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https://read.qxmd.com/read/30872306/head-injury-in-the-elderly-an-overview-for-the-physician
#1
William Beedham, George Peck, Simon E Richardson, Kevin Tsang, Michael Fertleman, David Jh Shipway
Head injury is a common cause for hospital admission and additionally 250,000 UK inpatients fall during hospital admissions annually. Head injury most commonly occurs as a result of falls from standing height in older adults. Older adults are frequently frail and multi-morbid; many have indications for anticoagulation and antiplatelet agents. The haemorrhagic complications of head injury occur in up to 16% of anticoagulated patients sustaining a head injury. These patients suffer adverse outcomes from surgery as a result of medical complications...
March 2019: Clinical Medicine: Journal of the Royal College of Physicians of London
https://read.qxmd.com/read/30854162/computed-tomography-in-trauma-patients-accepted-in-transfer-missed-injuries-and-rationale-for-repeat-imaging-can-we-do-better
#2
Seth A Vernon, Stephen D Helmer, Jeanette G Ward, James M Haan
Introduction: Computed tomography scans often are repeated on trauma patient transfers, leading to increased radiation exposure, resource utilization, and costs. This study examined the incidence of repeated computed tomography scans (RCT) in trauma patient transfers before and after software upgrades, physician education, and encouragement to reduce RCT. Methods: The number of RCTs at an American College of Surgeons Committee on Trauma verified level 1 trauma center was measured...
February 2019: Kansas Journal of Medicine
https://read.qxmd.com/read/30840092/suicidal-fall-from-heights-trauma-difficult-management-and-poor-results
#3
Dario Piazzalunga, Francesca Rubertà, Paola Fugazzola, Niccolò Allievi, Marco Ceresoli, Stefano Magnone, Michele Pisano, Federico Coccolini, Matteo Tomasoni, Giulia Montori, Luca Ansaloni
BACKGROUND: Self-inflicted injuries represent a consistent cause of trauma and falls from heights (FFH) represent a common dynamic used for suicidal attempts. The aim of the current report is to compare, among FFH patients, unintentional fallers and intentional jumpers in terms of demographical characteristics, clinical-pathological parameters and mortality, describing the population at risk for suicide by jumping and the particular patterns of injury of FFH patients. MATERIALS AND METHODS: The present study is a retrospective analysis of prospectively collected data regarding FFH patients, extracted from the Trauma Registry of the Papa Giovanni XXIII Hospital in Bergamo, Italy...
March 6, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://read.qxmd.com/read/30826834/death-and-dying-tools-to-help-respiratory-therapists-handle-frequent-exposure-to-end-of-life-care
#4
Kyle Mahan
Education and recognition of death anxiety are important for respiratory therapists. A vital component of respiratory therapy is managing mechanical ventilation and dealing with death and dying. For most institutions, respiratory therapy is a vital component of the rapid response team, code team, and trauma team. Removal of mechanical ventilation is a duty primarily bestowed upon the respiratory therapist. Exposure to death, on a frequent basis, can take an emotional toll and lead to burnout, stress, and increased turnover...
2019: Journal of Allied Health
https://read.qxmd.com/read/30824337/sensitivity-and-specificity-of-trauma-team-activation-protocol-criteria-in-an-italian-trauma-center-a-retrospective-observational-study
#5
Claudio Maliziola, Simona Frigerio, Salvatore Lanzarone, Alessandra Barale, Maurizio Berardino, Marco Clari
BACKGROUND: The trauma team (TT) model could reduce mortality, morbidity, and duration of hospital stay, costs, and complications. To avoid over- or undertriage for trauma team activation, robust criteria have to be chosen. OBJECTIVE: This study aimed to evaluate the sensitivity and specificity of a TT activation protocol for major trauma patients to predict the need for emergency treatment. METHODS: A retrospective observational study was carried out in the Emergency Department (ED) of a major Italian trauma center...
February 26, 2019: International Emergency Nursing
https://read.qxmd.com/read/30798651/geographical-distribution-and-roles-of-centralized-hand-trauma-services-in-europe
#6
Michel E H Boeckstyns, Hebe D Kvernmo
No abstract text is available yet for this article.
January 2019: Journal of Hand Surgery, European Volume
https://read.qxmd.com/read/30747642/patient-characteristics-associated-with-comfort-care-among-trauma-patients-at-a-level-i-trauma-center
#7
Sean P Geary, Maria R Brown, Christopher Decker, Lisa M Angotti, Ashar Ata, Carl Rosati
Trauma patients admitted to the intensive care unit are a unique population with high mortality. This study aims to identify characteristics predicting the likelihood of progressing to palliative management often referred to as comfort care measures, thus enabling the trauma team to broach end-of-life decisions earlier in these patients' care. This is a retrospective analysis of the prospectively collected New York State Trauma Registry database for a single Level I trauma center for patients admitted from 2008 to 2015...
November 1, 2018: American Surgeon
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
#8
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/30736956/a-novel-streamlined-trauma-response-team-training-improves-imaging-efficiency-for-pediatric-blunt-abdominal-trauma-patients
#9
Benjamin K Nti, Megan Laniewicz, Tracy Skaggs, Keith Cross, Mary E Fallat, Annie Rominger
BACKGROUND/PURPOSE: The morbidity and mortality of children with traumatic injuries are directly related to the time to definitive management of their injuries. Imaging studies are used in the trauma evaluation to determine the injury type and severity. The goal of this project is to determine if a formal streamlined trauma response improves efficiency in pediatric blunt trauma by evaluating time to acquisition of imaging studies and definitive management. METHODS: This study is a chart review of patients <18 years who presented to a pediatric trauma center following blunt trauma requiring trauma team activation...
January 23, 2019: Journal of Pediatric Surgery
https://read.qxmd.com/read/30723648/geriatric-consultation-reduces-high-risk-medication-usage-at-discharge-in-elderly-trauma-patients
#10
Jyoti Sharma, Manisha Parulekar, Peter Stewart, Melissa Blatt, Tania Zielonka, Themba Nyirenda, Christopher Rogers, Lisa Tank
Background Traumatic injury in a growing geriatric population is associated with higher mortality and complication rates. Geriatric consultation (GC) is vital in reducing risk factors that contribute to adverse outcomes. This study aims to determine if receiving a GC had an impact on high-risk medication usage. Methods Patients eligible for a GC, age ≥ 65, and length of stay > two days, were identified via a chart review from July 2013 to July 2014 at a Level II trauma center. This population was divided into those with and without a GC...
November 28, 2018: Curēus
https://read.qxmd.com/read/30720565/hermeneutic-phenomenological-study-of-military-nursing-officers
#11
Lisa Conlon, Rick Wiechula, Amanda Garlick
BACKGROUND: Nurses working in military trauma teams often work in hostile and remote locations. They are faced with the burden of carrying out their duties while ensuring the safety of their patients and themselves in areas of conflict and humanitarian crisis. The stories and experiences of military nurses often go untold. In a phenomenological study, six Australian Defence Force Nursing Officers share their stories of working as members of military trauma teams. OBJECTIVES: The aim of this study was to gain an understanding of the lived experiences of nursing officers when working as a member of a military trauma team...
January 31, 2019: Nursing Research
https://read.qxmd.com/read/30711425/the-golden-opportunity-multidisciplinary-simulation-training-improves-trauma-team-efficiency
#12
Andrea M Long, Cedric M Lefebvre, David A Masneri, Nathan T Mowery, Michael C Chang, James E Johnson, Jeffrey E Carter
OBJECTIVE: Every trauma patient has a golden hour, and resuscitation efficiency within that hour has large implications for patients. We instituted simulation based trauma resuscitation training with the hypothesis that it would improve trauma team efficiency. METHODS: Five simulation training sessions were conducted with immediate debriefing. Metrics collected in actual trauma resuscitations before and after simulation training included time of primary and secondary surveys and time to computed tomography (CT) scan...
January 30, 2019: Journal of Surgical Education
https://read.qxmd.com/read/30711226/advanced-trauma-life-support-%C3%A2-update-2019-management-and-applications-for-adults-and-special-populations
#13
REVIEW
Samuel M Galvagno, Jeffry T Nahmias, David A Young
As the principal operating room resuscitationists, anesthesiologists must be familiar with the principles of Advanced Trauma Life Support® , 10th edition. This edition recommends a highly structured approach to trauma patients and endorses several advances in trauma resuscitation. There are less stringent guidelines for crystalloid administration, references to video-assisted laryngoscopy, suggested use of viscoelastic methods to guide transfusion decisions, and other changes reflecting recent advances. This article discusses trauma team approach to resuscitation, greater focus on special populations, de-emphasis of spinal immobilization in favor of restriction of spinal motion, and other updates and technical advances...
March 2019: Anesthesiology Clinics
https://read.qxmd.com/read/30709761/the-cfi-score-validation-of-a-new-comprehensive-severity-scoring-system-for-facial-injuries
#14
Gabriele Canzi, Elena De Ponti, Giorgio Novelli, Fabio Mazzoleni, Osvaldo Chiara, Alberto Bozzetti, Davide Sozzi
At the time of writing there is no measuring scale for the severity of facial trauma that can effectively summarize its clinical relevance, and can therefore be proposed as a definitive tool in trauma center decision making. This paper introduces a new, simple, comprehensive, and reproducible score for facial trauma, in which its severity is expressed in relation to the surgical duration necessary for definitive treatment. This parameter is identified as the most significant in expressing the commitment of care required...
March 2019: Journal of Cranio-maxillo-facial Surgery
https://read.qxmd.com/read/30704778/facilitators-and-barriers-to-the-clinical-application-of-teamwork-skills-taught-in-multidisciplinary-simulated-trauma-team-training
#15
Margaret Murphy, Kate Curtis, Andrea McCloughen
BACKGROUND: Efforts to improve teamwork in trauma include simulation-based team training with a non-technical skills (NTS) focus. However, there is a lack of evidence to inform the development of team training programs for maximum uptake of NTS in clinical practice. This descriptive paper aims to evaluate the extent NTS were practiced by the trauma team in a Level 1 trauma hospital after NTS training and to identify facilitators and barriers to use of NTS in clinical practice. METHOD: A 38-item questionnaire targeting clinicians who attended a simulation based multidisciplinary Trauma Team Training program was developed...
January 19, 2019: Injury
https://read.qxmd.com/read/30700296/translatability-and-validation-of-non-technical-skills-scale-for-trauma-t-notechs-for-assessing-simulated-multi-professional-trauma-team-resuscitations
#16
Jussi P Repo, Eerika Rosqvist, Seppo Lauritsalo, Juha Paloneva
BACKGROUND: The 5-item non-technical skills scale for trauma (T-NOTECHS) with five response categories is developed to assess non-technical skills in trauma team resuscitations. This validated instrument assesses behavioral aspects in teamwork. Outcome instruments should undergo a robust adaptation process followed by psychometric validation to maintain their measurement properties when translated into different languages. The translatability of the T-NOTECHS into a non-Anglo-Saxon language has not been thus far unraveled...
January 30, 2019: BMC Medical Education
https://read.qxmd.com/read/30696350/primary-repair-of-duodenal-injuries-a-retrospective-cohort-study-from-a-major-trauma-centre-in-south-africa
#17
R D Weale, V Y Kong, W Bekker, J L Bruce, G V Oosthuizen, G L Laing, D L Clarke
BACKGROUND AND AIMS: The management of duodenal trauma remains controversial. This retrospective audit of a prospectively maintained database was intended to clarify the operative management of duodenal injury at our institution and to assess the risk factors for leak following primary duodenal repair. MATERIALS AND METHODS: This was a retrospective study undertaken at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa. Operative techniques used for duodenal repair were recorded...
January 29, 2019: Scandinavian Journal of Surgery: SJS
https://read.qxmd.com/read/30694849/implementation-of-a-trauma-quality-improvement-program-communications-package-decreases-time-to-operation-for-facial-trauma
#18
Patrick R Keller, Steven Schneeberger, Brian C Drolet, Salam Al Kassis, F Bennett Pearce, Galen Perdikis
INTRODUCTION: Facial trauma is common and carries significant morbidity and cost. Suboptimal interdisciplinary communication is associated with negative health outcomes. This study evaluates the clinical impact of implementation of American College of Surgeons Trauma Quality Improvement Program (TQIP) interdisciplinary communication guidelines between facial surgery and trauma teams. METHODS: Patients with facial trauma presenting to our level 1 trauma center between May and December 2017 were included (N = 812) and split into 3 groups, each anonymously representing a service that treats facial trauma...
January 28, 2019: Annals of Plastic Surgery
https://read.qxmd.com/read/30690872/improving-emergency-department-trauma-care-in-fiji-implementing-and-assessing-the-trauma-call-system
#19
Lavinesh Kumar Raj, Anne Creaton, Georgina Phillips
OBJECTIVE: The trauma team process was recently implemented at the Colonial War Memorial (CWM) Hospital, Suva. This study audits the trauma call procedure at the hospital over a period of 12 months. METHOD: Retrospective descriptive study of trauma calls from August 2015 to July 2016 at CWM Hospital. Data relating to patient demographics, time of presentation, time to team assembly and time to computed tomography (CT) scan were extracted from the ED trauma call database...
January 28, 2019: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/30682106/trauma-induced-acute-kidney-injury
#20
Zane B Perkins, Gabriella Captur, Ruth Bird, Liam Gleeson, Ben Singer, Benjamin O'Brien
BACKGROUND: Injured patients are at risk of developing acute kidney injury (AKI), which is associated with increased morbidity and mortality. The aim of this study is to describe the incidence, timing, and severity of AKI in a large trauma population, identify risk factors for AKI, and report mortality outcomes. METHODS: A prospective observational study of injured adults, who met local criteria for trauma team activation, and were admitted to a UK Major Trauma Centre...
2019: PloS One
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