Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses

BACKGROUND: The traditional definition of massive transfusion is 10 red blood cell units transfused within 24 hr. This definition has been faulted for excluding patients who die early from exsanguination. Alternative major bleeding definitions in the trauma literature include time-based (e.g., Resuscitation Intensity) and event based (e.g., Sharpe) transfusion thresholds. OBJECTIVE: The study objective was to compare four definitions of major bleeding, including a modification to the Sharpe definition, on clinically relevant processes and outcomes...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Millions of children are treated annually for trauma-related injuries but comprise a smaller proportion of emergency department visits than adults. As a result, emergency department teams may not have the knowledge, skills, and confidence to care for pediatric patients, and specialty teams may not interact enough as an interprofessional team to provide high-quality patient care. OBJECTIVE: The purpose of this project is to describe a novel interprofessional simulation-based education initiative to assist pediatric trauma team readiness...

BACKGROUND: Cervical spinal cord injury can greatly affect pulmonary function, resulting in complications, including respiratory failure with prolonged mechanical ventilation, ultimately leading to increased mortality and high health care costs. Weaning from mechanical ventilation is particularly challenging in patients with complete high spinal cord injury. CASE PRESENTATION: We present the case of a 42-year-old man who suffered a complete cervical 5-6 spinal cord injury following a rollover motor vehicle crash and subsequently developed postoperative pneumonia and severe hypoxemic respiratory failure...

BACKGROUND: This case report describes the use of ketamine as a rapid, effective treatment of depression in a 68-year-old female patient with no significant medical history of psychiatric disorders. Patients who experience intentional or unintentional traumas are at an increased risk for developing depression or posttraumatic stress disorder, and emerging evidence has supported the use of ketamine as an alternative treatment of depression. CASE PRESENTATION: This is the case of a 68-year-old female patient who was assaulted, resulting in multiple stab wounds to both hands and the right upper quadrant...

BACKGROUND: Early identification and treatment of alcohol misuse among trauma patients is the standard of care for trauma centers. Yet, trauma programs face significant barriers in adherence to sustained alcohol misuse screening. OBJECTIVE: This study aims to evaluate the impact of a rounding tool and clinical champion on screening, brief intervention, and referral to treatment compliance rates for alcohol use disorder in trauma patients. METHODS: This is a single-center, retrospective cohort design measuring the impact of a nursing rounding tool and clinical champion on screening, brief intervention, and referral to treatment for alcohol use disorder in trauma patients older than 14 years...

BACKGROUND: Trauma centers target injury prevention efforts based on trauma registry and local epidemiological data. Identifying geographic patterns of injury through geospatial mapping has emerged as a technology to help identify at-risk individuals. Yet, the feasibility of using spatial analysis to target injury prevention efforts remains unknown. OBJECTIVE: This study aims to demonstrate the use of geospatial mapping of older adult ground-level falls to target injury prevention efforts...

BACKGROUND: Little is known about the distribution and outcomes of hip fractures in pediatric patients during the COVID-19 pandemic. OBJECTIVE: To study the clinical outcomes of both pediatric and adult patients who underwent hip fracture surgeries and determine the effects of changes surrounding the COVID-19 pandemic. METHODS: Both pediatric and adult surgical hip fracture cases were analyzed from the pandemic year (2020) and the control year (2019) using the American College of Surgeons National Surgical Quality Improvement Program database...

BACKGROUND: The increase in firearm injuries at U.S. pediatric trauma centers is a national public health crisis. This spike in penetrating trauma has challenged even the most mature pediatric trauma centers. OBJECTIVE: This project aims to identify U.S. pediatric trauma center best practices for the evaluation and resources dedicated to pediatric firearm injuries. METHODS: This study used an exploratory cross-sectional survey design using a study-specific questionnaire...

No abstract text is available yet for this article.

BACKGROUND: Transitions between clinical units are vulnerable periods for patients. A significant body of evidence describes the importance of structured transitions, but there is limited reporting of what happens. Describing transitions within a conceptual model will characterize the salient forces that interact during a patient transition and, perhaps, lead to improved outcomes. OBJECTIVE: To describe the processes and resources that trauma centers use to transition patients from critical care to nonintensive care units...

No abstract text is available yet for this article.

BACKGROUND: Half of all reported violent incidents in health care settings occur in the emergency department (ED) placing all staff members at risk. However, research typically does not include all ED work groups or validated measures beyond nurses and physicians. OBJECTIVE: The aims of this study were to (a) validate an established instrument measuring perceptions of causes of violence and attitudes toward managing violence within an inclusive workforce sample; and (b) explore variation in perceptions, attitudes, and incidence of violence and safety to inform a violence prevention program...

No abstract text is available yet for this article.

BACKGROUND: Critically ill trauma patients are at an increased risk for infection, which can increase morbidity and mortality. The use of probiotic preparations for infection prevention is promising, yet the results of their effectiveness are mixed. OBJECTIVES: To synthesize current research regarding the use of probiotics to prevent and possibly treat infection in the critically ill adult trauma population. CONCLUSION: Upon reviewing the current body of evidence, one cannot definitively conclude that probiotic supplementation in the critically-ill trauma population decreases health care-associated infection rates and improves outcomes, but most published evidence supports their use...

BACKGROUND: Hypocalcemia is common in trauma patients receiving massive transfusion protocol and often leads to worsening coagulopathies. Despite the identified problem and recommendations for replacement, few institutions have implemented a standardized calcium replacement protocol. OBJECTIVE: This study aims to assess whether a revised massive transfusion protocol, including standardized calcium replacement, increases the incidence of calcium administration in trauma patients receiving massive transfusion protocol...

BACKGROUND: Emergent decompressive craniotomy/craniectomy can be a lifesaving surgical intervention for select patients with traumatic brain injury. Prompt management is critical as early decompression can impact traumatic brain injury outcomes. OBJECTIVE: This study aims to describe the feasibility and clinical impact of a new pathway for transporting patients with severe traumatic brain injury directly to the operating room from the trauma bay for decompressive craniotomy/craniectomy...

No abstract text is available yet for this article.

BACKGROUND: Hip fractures, predominantly occurring in the elderly, are a significant public health concern due to associated morbidity, disability, and mortality. Prolonged bed rest following the fracture often leads to complications, further threatening patient health. Enhanced recovery after surgery, a modern approach to postoperative care, is being explored for its potential to improve outcomes and quality of life in hip fracture patients. OBJECTIVE: This study investigates the impact of enhanced recovery after surgery on hip fracture patients...