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https://www.readbyqxmd.com/read/28513531/who-should-lead-a-trauma-team-surgeon-or-non-surgeon-a-systematic-review-and-meta-analysis
#1
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
#2
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
https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#3
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28486323/the-trauma-time-out-evaluating-the-effectiveness-of-protocol-based-information-dissemination-in-the-traumatically-injured-patient
#4
Heather R Nolan, Michael Fitzgerald, Brett Howard, Joey Jarrard, Danny Vaughn
Procedural time-outs are widely accepted safety standards that are protocolized in nearly all hospital systems. The trauma time-out, however, has been largely unstudied in the existing literature and does not have a standard protocol outlined by any of the major trauma surgery organizations. The goal of this study was to evaluate our institution's use of the trauma time-out and assess how trauma team members viewed its effectiveness. A multiple-answer survey was sent to trauma team members at a Level I trauma center...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28486265/effect-of-family-presence-on-advanced-trauma-life-support-task-performance-during-pediatric-trauma-team-evaluation
#5
Karen J OʼConnell, Elizabeth A Carter, Jennifer L Fritzeen, Lauren J Waterhouse, Randall S Burd
IMPORTANCE: In many hospitals, family members are separated from their children during the early phases of trauma care. Including family members during this phase of trauma care varies by institution and is limited by concerns for adverse effects on clinical care. OBJECTIVE: The aim of this study is to evaluate the effect of family presence (FP) on advanced trauma life support primary and secondary survey task performance by pediatric trauma teams. We hypothesized that trauma care with FP would be noninferior to care when families were absent...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28486263/predicting-thoracic-injury-in-children-with-multitrauma
#6
Kirstin D Weerdenburg, Paul W Wales, Derek Stephens, Suzanne Beno, Jessica Gantz, Jessie Alsop, Suzanne Schuh
OBJECTIVES: Previous pediatric trauma studies focused on predictors of abnormal chest radiographs or included patients with low injury severity. This study identified predictors of thoracic injury (TI) diagnoses in a high-risk population and determined TI rate without predictors. METHODS: This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28467026/prehospital-notification-for-major-trauma-patients-requiring-emergency-hospital-transport-a-systematic-review
#7
Anneliese Synnot, Adrian Karlsson, Lisa Brichko, Melissa Chee, Mark Fitzgerald, Mahesh C Misra, Teresa Howard, Joseph Mathew, Thomas Rotter, Michelle Fiander, Russell L Gruen, Amit Gupta, Satish Dharap, Madonna Fahey, Michael Stephenson, Gerard O'Reilly, Peter Cameron, Biswadev Mitra
OBJECTIVE: This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (< 30 days) and early (< 24 hours) mortality, hospital reception and trauma team presence (or equivalent) on arrival, time to critical interventions and length of hospital stay. METHODS: Experimental and observational studies of pre-hospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included...
May 3, 2017: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/28465003/the-modified-rapid-emergency-medicine-score-a-novel-trauma-triage-tool-to-predict-in-hospital-mortality
#8
Ross T Miller, Niaman Nazir, Tracy McDonald, Chad M Cannon
BACKGROUND: Trauma systems currently rely on imperfect and subjective tools to prioritize responses and resources, thus there is a critical need to develop a more accurate trauma severity score. Our objective was to modify the Rapid Emergency Medicine (REMS) Score for the trauma population and test its accuracy as a predictor of in-hospital mortality when compared to other currently used scores, including the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the "Mechanism, Glasgow Coma Scale, Age and Arterial Pressure" (MGAP) score, and the Shock Index (SI) score...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28461545/family-presence-during-trauma-resuscitation-family-members-attitudes-behaviors-and-experiences
#9
Karen O'Connell, Jennifer Fritzeen, Cathie E Guzzetta, Angela P Clark, Christina Lloyd, Shari H Scott, Michael D Aldridge, Barbara Kreling
BACKGROUND: The paradigm is shifting from separating family members from their children during resuscitation to one of patient- and family-centered care. However, widespread acceptance is still lacking. OBJECTIVE: To measure attitudes, behaviors, and experiences of family members of pediatric patients during the resuscitation phase of trauma care, including family members who were present and those who were not. METHODS: An observational mixed-methods study using structured interviews and focus groups was conducted at 3 level 1 pediatric trauma centers...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28452896/evaluating-trauma-team-performance-in-a-level-i-trauma-center-validation-of-the-trauma-team-communication-assessment-ttca-24
#10
Stephanie DeMoor, Shady A Rehim, Richard Olmsted, John G Myers, Jessica Parker-Raley
OBJECTIVE: Non-technical skills (NTS) such as team communication are well recognized determinants of trauma team performance and good patient care. Measuring these competencies during trauma resuscitations is essential, yet few valid and reliable tools are available. We aimed to demonstrate that the TTCA-24 is a valid and reliable instrument that measures communication effectiveness during activations. METHODS: Two tools with adequate psychometric strength (T-NOTCHES, TEAM) were identified during a systematic review of medical literature and compared with TTCA-24...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28400887/antibiotic-prophylaxis-in-orbital-fractures
#11
Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
PURPOSE: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. MAIN OUTCOME MEASURES: Development of orbital infection. RESULTS: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28372825/trauma-care-in-india-a-review-of-the-literature
#12
Hadley K H Wesson, Mimmie Kwong
BACKGROUND: We reviewed the published literature related to prehospital and hospital trauma care in India to identify how trauma care is defined in the literature and what factors limit the delivery of appropriate trauma care. In summarizing the evidence and recommendations regarding trauma care, this review identifies essential research and development goals to address the burden of injury in India. METHODS: A review of the literature was conducted between August 2014 and September 2014...
March 31, 2017: Surgery
https://www.readbyqxmd.com/read/28369494/emergency-video-assisted-thoracoscopic-surgery-for-haemopneumothorax-and-diaphragm-repair-after-stabbing-performed-through-pre-existing-wounds
#13
Aman Coonar, Laurence Orchard
Video of video-assisted thoracoscopic surgery (VATS) on a 16-year old who had been stabbed. The knife penetrated the diaphragm, lung and intercostal pedicle causing a haemopneumothorax. A chest drain was inserted by the trauma team. VATS was performed entirely through the stab and chest drain pre-existing wounds without extension.
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28368482/proposal-for-the-rapid-reversal-of-coagulopathy-in-patients-with-nonoperative-head-injuries-on-anticoagulants-and-or-antiplatelet-agents-a-case-study-and-literature-review
#14
Victoria L Watson, Nundia Louis, Brittany V Seminara, J Paul Muizelaar, Anthony Alberico
BACKGROUND: Emergency room physicians, trauma teams, and neurosurgeons are seeing increasing numbers of head-injured patients on anticoagulants, many of whom are nonoperative. Head injury and anticoagulation can lead to devastating consequences. These patients need immediate evaluation and often reversal of anticoagulation in order to decrease their high rates of morbidity and mortality. OBJECTIVE: To review data on the prevalence, risks, treatment, and complications of head-injured anticoagulated patients and provide a proposal for their anticoagulant management, and imaging requirements...
March 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28330737/optimizing-the-assessment-of-pediatric-injury-severity-in-low-resource-settings-consensus-generation-through-a-modified-delphi-analysis
#15
Etienne St-Louis, Dan Leon Deckelbaum, Robert Baird, Tarek Razek
INTRODUCTION: Although a plethora of pediatric injury severity scoring systems is available, many of them present important challenges and limitations in the low resource setting. Our aim is to generate consensus among a group of experts regarding the optimal parameters, outcomes, and methods of estimating injury severity for pediatric trauma patients in low resource settings. MATERIALS AND METHODS: A systematic review of the literature was conducted to identify and compare existing injury scores used in pediatric patients...
March 15, 2017: Injury
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#16
Christopher J DeFrancesco, Wudbhav N Sankar
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28291450/establishing-a-joint-theater-trauma-system-during-phase-zero-operations
#17
Jennifer J Walker, Zsolt T Stockinger, Colin G Chinn
OBJECTIVES: Military personnel risk injury due to accidents, disasters, and military threats during Phase Zero "shaping" operations. Medical facilities must be poised to respond. METHODS: The U.S. Pacific Command (PACOM) Area of Responsibility (AOR) covers more than 50% of the earth's surface; relevant Clinical Practice Guidelines must include the maritime setting and extended evacuation periods. Military hospitals in the region are not connected by a defined Trauma System...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28248804/standardizing-the-initial-resuscitation-of-the-trauma-patient-with-the-primary-assessment-completion-tool-using-video-review
#18
Lee Ann Wurster, Rajan K Thakkar, Kathy J Haley, Krista K Wheeler, Jeremy Larson, Michael Stoner, Yaffa Gewirtz, Todd Holman, Don Buckingham, Jonathan I Groner
BACKGROUND: Major trauma resuscitations at pediatric trauma centers have an elevated risk for error because of their high acuity and relatively low frequency. The Advanced Trauma Life Support (ATLS) treatment paradigm was established to improve the management of trauma patients during the initial resuscitation phase and has been shown to improve outcomes through a standardized approach. The goal of this quality improvement project was to decrease assessment physician variability and improve the compliance with the ATLS primary assessment for major resuscitations...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#19
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (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...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28184363/a-comparison-of-self-inflicted-stab-wounds-versus-assault-induced-stab-wounds
#20
Sanghyun Ahn, Dong Jin Kim, Kwang Yeol Paik, Jae Hee Chung, Woo-Chan Park, Wook Kim, In Kyu Lee
BACKGROUND: Although self-inflicted and assault-induced knife injuries might have different mortality and morbidity rates, no studies have actually evaluated the importance of the cause of knife injuries in terms of patient outcomes and treatment strategies. OBJECTIVES: The aims of this study were to assess the difference between the outcomes of patients presenting with self-inflicted stab wounds (SISW) versus assault-induced stab wounds (AISW). PATIENTS AND METHODS: A retrospective review of the relevant electronic medical records was performed for the period between January 2000 and December 2012 for patients who were referred to the department of surgery for stab wounds by the trauma team...
November 2016: Trauma Monthly
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