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https://www.readbyqxmd.com/read/28807193/does-increased-prehospital-time-lead-to-a-trial-of-life-effect-for-patients-with-blunt-trauma
#1
Thomas W Clements, Kelly Vogt, S Morad Hameed, Neil Parry, Andrew W Kirkpatrick, Sean C Grondin, Elijah Dixon, Jessica McKee, Chad G Ball
BACKGROUND: Variance in prehospital time among severely injured blunt trauma patients is dependent upon numerous factors. Effects on subsequent mortality and trauma team activation (TTA) rates are also unclear. The primary aim of this study was to evaluate the relationship between prehospital time and mortality at level I trauma referral centers amongst critically blunt injured patients. MATERIALS AND METHODS: This multiinstitutional study from three geographically distinct level I trauma centers analyzed all severely blunt injured patients (Injury Severity Score [ISS] ≥12)...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28799045/trauma-laparoscopy-when-to-start-and-when-to-convert
#2
Oleh Matsevych, Modise Koto, Moses Balabyeki, Colleen Aldous
BACKGROUND: The use of laparoscopy for stable patients with abdominal trauma is increasing and its accuracy is nearly 100%. However, indications for laparoscopy and for conversion differ among centers. The aim of this study was to investigate indications for trauma laparoscopy and for conversion to laparotomy. METHODS: All trauma patients managed with laparoscopy over a 4-year period were retrospectively analyzed. Indications for laparoscopy, morbidity, and reasons for conversion were investigated and predictors of morbidity and conversion were sought...
August 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28782875/comparison-of-trauma-care-systems-in-asian-countries-a-systematic-literature-review
#3
Se Jin Choi, Moon Young Oh, Na Rae Kim, Yoo Joong Jung, Young Sun Ro, Sang Do Shin
OBJECTIVE: The study aims to compare the trauma care systems in Asian countries. METHODS: Asian countries were categorised into three groups; 'lower middle-income country', 'upper middle-income country' and 'high-income country'. The Medline/PubMed database was searched for articles published from January 2005 to December 2014 using relevant key words. Articles were excluded if they examined a specific injury mechanism, referred to a specific age group, and/or did not have full text available...
August 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28780315/closed-loop-communication-improves-task-completion-in-pediatric-trauma-resuscitation
#4
Ibrahim Abd El-Shafy, Jennifer Delgado, Meredith Akerman, Francesca Bullaro, Nathan A M Christopherson, Jose M Prince
BACKGROUND: Pediatric trauma care requires effective and clear communication in a time-sensitive manner amongst a variety of disciplines. Programs such as Crew Resource Management in aviation have been developed to systematically prevent errors. Similarly, teamSTEPPS has been promoted in healthcare with a strong focus on communication. We aim to evaluate the ability of closed-loop communication to improve time-to-task completion in pediatric trauma activations. METHODS: All pediatric trauma activations from January to September, 2016 at an American College of Surgeons verified level I pediatric trauma center were video recorded and included in the study...
August 2, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28756147/defining-and-measuring-decision-making-for-the-management-of-trauma-patients
#5
Amin Madani, Amanda Gips, Tarek Razek, Dan L Deckelbaum, David S Mulder, Jeremy R Grushka
BACKGROUND: Effective management of trauma patients is heavily dependent on sound judgment and decision-making. Yet, current methods for training and assessing these advanced cognitive skills are subjective, lack standardization, and are prone to error. This qualitative study aims to define and characterize the cognitive and interpersonal competencies required to optimally manage injured patients. METHODS: Cognitive and hierarchical task analyses for managing unstable trauma patients were performed using qualitative methods to map the thoughts, behaviors, and practices that characterize expert performance...
July 26, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28738812/effectiveness-of-trauma-team-on-medical-resource-utilization-and-quality-of-care-for-patients-with-major-trauma
#6
Chih-Jung Wang, Shu-Ting Yen, Shih-Fang Huang, Su-Chen Hsu, Jeremy C Ying, Yan-Shen Shan
BACKGROUND: Trauma is one of the leading causes of death in Taiwan, and its medical expenditure escalated drastically. This study aimed to explore the effectiveness of trauma team, which was established in September 2010, on medical resource utilization and quality of care among major trauma patients. METHODS: This was a retrospective study, using trauma registry data bank and inpatient medical service charge databases. Study subjects were major trauma patients admitted to a medical center in Tainan during 2009 and 2013, and was divided into case group (from January, 2011 to August, 2013) and comparison group (from January, 2009 to August, 2010)...
July 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#7
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28715359/attempting-to-validate-the-over-under-triage-matrix-at-a-level-i-trauma-center
#8
James W Davis, Rachel C Dirks, Lawrence P Sue, Krista L Kaups
BACKGROUND: The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/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...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28714831/improving-the-quality-of-nutrition-in-pediatric-trauma
#9
Alice Wang, Helena Pelletier, Diana Calligan, Angela Coates, Karen Allison Bailey
Purpose Nutrition plays a key role in the recovery of pediatric trauma patients. A catabolic state in trauma patients may hinder recovery and inadequate nutrition may increase morbidity, mortality and length of hospital stay. The purpose of this paper is to review the current nutrition support practices for pediatric trauma patients at McMaster Children's Hospital (MCH), describe patient demographics and identify areas to improve the quality of patient care. Design/methodology/approach A retrospective chart review was conducted on pediatric trauma patients (age<18 years) identified through the trauma registry of MCH...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28703089/a-traumatic-tale-of-two-cities-a-comparison-of-outcomes-for-adults-with-major-trauma-who-present-to-differing-trauma-centres-in-neighbouring-canadian-provinces
#10
Jefferson Hayre, Colin Rouse, James French, Jacqueline Fraser, Ian Watson, Sue Benjamin, Allison Chisholm, George Stoica, Beth Sealy, Mete Erdogan, Robert Green, Paul Atkinson
OBJECTIVES: While the use of formal trauma teams is widely promoted, the literature is not clear that this structure provides improved outcomes over emergency physician delivered trauma care. The goal of this investigation was to examine if a trauma team model with a formalized, specialty-based trauma team, with specific activation criteria and staff composition, performs differently than an emergency physician delivered model. Our primary outcome was survival to discharge or 30 days...
July 13, 2017: CJEM
https://www.readbyqxmd.com/read/28701849/blunt-trauma-neck-with-complete-tracheal-transection-a-diagnostic-and-therapeutic-challenge-to-the-trauma-team
#11
K N J Prakash Raju, D Anandhi, R Surendar, Ashwith Shetty, Vinay R Pandit
Survival following trachea-esophageal transection is uncommon. Establishing a secure airway has the highest priority in trauma management. Airway management is a unique and a defining element to the specialty of emergency medicine. There is no doubt regarding the significance of establishing a patent airway in the critically ill patient in the emergency department. Cannot intubate and cannot ventilate situation is a nightmare to all emergency physicians. The most important take-home message from this case report is that every Emergency physician should have the ability to predict "difficult airway" and recognize "failed airway" very early and be skilled in performing rescue techniques when routine oral-tracheal intubation fails...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28700412/parathyroid-hormone-as-a-marker-for-hypoperfusion-in-trauma-a-prospective-observational-study
#12
Scott C Fligor, Katie M Love, Bryan R Collier, Daniel I Lollar, Mark E Hamill, Andrew D Benson, Eric H Bradburn
BACKGROUND: Hyperparathyroidism is common in critical illness. Intact parathyroid hormone has a half-life of 3 to 5 minutes due to rapid clearance by the liver, kidneys, and bone. In hemorrhagic shock, decreased clearance may occur, thus making parathyroid hormone a potential early marker for hypoperfusion. We hypothesized that early hyperparathyroidism predicts mortality and transfusion in trauma patients. METHODS: A prospective observational study was performed at a Level 1 trauma center in consecutive adult patients receiving the highest level of trauma team activation...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28669694/epidemiology-of-preoperative-hematologic-assessment-of-children-cared-for-in-a-pediatric-emergency-department
#13
Christopher Woll, P Brian Smith, James Walter Fox
OBJECTIVE: To assess frequency of preoperative hematologic testing in a tertiary care pediatric emergency department (PED) and how often these values predict clinical outcome or change management decisions. METHODS: Single-center retrospective cohort study in a tertiary-care children's hospital PED. Patients 0-18years old, presenting between July 1, 2009-July 1, 2011, ultimately undergoing a surgical procedure within 48h of presentation were included. Patients were defined as having "preoperative" hematologic assessment if these studies were performed solely because the child was going to the operative suite...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28661260/effect-of-team-training-on-efficiency-of-trauma-care-in-a-chinese-hospital
#14
Yucai Hong, Xiujun Cai
Objective Multidisciplinary trauma teams are the standard of care in the USA, but staffing differences and lack of advanced trauma life support training hinder replication of this system in Chinese hospitals. We investigated the effect of simulation team training on initial trauma care. Methods Over 15 months, we compared grade I trauma patients cared for by the trained team and those cared for using traditional practice on times from emergency room arrival to tests/procedures. Propensity-score analysis was performed to improve between-group comparisons...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#15
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28590357/rotem-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#16
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood (WB) by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28564706/patient-experiences-of-trauma-resuscitation
#17
Elinore J Kaufman, Therese S Richmond, Douglas J Wiebe, Sara F Jacoby, Daniel N Holena
Importance: Patient satisfaction is an increasingly common feature of quality measurement, and patient-centered care is a key aspect of high-quality clinical care. Incorporating patient preferences in an acute context, such as trauma resuscitation, presents distinct challenges; however, to our knowledge, patients' experiences of trauma resuscitation have not been explored. Objectives: To describe patient experiences of trauma resuscitation and to identify opportunities to improve patient experience without compromising speed or thoroughness...
May 31, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28550896/pediatric-near-drowning-events-do-they-warrant-trauma-team-activation
#18
Pranit N Chotai, Lisa Manning, Benjamin Eithun, Joshua C Ross, James W Eubanks, Chad Hamner, Ankush Gosain
BACKGROUND: The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. MATERIALS AND METHODS: An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28513531/who-should-lead-a-trauma-team-surgeon-or-non-surgeon-a-systematic-review-and-meta-analysis
#19
Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Presence of a trauma team leader (TTL) in the trauma team is associated with positive patient outcomes in major trauma. The TTL is traditionally a surgeon who coordinates the resuscitation and ensures adherence to Advanced Trauma Life Support (ATLS) guidelines. The necessity of routine surgical leadership in the resuscitative component of trauma care has been questioned by some authors. Therefore, it remains controversial who should lead the trauma team. We aimed to evaluate outcomes associated with surgeon versus non-surgeon TTLs in management of trauma patients...
June 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28499679/aeromedical-ultrasound-the-evaluation-of-point-of-care-ultrasound-during-helicopter-transport
#20
Jeffrey G Yates, Denise Baylous
INTRODUCTION: This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. METHODS: This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina...
May 2017: Air Medical Journal
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