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Pediatric Trauma

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167 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28302279/venous-thromboembolism-prophylaxis-in-the-pediatric-trauma-patient
#1
REVIEW
John K Petty
Although venous thromboembolism (VTE) occurs in less than 1% of hospitalized pediatric trauma patients, care providers must make decisions about VTE prophylaxis on a daily basis. The consequences of VTE are significant; the risks of developing VTE are variable; and the effectiveness of prophylaxis against VTE is not conclusive in children. While the value of VTE prophylaxis is well defined in adult trauma care, it is unclear how this translates to the care of injured children. This review evaluates the incidence and risks of VTE in pediatric trauma and assesses the merits of prophylaxis in children...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302280/blunt-cerebrovascular-injury-in-children
#2
REVIEW
Stephen J Fenton, Robert J Bollo
Blunt cerebrovascular injury in children is an uncommon occurrence that if missed and left untreated can result in devastating long-term neurologic consequences. Diagnosis can be readily obtained by a computed tomographic angiogram of the head and neck. If confirmed, treatment with antithrombotic therapy dramatically reduces the risk of a cerebrovascular accident. The difficulty lies in determining which child should be screened for such an injury. Several institutions have come up with criteria for screening...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302281/the-art-and-science-of-pediatric-damage-control
#3
REVIEW
Anthony Tran, Brendan T Campbell
Damage control is a surgical strategy that has evolved and expanded considerably over the past 25 years. The approach was initially developed as a "bail out" procedure to control bleeding with severe abdominal injuries in the setting of unmitigated hemorrhagic shock. Damage control is now more broadly applied as a comprehensive management plan for the resuscitation and surgical treatment of injured patients with exhausted physiologic and metabolic reserve. This article reviews the most current concepts in damage control that are important and relevant to the practicing pediatric surgeon...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#4
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/28302283/pediatric-thoracic-trauma-current-trends
#5
REVIEW
Erik G Pearson, Caitlin A Fitzgerald, Matthew T Santore
Pediatric thoracic trauma is relatively uncommon but results in disproportionately high levels of morbidity and mortality when compared with other traumatic injuries. These injuries are often more devastating due to differences in children׳s anatomy and physiology relative to adult patients. A high index of suspicion is of utmost importance at the time of presentation because many significant thoracic injuries will have no external signs of injury. With proper recognition and management of these injuries, there is an associated improved long-term outcome...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302284/hospital-based-screening-tools-in-the-identification-of-non-accidental-trauma
#6
Dani O Gonzalez, Katherine J Deans
Over 700,000 children are victims of abuse and neglect each year in the United States. Effective screening programs that entail broad capture of suspected non-accidental trauma (NAT) may help to identify sentinel injuries. This can facilitate earlier detection and psychosocial interventions in hopes of decreasing recurrent NAT, which confers a higher mortality rate. The purpose of this article is to outline essential components of hospital-based NAT screening tools and highlight existing programs. In general, these tools should include several components: education sessions for healthcare providers on how to identify signs of NAT, automated notes or checklists within the electronic medical record to prompt specialty referrals, and a multidisciplinary team of experts that can address the needs of these children in the acute care setting...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302285/the-use-of-telemedicine-in-the-care-of-the-pediatric-trauma-patient
#7
REVIEW
Paul T Kim, Richard A Falcone
Telemedicine is increasingly becoming an important part of the health care system as it has the potential to help deliver quality medical care to underserved areas. When implemented correctly, it can be a cost-effective way of expanding access to excellent medical care. However, because it is a relatively new and quickly changing field, there are multiple issues and challenges that need to be addressed. This article reviews the current literature on various modalities of telemedicine, evidence for teletrauma, and challenges and barriers related to telemedicine...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302286/viscoelastic-hemostatic-assays-in-the-management-of-the-pediatric-trauma-patient
#8
Christine M Leeper, Barbara A Gaines
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/26953754/trauma-team-discord-and-the-role-of-briefing
#9
Susan Steinemann, Ajay Bhatt, Gregory Suares, Alexander Wei, Nina Ho, Gene Kurosawa, Eunjung Lim, Benjamin Berg
BACKGROUND: Briefing of the trauma team before patient arrival is unstructured in many centers. We surveyed trauma teams regarding agreement on patient care priorities and evaluated the impact of a structured, physician-led briefing on concordance during simulated resuscitations. METHODS: Trauma nurses at our Level II center were surveyed, and they participated in four resuscitation scenarios, randomized to "briefed" or "nonbriefed." For nonbriefed scenarios, nurses independently reviewed triage sheets with written information...
July 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27625718/leadership-and-teamwork-in-trauma-and-resuscitation
#10
REVIEW
Kelsey Ford, Michael Menchine, Elizabeth Burner, Sanjay Arora, Kenji Inaba, Demetrios Demetriades, Bertrand Yersin
INTRODUCTION: Leadership skills are described by the American College of Surgeons' Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/22365872/trauma-leadership-does-perception-drive-reality
#11
COMPARATIVE STUDY
Joseph V Sakran, Bo Finneman, Chris Maxwell, Seema S Sonnad, Babak Sarani, Jose Pascual, Patrick Kim, C William Schwab, Carrie Sims
INTRODUCTION: Leadership plays a key role in trauma team management and might affect the efficiency of patient care. Our hypothesis was that a positive relationship exists between the trauma team members' perception of leadership and the efficiency of the injured patient's initial evaluation. METHODS: We conducted a prospective observational study evaluating trauma attending leadership (TAL) over 5 months at a level 1 trauma center. After the completion of patient care, trauma team members evaluated the TAL's ability using a modified Campbell Leadership Descriptor Survey tool...
March 2012: Journal of Surgical Education
https://www.readbyqxmd.com/read/26801092/role-confusion-and-self-assessment-in-interprofessional-trauma-teams
#12
Susan Steinemann, Gene Kurosawa, Alexander Wei, Nina Ho, Eunjung Lim, Gregory Suares, Ajay Bhatt, Benjamin Berg
BACKGROUND: Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses' teamwork self-assessment differs from experts', and that video debriefing might improve accuracy of self-assessment. METHODS: Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities. Subsequently, nurses joined interprofessional teams in simulated trauma resuscitations...
February 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/16316282/contingent-leadership-and-effectiveness-of-trauma-resuscitation-teams
#13
COMPARATIVE STUDY
Seokhwa Yun, Samer Faraj, Henry P Sims
This research investigated leadership and effectiveness of teams operating in a high-velocity environment, specifically trauma resuscitation teams. On the basis of the literature and their own ethnographic work, the authors proposed and tested a contingency model in which the influence of leadership on team effectiveness during trauma resuscitation differs according to the situation. Results indicated that empowering leadership was more effective when trauma severity was low and when team experience was high...
November 2005: Journal of Applied Psychology
https://www.readbyqxmd.com/read/27842918/qualitative-assessment-of-simulation-based-training-for-pediatric-trauma-resuscitation
#14
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...
May 2017: Surgery
https://www.readbyqxmd.com/read/27839721/missed-injuries-and-unplanned-readmissions-in-pediatric-trauma-patients
#15
Pamela M Choi, Jennifer Yu, Martin S Keller
BACKGROUND: We sought to determine the incidence and characteristics of missed injuries and unplanned readmissions at a Level-1 pediatric trauma center. METHODS: We conducted a retrospective review of all trauma patients who presented to our ACS-verified Level-1 pediatric trauma center from 2009 to 2014. RESULTS: Overall, there were 27 readmissions and 27 missed injuries (0.38%). Patients who were unplanned readmissions had a greater Injury Severity Score (ISS) (8...
March 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27482060/trampoline-park-and-home-trampoline-injuries
#16
Kathryn E Kasmire, Steven C Rogers, Jesse J Sturm
BACKGROUND AND OBJECTIVE: Trampoline parks, indoor recreational facilities with wall-to-wall trampolines, are increasing in number and popularity. The objective was to identify trends in emergency department visits for trampoline park injuries (TPIs) and compare TPI characteristics with home trampoline injuries (HTIs). METHODS: Data on trampoline injuries from the National Electronic Injury Surveillance System from 2010 to 2014 were analyzed. Sample weights were applied to estimate yearly national injury trends; unweighted cases were used for comparison of injury patterns...
September 2016: Pediatrics
https://www.readbyqxmd.com/read/27862642/external-validation-of-the-pecarn-head-trauma-prediction-rules-in-japan
#17
Kentaro Ide, Satoko Uematsu, Kenichi Tetsuhara, Satoshi Yoshimura, Takahiro Kato, Tohru Kobayashi
OBJECTIVES: The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules are used to assist computed tomography (CT) decision-making for children with minor head trauma. Although the PECARN rules have been validated in North America and Europe, they have not yet been validated in Asia. In Japan, there are no clinical decision rules for children with minor head trauma. The rate of head CT for children with minor head trauma in Japan is high since CT is widely accessible across the country...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27852453/current-use-and-outcomes-of-helicopter-transport-in-pediatric-trauma-a-review-of-18-291-transports
#18
Brian R Englum, Kristy L Rialon, Jina Kim, Mark L Shapiro, John E Scarborough, Henry E Rice, Obinna O Adibe, Elisabeth T Tracy
PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27717564/prospective-validation-of-the-shock-index-pediatric-adjusted-sipa-in-blunt-liver-and-spleen-trauma-an-atomac-study
#19
MULTICENTER STUDY
Maria E Linnaus, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Adam C Alder, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton
BACKGROUND: Age-adjusted pediatric shock index (SIPA) does not require knowledge of age-adjusted blood pressure norms, yet correlates with mortality, serious injury, and need for transfusion in trauma. No prospective studies support its validity. METHODS: A multicenter prospective observational study of patients 4-16years presenting April 2013-January 2016 with blunt liver and/or spleen injury (BLSI). SIPA (maximum heart rate/minimum systolic blood pressure) thresholds of >1...
February 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27367538/pelvic-angiography-for-trauma-in-children-a-rare-but-useful-adjunct
#20
Katherine W Gonzalez, Brian G Dalton, Michael C Kerisey, Pablo Aguayo, David Juang
Introduction Pelvic angiography with embolization can successfully control hemorrhage in adults with pelvic fractures. However, evidence to support similar application in children is sparse. We describe our experience using angiography for pediatric pelvic fractures to further highlight the safety and efficacy of this treatment approach. Methods A retrospective review at a pediatric tertiary care center was performed from 2004 to 2014. Inpatients treated for a pelvic fracture were considered. Results A total of 216 patients were analyzed...
April 2017: European Journal of Pediatric Surgery
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