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"Triage" AND "Trauma"

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https://read.qxmd.com/read/30774531/validity-and-reliability-of-the-manchester-scale-used-in-the-orthopedic-emergency-department
#1
Fernando Brandão Andrade-Silva, Renan Lyuji Takemura, Renato Tavares Bellato, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Jorge Dos Santos Silva
Objectives: To describe the clinical utility of the Manchester triage scale adapted for orthopedic emergency departments and to evaluate its validity in identifying patients with the need for hospital care and its reliability when reproduced by different professionals. Methods: Five triage flowcharts were developed based on the Manchester scale for the following orthopedic disorders: traumatic injuries, joint pain, vertebral pain, postoperative disorders, and musculoskeletal infections...
January 2019: Acta Ortopedica Brasileira
https://read.qxmd.com/read/30770955/a-mixed-psychiatric-and-somatic-care-unit-for-trauma-patients-10-years-of-experience-in-an-urban-level-i-trauma-center-in-the-netherlands
#2
Lisette Dekker, Hansje M Heller, Jessica E van der Meij, Annelies E J Toor, Leo M G Geeraedts
BACKGROUND: A medical-psychiatric unit (MPU) is a special ward where staff is trained in caring for patients with psychiatric or behavioural problems that need hospitalisation for physical health problems. It is well known that these patients are at higher risk of complications and have a longer length of stay resulting in higher costs than patients without psychiatric comorbidity. The objective of this study was to analyse the trauma patient population of the first 10 years of existence of the MPU in a level I trauma center...
February 15, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/30747699/early-fast-examinations-during-resuscitation-may-compromise-trauma-outcomes
#3
John Kleinman, Kenji Inaba, Emily Pott, Kazuhide Matsushima, Demetrios Demetriades, Aaron Strumwasser
Focused assessment with Sonography for trauma (FAST) examination is essential to trauma triage. We sought to determine whether FASTs completed early in sequencing portend worse outcomes. A two-year review (2014-2015) of all trauma activations at our Level I trauma center was performed. Patients were matched at baseline and FAST times were compared. Outcomes included resuscitation time (RESUS-h), ventilation days (d), hospital length of stay (HLOS-d), ICU length of stay (LOS-d), survival (%), nosocomial infection rate (%), and venous thromboembolism complication rate (%)...
October 1, 2018: American Surgeon
https://read.qxmd.com/read/30744682/comparison-of-minor-head-trauma-management-in-the-emergency-departments-of-a-united-states-and-italian-children-s-hospital
#4
Brittany M Stopa, Stefano Amoroso, Luca Ronfani, Elena Neri, Egidio Barbi, Lois K Lee
BACKGROUND: Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital. METHODS: We conducted a retrospective chart review of children 0-18 years old presenting after minor head trauma (Glasgow Coma Scale 14-15) from two emergency departments, in Boston, Massachusetts, United States and Trieste, Italy, between January and December 2013. Frequencies of demographic, clinical, and management characteristic were calculated...
February 11, 2019: Italian Journal of Pediatrics
https://read.qxmd.com/read/30739888/the-predictive-value-of-triage-early-warning-score-tews-on-mortality-of-trauma-patients-presenting-to-the-emergency-department
#5
Gökhan Torun, Vahide Aslihan Durak
INTRODUCTION: Posttraumatic injuries are among the most frequent reasons of admission to emergency room services (ERs). In the first assessment of the cases, ATLS protocols recommends use of triage decision scheme consisting of parametres of abnormal physiologic findings, anatomic injury site, pathogenic mechanism of injury, concomitant diseases and conditions, and activation of trauma teams in line with these criteria. The aim of this study is to evaluate TEWS(Triage Early Warning Score) as a marker for predicting mortality in trauma patients who presented to Emergency Services...
February 4, 2019: Annali Italiani di Chirurgia
https://read.qxmd.com/read/30735553/defining-the-representativeness-heuristic-in-trauma-triage-a-retrospective-observational-cohort-study
#6
Shreyus S Kulkarni, Barry Dewitt, Baruch Fischhoff, Matthew R Rosengart, Derek C Angus, Melissa Saul, Donald M Yealy, Deepika Mohan
BACKGROUND: Under-triage of severely injured patients presenting to non-trauma centers (failure to transfer to a trauma center) remains problematic despite quality improvement efforts. Insights from the behavioral science literature suggest that physician heuristics (intuitive judgments), and in particular the representativeness heuristic (pattern recognition), may contribute to under-triage. However, little is known about how the representativeness heuristic is instantiated in practice...
2019: PloS One
https://read.qxmd.com/read/30725101/development-and-validation-of-a-prediction-model-for-prehospital-triage-of-trauma-patients
#7
Eveline A J van Rein, Rogier van der Sluijs, Frank J Voskens, Koen W W Lansink, R Marijn Houwert, Rob A Lichtveld, Mariska A de Jongh, Marcel G W Dijkgraaf, Howard R Champion, Frank J P Beeres, Luke P H Leenen, Mark van Heijl
Importance: Prehospital trauma triage protocols are used worldwide to get the right patient to the right hospital and thereby improve the chance of survival and avert lifelong disabilities. The American College of Surgeons Committee on Trauma set target levels for undertriage rates of less than 5%. None of the existing triage protocols has been able to achieve this target in isolation. Objective: To develop and validate a new prehospital trauma triage protocol to improve current triage rates...
February 6, 2019: JAMA Surgery
https://read.qxmd.com/read/30725075/optimizing-prehospital-trauma-triage-a-step-closer
#8
Jason S Haukoos, Eric M Campion, Peter T Pons
No abstract text is available yet for this article.
February 6, 2019: JAMA Surgery
https://read.qxmd.com/read/30719879/early-diagnosis-of-traumatic-intracranial-hematomas
#9
Hasan Ayaz, Meltem Izzetoglu, Kurtulus Izzetoglu, Banu Onaral, Baruch Ben Dor
Timing of the intervention for intracranial hematomas is critical for its success, specifically since expansion of the hemorrhage can result in debilitating and sometimes fatal outcomes. Led by Britton Chance, we and an extended team from University of Pennsylvania, Baylor and Drexel universities developed a handheld brain hematoma detector for early triage and diagnosis of head trauma victims. After obtaining de novo Food and Drug Administration clearance, over 200 systems are deployed in all Marine battalion aid stations around the world...
February 2019: Journal of Biomedical Optics
https://read.qxmd.com/read/30703160/predicting-in-hospital-mortality-among-non-trauma-patients-based-on-vital-sign-changes-between-prehospital-and-in-hospital-an-observational-cohort-study
#10
Yohei Kamikawa, Hiroyuki Hayashi
OBJECTIVE: To prevent misjudgment of the severity of patients in the emergency department who initially seem non-severe but are in a critical state, methods that differ from the conventional viewpoint are needed. We aimed to determine whether vital sign changes between prehospital and in-hospital could predict in-hospital mortality among non-trauma patients. METHODS: This observational cohort study was conducted in two tertiary care hospitals. Patients were included if they were transported by ambulance for non-trauma-related conditions but were excluded if they experienced prehospital cardiopulmonary arrest, were pregnant, were aged <15 years, had undergone inter-hospital transfer, or had complete missing data regarding prehospital or in-hospital vital signs...
2019: PloS One
https://read.qxmd.com/read/30702641/management-of-pain-after-pediatric-trauma
#11
Lindsay Marie Day, Rong Huang, Pamela Joy Okada
OBJECTIVES: The primary objective of this study was to evaluate the management of pain after traumatic injury in the pediatric emergency department (ED) as measured by time to analgesic administration and pain resolution, stratified by triage acuity level. METHODS: This is a retrospective descriptive study evaluating the management of children who presented with pain after injury to an urban level 1 trauma center. Consecutive enrollment of 1000 patients identified by ICD-9 codes that included all injuries or external causes for injury (700-999 and all E codes) and who had pain identified by triage pain assessment was performed...
January 29, 2019: Pediatric Emergency Care
https://read.qxmd.com/read/30694834/thoracic-trauma-in-military-settings-a-review-of-current-practices-and-recommendations
#12
Corey Scher, Robert Mansky
PURPOSE OF REVIEW: To examine current literature on thoracic trauma related to military combat and to explore its relevance to the civilian population. RECENT FINDINGS: Damage control resuscitation (DCR) has improved the management of hemorrhaging trauma patients. Permissive hypotension below 110 mmHg and antifibrinolytic use during DCR is widely accepted, whereas the use of freeze-dried plasma and whole blood is gaining popularity. The Modified Physiologic Triaging Tool can be used for primary triage and it may have applications in civilian trauma systems...
January 28, 2019: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/30694782/interfacility-transfer-is-associated-with-lower-mortality-in-undertriaged-gunshot-wound-patients
#13
Audrey Renson, Finn D Schubert, Laura J Gabbe, Marc A Bjurlin
BACKGROUND: Treatment at a Level I trauma center yields better outcomes for patients with moderate-to-severe injury as compared with treatment in nontrauma centers. We examined the association between interfacility transfer to a level I or II trauma center and mortality for gunshot wound patients, among patients initially transported to a lower level or undesignated facility. MATERIALS AND METHODS: This retrospective cohort study included all patients from the National Trauma Data Bank (2010-2015) with firearm as the external cause of injury, who met CDC criteria for emergency medical services triage to a higher level (American College of Surgeons [ACS] Level II or above) trauma center...
December 7, 2018: Journal of Surgical Research
https://read.qxmd.com/read/30691789/is-it-safe-to-fly-patients-with-penetrating-trauma-in-a-rural-state
#14
Jordan W Greer, Rebecca Reif, Saleema Karim, William C Beck, Avi Bhavaraju, Ben Davis, John R Taylor, Kevin W Sexton
BACKGROUND: There is limited data pertaining to the triage and transportation of patients with penetrating trauma in rural states. Large urban trauma centers have found rapid transport to be beneficial even when done by nonemergency medical staff. However, there is limited application to a rural state with only a single level 1 trauma center. MATERIALS AND METHODS: This a retrospective observational study of 854 trauma patients transported by helicopter emergency services between 2009 and 2015 to the state's only level 1 trauma center...
March 2019: Journal of Surgical Research
https://read.qxmd.com/read/30691557/retrospective-analysis-of-emergency-computed-tomography-imaging-utilization-at-an-academic-centre-an-analysis-of-clinical-indications-and-outcomes
#15
Jason Seidel, Mary Beth Bissell, Sannihita Vatturi, Angus Hartery
PURPOSE: To explore resource utilization through evaluation of computed tomography (CT) imaging trends in the emergency department by examining common indications/outcomes for imaging in this setting. METHODS: A retrospective analysis of clinical indications/outcomes for all CT imaging in 3 emergency departments over a 1-year period was conducted. Scans were divided by body part and the most common indications for each type of scan were determined. Clinical outcomes from each study were extracted from final interpretations by the reporting radiologist...
February 2019: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://read.qxmd.com/read/30686364/gunshot-wounds-ballistics-and-imaging-findings
#16
Antonio Pinto, Anna Russo, Alfonso Reginelli, Francesca Iacobellis, Marco Di Serafino, Sabrina Giovine, Luigia Romano
Ballistic traumas are defined by a projectile entering the body. Such projectiles include bullets, birdshot, and metal fragments from the covering or the contents of an explosive device. They frequently cause severe wounds characterized by a range of clinical pictures and a large spectrum of concomitant wounds. The major aims of imaging are to define the path of the projectile or projectiles, to evaluate which tissues have been injured, to estimate the severity of injury, and to determine what additional studies are needed...
February 2019: Seminars in Ultrasound, CT, and MR
https://read.qxmd.com/read/30667041/mass-casualty-incidents-and-b-con-training
#17
Jose A Robaina, Scott B Crawford, Diane Huerta, Danielle Austin, Radosveta M Wells, Stormy M Monks
OBJECTIVE: The purpose of this study was to determine if providing mass casualty training, utilizing the Bleeding Control for the Injured (B-Con) course would allow participants to feel more confident to provide bystander aid to wounded victims in a mass casualty incident (MCI). DESIGN: Quasi-experimental pre-post intervention study. SETTING: Participants were healthcare providers attending a trauma research conference hosted by a medical university...
November 2018: Journal of Emergency Management: JEM
https://read.qxmd.com/read/30664055/ability-of-a-risk-prediction-tool-to-stratify-quality-and-cost-of-older-patients-with-operative-ankle-fractures
#18
Ariana Lott, Kenneth A Egol, Thomas Lyon, Sanjit R Konda
OBJECTIVES: To investigate the ability of a validated geriatric trauma risk prediction tool to stratify hospital quality metrics and inpatient cost for middle-aged and geriatric patients admitted from the ED for operative treatment of an ankle fracture. DESIGN: Prospective cohort study SETTING:: Single Academic Medical Center PATIENTS:: Patients aged 55 and older who sustained a rotational ankle fracture and were treated operatively during their index hospitalization INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional status...
January 17, 2019: Journal of Orthopaedic Trauma
https://read.qxmd.com/read/30662202/magnetic-resonance-imaging-of-ankle-ligaments-a-pictorial-essay
#19
Yogini Nilkantha Sawant, Darshana Sanghvi
Ankle trauma is commonly encountered and is most often a sprain injury affecting the ligaments. Accurate diagnosis and appropriate treatment rest on knowledge of complex ligamentous anatomy of ankle and the entire spectrum of pathologies. Magnetic resonance imaging (MRI) is the imaging modality of choice for diagnosing ligament pathologies because of its multiplanar capability and high soft tissue contrast. With MRI, it is possible to triage and attribute the cause of post traumatic ankle pain to bone, ligament, or tendon pathologies, which otherwise overlap clinically...
October 2018: Indian Journal of Radiology & Imaging
https://read.qxmd.com/read/30661273/identifying-predictors-of-under-triage-in-injured-older-adults-after-implementation-of-statewide-geriatric-trauma-triage-criteria
#20
Jeffrey Amoako, Sara Evans, Nicole V Brown, Salman Khaliqdina, Jeffrey M Caterino
OBJECTIVES: Identify factors associated with transport of injured older adults meeting statewide geriatric trauma triage criteria to a trauma center. METHODS: An observational retrospective cohort study using the 2009-2011 Ohio Trauma Registry. Subjects were adults ≥70 years old who met Ohio's geriatric triage criteria for trauma center transport by emergency medical services. We created multivariable logistic regression models to identify predictors of initial and ultimate (e...
January 20, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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