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https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#1
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#2
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27976464/methods-for-collecting-paired-observations-from-emergency-medical-services-and-emergency-department-providers-for-pediatric-cervical-spine-injury-risk-factors
#3
Fahd A Ahmad, Hamilton Schwartz, Lorin R Browne, Sherry Lassa-Claxton, Michael Wallendorf, E Brooke Lerner, Nathan Kuppermann, Julie C Leonard
OBJECTIVES: Cervical spine injuries (CSI) after blunt trauma in children are rare but cause substantial morbidity and mortality. Emergency medical services (EMS) and emergency department (ED) providers routinely use spinal precautions and cervical spine imaging respectively during the management of children experiencing blunt trauma. These practices lack evidence, and there is concern that they may be harmful. A pediatric CSI risk-assessment tool is needed to inform EMS and ED provider decision-making...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27939022/trauma-surgeon-utilization-of-computerized-tomography-scanning-room-for-improvement
#4
Adrian W Ong, Jeffery Moyer, Fikir D Wordofa, Adam Sigal, Kristen Sandel, Forrest B Fernandez
BACKGROUND: We aimed to evaluate computerized tomography (CT) utilization and yield rates for trauma team activations (TTA). METHODS: A retrospective review of all TTAs was conducted over nine months. TTAs consisted of two levels--trauma alert (TAL) and trauma response (TR). Yields of CT for significant findings (SF) for four CT types (brain, cervical, chest, abdomen/pelvis) were recorded. RESULTS: 647 patients were included. There was no difference in the utilization rates of CTs except for brain CTs (TAL, 98% vs TR, 94%, p = 0...
November 28, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27918104/quality-of-life-following-trauma-before-and-after-implementation-of-a-physician-staffed-helicopter
#5
K S Funder, L S Rasmussen, R Hesselfeldt, V Siersma, N Lohse, A Sonne, S Wulffeld, J Steinmetz
BACKGROUND: Implementation of a physician-staffed helicopter emergency medical service (PS-HEMS) in Denmark was associated with lower 30-day mortality in severely injured trauma patients and less time on social subsidy. However, the reduced 30-day mortality in severely injured patients might be at the expense of a worse functional outcome and quality of life (QoL) in those who survive. The aim of this study was to investigate the effect of a physician-staffed helicopter on long-term QoL in trauma patients...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27915401/erratum-to-trauma-team-utilization-of-universal-precautions-if-you-see-something-say-something
#6
T Peponis, M C Cropano, A Larentzakis, G M van der Wilden, Y A Mejaddam, C A Sideris, M Michailidou, K Fikry, A Bramos, S Janjua, Y Chang, D R King
No abstract text is available yet for this article.
December 3, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27900417/definition-of-hemodynamic-stability-in-blunt-trauma-patients-a-systematic-review-and-assessment-amongst-dutch-trauma-team-members
#7
S A I Loggers, T W A Koedam, G F Giannakopoulos, E Vandewalle, M Erwteman, W P Zuidema
INTRODUCTION: Trauma is a great contributor to mortality worldwide. One of the challenges in trauma care is early identification and management of bleeding. The circulatory status of blunt trauma patients in the emergency room is evaluated using hemodynamic (HD) parameters. However, there is no consensus on which parameters to use. In this study, we evaluate the used terms and definitions in the literature for HD stability and compare those to the opinion of Dutch trauma team members...
November 30, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27851181/1545-collaboration-and-satisfaction-of-trauma-team-members-greater-satisfaction-for-physicians-and-men
#8
Maureen McCunn, Kinjal Sethuraman, Wendy Chang, Amy Zhou, Boyan Xia
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849499/trauma-resuscitation-evaluation-times-and-correlating-human-patient-simulation-training-differences-what-is-the-standard
#9
Timothy J Bonjour, Grigory Charny, Robert E Thaxton
BACKGROUND: Rapid effective trauma resuscitations (TRs) decrease patient morbidity and mortality. Few studies have evaluated TR care times. Effective time goals and superior human patient simulator (HPS) training can improve patient survivability. OBJECTIVES: The purpose of this study was to compare live TR to HPS resuscitation times to determine mean incremental resuscitation times and ascertain if simulation was educationally equivalent. The study was conducted at San Antonio Military Medical Center, Department of Defense Level I trauma center...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27842918/qualitative-assessment-of-simulation-based-training-for-pediatric-trauma-resuscitation
#10
Rita V Burke, Natalie E Demeter, Catherine J Goodhue, Heather Roesly, Alyssa Rake, L Caulette Young, Todd P Chang, Elizabeth Cleek, Inge Morton, Jeffrey S Upperman, Aaron R Jensen
BACKGROUND: Effective teamwork is critical in the trauma bay, although there is a lack of consensus related to optimal training for these skills. We implemented in situ trauma simulations with debriefing as a possible training methodology to improve team-oriented skills. METHODS: Focus groups were conducted with multidisciplinary clinicians who respond to trauma activations. The focus group questions were intended to elicit discussion on the clinicians' experiences during trauma activations and simulations with an emphasis on confidence, leadership, cooperation, communication, and opportunities for improvement...
November 11, 2016: Surgery
https://www.readbyqxmd.com/read/27828887/comprehensive-geriatric-assessment-for-trauma-operationalizing-the-trauma-quality-improvement-program-directive
#11
Stephanie Devore, Sara E Parli, Douglas R Oyler, Andrew Bernard
Elderly patients are the fastest growing trauma demographic and present some of the most complicated clinical challenges. This feasibility study employed observational data from a geriatric cohort. Comprehensive geriatric assessments (CGAs) were performed biweekly on eligible patients, 65 years or older, who met screening criteria. Mobility, activities of daily living impairment, frailty, and depression were screened and documented, and along with summative recommendations, were entered into the medical record, communicated to the patient's primary care provider, and discussed with family...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27828886/injury-prevention-at-the-bedside
#12
Sean Elwell, Jennifer Zakrzewski, Jennifer McCue
It is estimated that 1 in 4 children will have an unintentional injury that requires medical attention or intervention by the time they are 21 years of age. Emergency department staff have an opportunity to engage families in injury prevention messaging right at the bedside. Having staff who participate in an injured patient's care can better prepare a family or prevent another injury. Our emergency department staff identified these moments as prime teaching opportunities and worked with our trauma team to develop resources and education for patients and families that present to our department...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27821600/study-protocol-for-a-framework-analysis-using-video-review-to-identify-latent-safety-threats-trauma-resuscitation-using-in-situ-simulation-team-training-trust
#13
Mark Fan, Andrew Petrosoniak, Sonia Pinkney, Christopher Hicks, Kari White, Ana Paula Siquiera Silva Almeida, Douglas Campbell, Melissa McGowan, Alice Gray, Patricia Trbovich
INTRODUCTION: Errors in trauma resuscitation are common and have been attributed to breakdowns in the coordination of system elements (eg, tools/technology, physical environment and layout, individual skills/knowledge, team interaction). These breakdowns are triggered by unique circumstances and may go unrecognised by trauma team members or hospital administrators; they can be described as latent safety threats (LSTs). Retrospective approaches to identifying LSTs (ie, after they occur) are likely to be incomplete and prone to bias...
November 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27814956/shock-index-pediatric-age-adjusted-sipa-is-more-accurate-than-age-adjusted-hypotension-for-trauma-team-activation
#14
Shannon N Acker, Brooke Bredbeck, David A Partrick, Ann M Kulungowski, Carlton C Barnett, Denis D Bensard
BACKGROUND: We demonstrated previously that shock index, pediatric age-adjusted identifies severely injured children accurately after blunt trauma. We hypothesized that an increased shock index, pediatric age-adjusted would identify more accurately injured children requiring the highest trauma team activation than age-adjusted hypotension. METHODS: We reviewed all children age 4-16 admitted after blunt trauma with an injury severity score ≥15 from January 2007-June 2013...
November 1, 2016: Surgery
https://www.readbyqxmd.com/read/27797817/self-disembowelment-during-delirium-tremens-why-early-diagnosis-is-vital
#15
Rachel Thomasson, Vanessa Craig, Elspeth Guthrie
Delirium tremens is a serious yet treatable complication of alcohol withdrawal. Timely diagnosis is critical as there are well-established treatment regimens that provide symptomatic relief within hours to days. We report the case of a 34-year-old man with an undisclosed history of alcohol dependency. He presented with paranoid beliefs and was transferred to a psychiatric inpatient unit with suspected schizophrenia. Classic features of delirium tremens such as sympathetic overdrive and visual hallucinations were not salient features of his presentation...
October 24, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27760561/acute-transfusion-related-abdominal-injury-in-trauma-patients-a-case-report
#16
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
https://www.readbyqxmd.com/read/27712903/end-tidal-co2-on-admission-is-associated-with-hemorrhagic-shock-and-predicts-the-need-for-massive-transfusion-as-defined-by-the-critical-administration-threshold-a-pilot-study
#17
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+...
January 2017: Injury
https://www.readbyqxmd.com/read/27673583/kunskap-och-kommunikation-%C3%A3-r-en-ledares-plattform-tv%C3%A3-rvetenskaplig-studie-av-traumateam%C3%A3-vningar-visar-betydelsen-av-verbal-och-icke-verbal-kommunikation
#18
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
https://www.readbyqxmd.com/read/27668332/length-of-stay-wait-time-to-surgery-and-30-day-mortality-for-patients-with-hip-fractures-after-the-opening-of-a-dedicated-orthopedic-weekend-trauma-room
#19
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
https://www.readbyqxmd.com/read/27631215/the-evolution-of-computed-tomography-from-organ-selective-to-whole-body-scanning-in-managing-unconscious-patients-with-multiple-trauma-a-retrospective-cohort-study
#20
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)
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