alexandru Florin Rogobete, Dorel Sandesc, Ovidiu Horea Bedreag, Sonia Tanasescu, Razvan Nitu, Sonia Elena Popovici, Zorin Petrisor Crainiceanu
The patient with severe burns always represents a challenge for the trauma team due to the severe biochemical and physiopathological disorders. Although there are many resuscitation protocols of severe burn patient, systemic inflammatory response, oxidative stress, decreased immune response, infections, and multiple organ dysfunction syndromes are still secondary complications of trauma, present at maximum intensity in this type of patients. Currently there are numerous studies regarding the evaluation, monitoring, and minimizing the side effects induced by free radicals through antioxidant therapy...
July 27, 2016: Biochemical Genetics
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