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https://www.readbyqxmd.com/read/29438134/better-compliance-with-triage-criteria-in-trauma-would-reduced-costs-with-maintained-patient-safety
#1
Fredrik Linder, Lina Holmberg, Hampus Eklöf, Martin Björck, Claes Juhlin, Kevin Mani
OBJECTIVE: To evaluate trauma triage criteria in terms of compliance, undertriage, and overtriage and identify risk factors for mistriage. METHODS: In a retrospective cohort study, all consecutive trauma patients at a University Hospital in Sweden in 2012 were included. Patients were stratified into three groups on the basis of trauma team activation (full trauma team, limited trauma team, and no trauma team). Case records were reviewed for mechanism of injury, vital signs, and injuries...
February 12, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29401336/cavh-in-the-combat-environment-a-case-report-and-lessons-learned-in-southern-afghanistan
#2
Jacob Glaser, Joseph Zeman, Stephen Noble, Nathanial Fernandez
Background: Acute kidney injury is a common complication of both civilian and military trauma. The lack of dedicated resources restrict dialysis in the forward setting. We report a case of a combat polytrauma and renal failure, using continuous arteriovenous hemofiltration to clear uremia and remove volume, allowing for ventilator liberation and safe disposition. Materials and Methods: The patient presented with traumatic lower extremity injuries and abdominal wounds and developed acute post-traumatic renal failure...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29395240/using-epistemic-network-analysis-to-identify-targets-for-educational-interventions-in-trauma-team-communication
#3
Sarah Sullivan, Charles Warner-Hillard, Brendan Eagan, Ryan J Thompson, A R Ruis, Krista Haines, Carla M Pugh, David Williamson Shaffer, Hee Soo Jung
BACKGROUND: Epistemic Network Analysis (ENA) is a technique for modeling and comparing the structure of connections between elements in coded data. We hypothesized that connections among team discourse elements as modeled by ENA would predict the quality of team performance in trauma simulation. METHODS: The Modified Non-technical Skills Scale for Trauma (T-NOTECHS) was used to score a simulation-based trauma team resuscitation. Sixteen teams of 5 trainees participated...
February 1, 2018: Surgery
https://www.readbyqxmd.com/read/29375943/penetrating-obturator-artery-injury-after-gunshot-wounds-a-successful-multidisciplinary-trauma-team-approach-to-a-potentially-lethal-injury
#4
Tareq I Maraqa, Ji-Sun J Shin, Ismael Diallo, Gul R Sachwani-Daswani, Leo C Mercer
Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A 23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries...
November 17, 2017: Curēus
https://www.readbyqxmd.com/read/29360717/noncompliance-with-american-college-of-surgeons-committee-on-trauma-recommended-criteria-for-full-trauma-team-activation-is-associated-with-undertriage-deaths
#5
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 undertriage rates and improved overall mortality. METHODS: Data from a state-wide collaborative quality initiative was used...
February 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#6
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29324632/chair-lift-falls-and-injuries-in-children
#7
Eric W Glissmeyer, Ryan R Metzger, Robert Bolte
OBJECTIVE: The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. METHODS: Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014...
February 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29318578/trauma-team-activation-common-rules-common-gain
#8
EDITORIAL
T Dehli, O Uleberg, T Wisborg
No abstract text is available yet for this article.
February 2018: Acta Anaesthesiologica Scandinavica
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
#9
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
#10
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
#11
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...
December 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
February 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29117055/improving-patient-experience-through-nursing-satisfaction
#19
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
#20
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
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