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Journal of Trauma and Acute Care Surgery

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https://read.qxmd.com/read/30768564/how-much-green-does-it-take-to-be-orange-determining-the-cost-associated-with-trauma-center-readiness
#1
Dennis W Ashley, Robert F Mullins, Christopher J Dente, Tracy J Johns, Laura E Garlow, Regina S Medeiros, Elizabeth V Atkins, Gina Solomon, Dena Abston, Colville H Ferdinand
BACKGROUND: Readiness Costs are real expenses incurred by trauma centers to maintain essential infrastructure to provide emergent services on a 24/7 basis. Although the components for readiness are well described in the American College of Surgeon's Resources for Optimal Care of the Injured Patient, the cost associated with each component is not well defined. We hypothesized that meeting the requirements of the 2014 Resources for Optimal Care of the Injured Patient would result in significant costs for trauma centers...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768563/addressing-post-traumatic-amnesia-recommendations-for-improving-patient-lives-after-brain-injury
#2
Cathy Meng Fei Li, Lawrence Russell Robinson, Alan Ka Ho Tam
No abstract text is available yet for this article.
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768562/psychiatric-outcome-at-least-20-years-after-trauma-a-survey-on-the-status-of-subjective-general-health-and-psychiatric-symptoms-with-a-focus-on-posttraumatic-stress-disorder
#3
Sascha Halvachizadeh, Henrik Teuber, Florin Allemann, Anna Theresa Luidl, Roland von Känel, Boris Zelle, Simon Tiziani, Katrin Rauen, Hans-Christoph Pape, Roman Pfeifer
BACKGROUND: Information on long-term psychiatric sequelae after severe trauma is sparse. We therefore performed a survey addressing several symptoms related to post traumatic stress disorder (PTSD) in patients that sustained multiple injuries more than 20 years after trauma. METHODS: Patients injured between January 1, 1973 and December 31, 1990 were contacted at least 20 years later. We included multiply injured patients aged between 3 and 60 years of age from a single level I Trauma center...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768561/safe-duration-of-aajt-application
#4
Bijan S Kheirabadi, Michael A Dubick
No abstract text is available yet for this article.
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768560/regulation-of-endothelial-cell-permeability-by-platelet-derived-extracellular-vesicles
#5
Byron Miyazawa, Alpa Trivedi, Padma Priya Togarrati, Daniel Potter, Gyulnar Baimukanova, Lindsay Vivona, Maximillian Lin, Ernesto Lopez, Rachael Callcut, Amit K Srivastava, Lucy Z Kornblith, Alexander T Fields, Martin A Schreiber, Charles E Wade, John B Holcomb, Shibani Pati
BACKGROUND: Platelet (Plt) derived-extracellular vesicles (Plt-EVs) have hemostatic properties similar to Plts. In addition to hemostasis, Plts also function to stabilize the vasculature and maintain endothelial cell (EC) barrier integrity. We hypothesized that Plt-EVs would inhibit vascular endothelial cell permeability, similar to fresh Plts. To investigate this hypothesis we utilized in vitro and in vivo models of vascular endothelial compromise and bleeding. METHODS: In vitro: Plt-EVs were isolated by ultracentrifugation and characterized for Plt markers and particle size distribution...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768559/the-acute-inflammatory-response-after-trauma-is-heightened-by-frailty-a-prospective-evaluation-of-inflammatory-and-endocrine-system-alterations-in-frailty
#6
James Palmer, Viraj Pandit, Muhammad Zeeshan, Narong Kulvatunyou, Mohammad Hamidi, Kamil Hanna, Mindy Fain, Janko Nikolich-Zugich, El-Rasheid Zakaria, Bellal Joseph
INTRODUCTION: Frailty is a geriatric syndrome characterized by decreased physiological reserves, increased inflammation, and decreased anabolic-endocrine response. The biomarkers associated with frailty are poorly understood in trauma. The aim of this study was to analyze the association between frailty and immune: IL-1β, IL-6, IL-2Rα, TNF-α and endocrine biomarkers: Insulin-like growth factor-1(IGF-1), and growth hormone(GH) in trauma patients. METHODS: We conducted a one-year(2017-2018) prospective analysis of geriatric(≥ 65y) trauma patients admitted to our level-1 trauma center...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768558/the-promising-future-of-drones-in-prehospital-medical-care-and-its-application-to-battlefield-medicine
#7
Jonathan Braun Bsc, S David Gertz, Ariel Furer, Tarif Bader, Hagay Frenkel, Jacob Chen, Elon Glassberg, Dean Nachman
Unmanned aerial vehicles (UAV), commonly referred to as drones, have been made widely available in recent years leading to an exponential growth in their roles and applications. The rapidly developing field of medical drones is on the verge of revolutionizing pre-hospital medicine enabling advanced healthcare delivery to once-inaccessible patients. The aim of this review is to clarify the basic technical properties of currently available medical drones and review recent advances and their usefulness in military and civilian healthcare missions...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768557/not-all-dvt-is-created-equal-incidence-of-pre-existing-chronic-dvt-among-high-risk-traumatized-patients
#8
Amy Tefft, Tovah Moss, Andrew Stanley, Ajai K Malhotra
BACKGROUND: Traumatized patients are at risk of developing Deep Vein Thrombosis (DVT) and DVT prophylaxis is the standard of care. The Centers for Medicare and Medicaid Services classifies DVT as a Hospital Acquired Condition and can deny payment for treatment of DVT and, in addition, place financial penalties on hospitals with higher than acceptable rates of DVT, unless the DVT was pre-existing. We sought to determine the rate of pre-existing chronic DVT among symptomatic traumatized inpatients at our ACS-verified Level 1 trauma center...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768556/prehospital-trauma-experience-of-the-israel-defense-forces-on-the-syrian-border-2013-2017
#9
Avi Benov, Irena Shkolnik, Elon Glassberg, Roy Nadler, Sami Gendler, Ben Antebi, Jacob Chen, Noam Fink, Tarif Bader
BACKGROUND: The Israeli Defense Force Medical Corps (IDF-MC) is routinely collecting pre-hospital data to establish a pre-hospital registry. Since February 2013, Israel has been providing medical care to Syrian refugees. This unique humanitarian aid begins in pre-hospital settings and typically culminates in Israeli civilian hospitals. This report describes the accumulated experience of the IDF-MC to provide Syrian refugees with prehospital treatment. METHODS: Care provided by IDF-MC medical teams, including pre-hospital casualty care, is regularly documented and after-action reports are conducted...
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768555/dynamics-of-ards-development-due-to-smoke-inhalation-injury-implications-for-prolonged-field-care
#10
Andriy I Batchinsky, Ruth Wyckoff, Jae Hyek Choi, DVSc PhD, David Burmeister, Bryan S Jordan, Corina Necsoiu, Samuel E Burkett, Michael J Morris, Kevin K Chung, Leopoldo C Cancio
No abstract text is available yet for this article.
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30768554/american-association-for-the-surgery-of-trauma-aast-emergency-general-surgery-guidelines-gap-analysis
#11
Kevin Schuster, Kimberly Davis, Matthew Hernandez, Daniel Holena, Ali Salim, Marie Crandall
No abstract text is available yet for this article.
February 13, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741887/life-after-90-predictors-of-mortality-and-performance-of-the-acs-nsqip-risk-calculator-in-4-724-nonagenarian-patients-undergoing-emergency-general-surgery
#12
Manasnun Kongwibulwut, Kevin Chiang, Jae Moo Lee, Ahmed I Eid, Napaporn Kongkaewpaisan, Kelsey Han, Ask Tybjærg Nordestgaard, David King, Noelle Saillant, April E Mendoza, George Velmahos, Haytham M A Kaafarani
BACKGROUND: The decision to emergently operate on nonagenarian patients (NONAs) can be complex due to the uncertainty about outcomes and goals of care at this advanced age. We sought to study: 1) the outcomes and predictors of mortality for NONAs undergoing emergency general surgery (EGS) and 2) the accuracy of ACS-NSQIP mortality risk calculator in this special population. METHODS: Using the 2007-2015 ACS-NSQIP database, we included all patients older than 90 years of age who underwent an emergent operation with a CPT code for "digestive system"...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741886/american-firearm-homicides-the-impact-of-your-neighbors
#13
Erik J Olson, Mark Hoofnagle, Elinore J Kaufman, C William Schwab, Patrick M Reilly, Mark J Seamon
BACKGROUND: Restrictive firearm legislation has correlated with decreased overall firearm fatality rates, but not with firearm related homicide or firearm mortality among Black Americans. We hypothesized that firearm trafficking from states with less restrictive firearm legislation to neighboring states with more restrictive firearm legislation increases firearm homicide rates in those restrictive states. METHODS: For years 2011-2015, state firearm legislation Brady Campaign to Prevent Gun Violence scorecards were analyzed in relation to firearms traced by the Bureau of Alcohol, Tobacco, and Firearms and Center for Disease Control and Prevention firearm mortality rates...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741885/structure-and-function-of-a-trauma-intensive-care-unit-a-report-from-the-trauma-icu-prevalence-project-tripp
#14
Christopher P Michetti, Samir M Fakhry, Karen Brasel, Niels D Martin, Erik J Teicher, Chang Liu, Anna Newcomb
BACKGROUND: Specialized trauma ICU (TICU) care impacts patient outcomes. Few studies describe where and how TICU care is delivered. We performed an assessment of TICU structure and function at a sample of U.S. trauma center TICUs. METHODS: This was a multicenter study in which participants supplied information about their trauma centers, staff, clinical protocols, processes of care, and study TICU (the ICU admitting the majority of trauma patients). RESULTS: 45 Level 1 trauma centers trauma centers enrolled through the AAST multi-institutional trials platform; 71...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741884/a-nomogram-predicting-the-need-for-bleeding-interventions-after-high-grade-renal-trauma-results-from-the-american-association-for-the-surgery-of-trauma-aast-genitourinary-trauma-study
#15
Sorena Keihani, Douglas M Rogers, Bryn E Putbrese, Rachel A Moses, Chong Zhang, Angela P Presson, James M Hotaling, Raminder Nirula, Xian Luo-Owen, Kaushik Mukherjee, Bradley J Morris, Sarah Majercik, Joshua Piotrowski, Christopher M Dodgion, Ian Schwartz, Sean P Elliott, Erik S DeSoucy, Scott Zakaluzny, Brenton G Sherwood, Bradley A Erickson, Nima Baradaran, Benjamin N Breyer, Brian P Smith, Barbara U Okafor, Reza Askari, Brandi Miller, Richard A Santucci, Matthew M Carrick, Jurek F Kocik, Timothy Hewitt, Frank N Burks, Marta E Heilbrun, Jeremy B Myers
BACKGROUND: The management of high-grade renal trauma (HGRT) and the indications for intervention are not well-defined. The American Association for the Surgery of Trauma (AAST) renal grading does not incorporate some important clinical and radiologic variables associated with increased risk of interventions. We aimed to use data from a multi-institutional contemporary cohort to develop a nomogram predicting risk of interventions for bleeding after HGRT. METHODS: From 2014 to 2017, data on adult HGRT (AAST grades III-V) were collected from 14 Level-1 trauma centers...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741883/thromboelastography-on-the-go-evaluation-of-the-teg-6s-device-during-ground-and-high-altitude-aeromedical-evacuation-with-extracorporeal-life-support
#16
Teryn R Roberts, John A Jones, Jae-Hyek Choi, Kyle N Sieck, George T Harea, Daniel S Wendorff, Brendan M Beely, Vitali Karaliou, Andrew P Cap, Michael R Davis, Leopoldo C Cancio, Valerie G Sams, Andriy I Batchinsky
BACKGROUND: Coagulation monitoring capabilities during transport are limited. Thromboelastography (TEG) is a whole-blood clotting test measuring clot formation, stabilization and fibrinolysis; and is traditionally performed in a laboratory. We evaluated a new point-of-care TEG analyzer, TEG 6s (Haemonetics; Braintree, MA), in a large animal model of combat-relevant trauma managed with extracorporeal life support (ECLS) during ground and high-altitude aeromedical evacuation. The objective was to compare TEG 6s used during transport vs...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741882/helicopter-medevac-in-the-korean-war-did-it-matter
#17
Justin Barr, Sean P Montgomery
BACKGROUND: Due to M*A*S*H and other popular portrayals, helicopter evacuation of casualties has been closely linked to the Korean War. We sought to investigate their role in military medicine during this conflict. MATERIALS AND METHODS: This study incorporated a thorough review of the original source documents dating to the Korean War that are housed in the National Archives, the Military History Institute, and other repositories. RESULTS: Medical evacuation helicopters entered the war late, after the United Nations forces had suffered the majority of their casualties...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741881/comparison-of-the-efficacy-of-a-bougie-and-stylet-in-patients-with-endotracheal-intubation-a-meta-analysis-of-randomized-controlled-trials
#18
Yu-Jia Sheu, Sung-Wei Yu, Tsai-Wei Huang, Feng-Lin Liu, Yen-Kuang Lin, Ka-Wai Tam
BACKGROUND: Endotracheal intubation (ETI) is a procedure widely performed for several clinical indications. In typical ETI, an endotracheal tube is placed into a patient's trachea with the help of a malleable metal rod covered with a clear plastic sheath (called a "stylet"). However, another intubation aid, a bougie (also named a "gum elastic bougie" or "endotracheal tube introducer"), was also introduced in the clinical setting to improve the efficacy of conventional ETI...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741880/pediatric-blunt-renal-trauma-practice-management-guidelines-collaboration-between-the-eastern-association-for-the-surgery-of-trauma-and-the-pediatric-trauma-society
#19
Judith C Hagedorn, Nicole Fox, Jonathan S Ellison, Robert Russell, Cordelie E Witt, Kristen Zeller, Paula Ferrada, John M Draus
BACKGROUND: Injury to the kidney from either blunt or penetrating trauma is the most common urinary tract injury. Children are at higher risk of renal injury from blunt trauma than adults, but no pediatric renal trauma guidelines have been established. The authors reviewed the literature to guide clinicians in the appropriate methods of management of pediatric renal trauma. METHODS: GRADE methodology was used to aid with the development of these evidence based practice management guidelines...
February 7, 2019: Journal of Trauma and Acute Care Surgery
https://read.qxmd.com/read/30741879/pediatric-firearm-incidents-it-s-time-to-decrease-on-scene-mortality
#20
Jessica Friedman, Marcus Hoof, Alison Smith, Danielle Tatum, Kareem Ibraheem, Chrissy Guidry, Rebecca Schroll, Juan Duchesne, Patrick McGrew
BACKGROUND: Previous epidemiological studies on pediatric firearm mortality have focused on overall mortality rather than on-scene mortality. Despite advances in trauma care, the number of potentially preventable deaths remains high. This study utilized the National Emergency Medical Services Information Systems database (NEMSIS) to characterize patterns of on-scene mortality in order to identify patients who may benefit from changes to prehospital care practices. METHODS: NEMSIS was searched for all pediatric firearm incidents from 2010-2015...
February 7, 2019: Journal of Trauma and Acute Care Surgery
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