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"Trauma" AND ("Pre-Hospital" OR "Pre Hospital")

Tsegazeab Laeke, Abenezer Tirsit, Finot Debebe, Biruk Girma, Desalegn Gere, Kee B Park, Aklilu Azazh
BACKGROUND: Consistent data on head injury is lacking especially in the low and middle income countries. Our study tries to characterize head injury patients at the emergency room of one of the few tertiary public hospitals giving neurosurgical care in the country. METHODS: A retrospective cross sectional study done from May 2015 -October 2015 in one of the neurosurgical teaching hospitals, Black Lion Specialized Hospital. All adult head injury patients who visited the emergency department during the study period were included...
March 13, 2019: World Neurosurgery
(no author information available yet)
In order to provide the clinical guidelines of acute thoracolumbar injury for the Chinese orthopedic surgeons, the Spine Trauma Group of Chinese Association of Orthopedic Surgeons compiled this guideline. The guideline applies to adult patients with acute (less than 3 weeks) thoracolumbar fracture and(or) dislocation with or without spinal cord, cauda equina or nerve root injuries. The Study Group wrote the guideline by setting up questions, determining search words, screening literatures according to inclusion and exclusion criteria, analyzing the included literatures, confirming evidence levels and then providing recommendations...
March 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Stéphanie Roullet, Laurent Weinmann, Sylvie Labrouche, Chloé Gisbert-Mora, Matthieu Biais, Philippe Revel, Geneviève Freyburger
Hyperfibrinolysis contributes to the pathophysiology of trauma-induced coagulopathy. At present, systematic administration of tranexamic acid (TXA) is recommended in all patients in the early phase of trauma. However, there is some debate regarding whether TXA is beneficial in all trauma patients. A rapid and accurate tool to diagnose hyperfibrinolysis may be useful for tailoring TXA treatment. We conducted a proof-of-concept study of consecutive adult trauma patients. A first blood sample was obtained at the time of pre-hospital care (T1)...
March 12, 2019: Scandinavian Journal of Clinical and Laboratory Investigation
David Gomez, Kristian Larsen, Brian J Burns, Michael Dinh, Jeremy Hsu
INTRODUCTION: Getting the right patient, to the right place, at the right time is dependent on a multitude of modifiable and non-modifiable factors. One potentially modifiable factor is the number and location of trauma centres (TC). Overabundance of TC dilutes volumes and could be associated with worse outcomes. We describe a methodology that evaluates trauma system reconfiguration without reductions in potential access to care. We used the mature trauma system of New South Wales (NSW) as a model given the perceived overabundance of urban major trauma centres (MTC)...
February 27, 2019: Injury
Kenton L Anderson, Alejandra G Mora, Andrew D Bloom, Joseph K Maddry, Vikhyat S Bebarta
INTRODUCTION: Survival from traumatic cardiopulmonary arrest (TCA) has been reported at a rate as low as 0-2.6% in the civilian pre-hospital setting, and many consider resuscitation of this group to be futile. The aim of this investigation was to describe patients who received cardiac massage during TCA in a battlefield setting; we also aimed to identify predictors of survival. METHODS: We conducted a review of the Department of Defense Trauma Registry to identify patients who received cardiac massage in the battlefield between 2007 and 2014...
February 27, 2019: Resuscitation
Nanyori J Lucumay, Hendry R Sawe, Amour Mohamed, Erasto Sylvanus, Upendo George, Juma A Mfinanga, Ellen J Weber
BACKGROUND: The outcomes of trauma are considered to be time dependent. Efficient and timely pre-referral stabilization of trauma patients has been shown to impact survival. Tanzania has no formal pre-hospital or trauma system. World Health Organisation has provided a set of standards for initial stabilization of trauma patients according to the level of the hospitals. We aimed to describe pre-referral stabilization provided to adult trauma patient referred to the national referral hospital and compliance with World Health Organisation guidelines...
February 28, 2019: BMC Emergency Medicine
Federico Coccolini, Giacinto Pizzilli, Davide Corbella, Massimo Sartelli, Vanni Agnoletti, Vanessa Agostini, Gian Luca Baiocchi, Luca Ansaloni, Fausto Catena
Background: Trauma-induced coagulopathy is one of the most difficult issues to manage in severely injured patients. The plasma efficacy in treating haemorrhagic-shocked patients is well known. The debated issue is the timing at which it should be administered. Few evidences exist regarding the effects on mortality consequent to the use of plasma alone given in pre-hospital setting. Recently, two randomized trials reported interesting and discordant results. The present paper aims to analyse data from those two randomized trials in order to obtain more univocal results...
2019: World Journal of Emergency Surgery: WJES
Lusha Xiang, Michael S Thompson, John S Clemmer, Peter N Mittwede, Tazim Khan, Robert L Hester
Early post-trauma hyperglycemia (EPTH) is correlated with later adverse outcomes including acute kidney injury (AKI). We have shown that following orthopedic trauma, obese Zucker rats (OZ) exhibit EPTH and a later development of AKI (within 24 hours). We hypothesized that GLP-1 treatment after trauma decreases EPTH and protects renal function in OZ. OZ were fasted for 4 hours before trauma. Soft tissue injury, fibula fracture, and homogenized bone component injection were then performed in both hind limbs to induce severe extremity trauma...
February 27, 2019: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Arasch Wafaisade, Michael Caspers, Bertil Bouillon, Matthias Helm, Matthias Ruppert, Michael Gäßler
BACKGROUND: Airway management and use of intravenous anaesthetics to facilitate tracheal intubation after major trauma remains controversial. Numerous agents are available and used for pre-hospital rapid-sequence induction (RSI). The aim was to investigate usage and potential changes in administration of intravenous anaesthetics for pre-hospital RSI in trauma patients over a ten-year period. METHODS: Based on a large helicopter emergency medical service (HEMS) database in Germany between 2006 and 2015, a total of 9720 HEMS missions after major trauma leading to RSI on scene were analysed...
February 26, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Rauend Rauf, Francesca von Matthey, Moritz Croenlein, Michael Zyskowski, Martijn van Griensven, Peter Biberthaler, Rolf Lefering, Stefan Huber-Wagner
BACKGROUND: The temporal distribution of trauma mortality has been classically described as a trimodal pattern with an immediate, early and late peak. In modern health care systems this time distribution has changed. METHODS: Data from the TraumaRegister DGU was analysed retrospectively. Between 2002 and 2015, all registered in-hospital deaths with an Injury Severity Score (ISS) ≥ 16 were evaluated considering time of death, trauma mechanism, injured body area, age distribution, rates of sepsis and multiple organ failure...
2019: PloS One
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
Bismil Ali Ali, Tuomas Brinck, Lauri Handolin, Tomas Belzunegui Otano
PURPOSE: To compare the profile, treatment and outcome of elderly patients with severe traumatic brain injuries (TBI) between southern Finland and Navarra (Spain). METHODS: Data collected from, 2010 to 2015, in the Major Trauma Registry of Navarra (MTR-N) and the Helsinki Trauma Registry (HTR) were compared. Patients with New Injury Severity Score (NISS) ≥ 16 and age ≥ 65 with isolated severe TBI were considered. Patients who had been admitted to the hospital ≥ 24 h after the trauma, had been pronounced dead before hospital arrival, or had been injured by hanging, drowning or burns, were excluded...
February 12, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Il-Jae Wang, Byung-Kwan Bae, Sung-Wook Park, Young-Mo Cho, Dae-Sup Lee, Mun-Ki Min, Ji-Ho Ryu, Gil-Hwan Kim, Jae-Hoon Jang
BACKGROUND: Modified shock index (MSI) is a useful predictor in trauma patients. However, the value of prehospital MSI (preMSI) in trauma patients is unknown. The aim of this study was to investigate the accuracy of preMSI in predicting massive transfusion (MT) and hospital mortality among trauma patients. METHODS: This was a retrospective, observational, single-center study. Patients presenting consecutively to the trauma center between January 2016 and December 2017, were included...
February 1, 2019: American Journal of Emergency Medicine
Dominic Pang, Diane Hildebrand, Paul Bachoo
BACKGROUND: Blunt traumatic thoracic aortic injury (BTAI) is a life-threatening surgical emergency associated with mortality up to 8000 per year, most commonly caused by rapid acceleration/deceleration injury sustained through motor vehicle accident and/or blunt thoracic trauma. BTAI has high pre-hospital mortality following the primary injury, with only 10% to 15% of patients surviving long enough to reach the hospital. Open surgical repair had remained the standard treatment option for BTAI since successfully introduced in 1959...
February 6, 2019: Cochrane Database of Systematic Reviews
Tim Cunningham, Dallas M Ducar, Jessica Keim-Malpass
"The Pause" was first practiced by a nurse at a Level 1 trauma center to honor the death of a deceased patient. This practice has spread internationally and is used in emergency departments, intensive care, transplant, and oncology units, in addition to pre-hospital settings. There is a paucity of research published on the effects of The Pause for health care workers. We used a three-staged Delphi methodology to understand the barriers, benefits, and language used in The Pause. Analyses of email communication and interview transcripts suggest that The Pause poses minimal risk and has considerable benefits...
January 30, 2019: Western Journal of Nursing Research
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
Matthew J Martin, John Holcomb, Travis Polk, Matthew Hannon, Brian Eastridge, Saafan Z Malik, Virginia Blackman, Joseph M Galante, Daniel Grabo, Martin Schreiber, Jennifer Gurney, Frank K Butler, Stacy Shackelford
BACKGROUND: The US Military has achieved the highest casualty survival rates in its history. However, there remain multiple areas in combat trauma that present challenges to the delivery of high quality and effective trauma care. Previous work has identified research priorities for pre-hospital care, but there has been no similar analysis for forward surgical care. METHODS: A list of critical "focus areas" was developed by the Committee on Surgical Combat Casualty Care (CoSCCC)...
January 10, 2019: Journal of Trauma and Acute Care Surgery
Aaron M Williams, Isabel S Dennahy, Umar F Bhatti, Ben E Biesterveld, Nathan Graham, Yongqing Li, Hasan B Alam
Trauma remains a leading cause of morbidity and mortality among all age groups in the United States. Hemorrhagic shock and traumatic brain injury (TBI) are major causes of preventable death in trauma. Initial treatment involves fluid resuscitation to improve the intravascular volume. Although crystalloids may provide volume expansion, they do not have any pro-survival properties. Furthermore, aggressive fluid resuscitation can provoke a severe inflammatory response and worsen clinical outcomes. Due to logistical constraints, however, definitive resuscitation with blood products is often not feasible in the pre-hospital setting - highlighting the importance of adjunctive therapies...
December 21, 2018: Shock
E Ter Avest, J Griggs, C Prentice, J Jeyanathan, R M Lyon
INTRODUCTION: Helicopter emergency medical services (HEMS) are often dispatched to patients in traumatic cardiac arrest (TCA) as they can provide treatments and advanced interventions in the pre-hospital environment that have the potential to contribute to an increased survival. This study, aimed to investigate the added value of HEMS in the treatment of TCA. METHODS: We performed a retrospective cohort study of all patients with a pre-hospital TCA who were attended by a non-urban HEMS (Kent, Surrey and Sussex Air Ambulance trust) between July 1st 2013 and May 1st 2018...
December 28, 2018: Resuscitation
E Ter Avest, J Griggs, C Prentice, J Jeyanathan, R M Lyon
INTRODUCTION: Helicopter emergency medical services (HEMS) are often dispatched to patients in traumatic cardiac arrest (TCA) as they can provide treatments and advanced interventions in the pre-hospital environment that have the potential to contribute to an increased survival. This study, aimed to investigate the added value of HEMS in the treatment of TCA. METHODS: We performed a retrospective cohort study of all patients with a pre-hospital TCA who were attended by a non-urban HEMS (Kent, Surrey and Sussex Air Ambulance trust) between July 1st 2013 and May 1st 2018...
December 28, 2018: Resuscitation
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