collection
https://read.qxmd.com/read/25425230/prehospital-identification-of-trauma-patients-with-early-acute-coagulopathy-and-massive-bleeding-results-of-a-prospective-non-interventional-clinical-trial-evaluating-the-trauma-induced-coagulopathy-clinical-score-ticcs
#21
JOURNAL ARTICLE
Martin L Tonglet, Jean Marc Minon, Laurence Seidel, Jean Louis Poplavsky, Michel Vergnion
INTRODUCTION: Identifying patients who need damage control resuscitation (DCR) early after trauma is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been developed to identify such patients, but most of them are not simple enough to be used in prehospital settings in the early post-traumatic phase. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure and strictly clinical trauma score developed to meet this medical need...
November 26, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/24641269/an-evidence-based-prehospital-guideline-for-external-hemorrhage-control-american-college-of-surgeons-committee-on-trauma
#22
REVIEW
Eileen M Bulger, David Snyder, Karen Schoelles, Cathy Gotschall, Drew Dawson, Eddy Lang, Nels D Sanddal, Frank K Butler, Mary Fallat, Peter Taillac, Lynn White, Jeffrey P Salomone, William Seifarth, Michael J Betzner, Jay Johannigman, Norman McSwain
This report describes the development of an evidence-based guideline for external hemorrhage control in the prehospital setting. This project included a systematic review of the literature regarding the use of tourniquets and hemostatic agents for management of life-threatening extremity and junctional hemorrhage. Using the GRADE methodology to define the key clinical questions, an expert panel then reviewed the results of the literature review, established the quality of the evidence and made recommendations for EMS care...
2014: Prehospital Emergency Care
https://read.qxmd.com/read/25400690/patient-delay-is-the-main-cause-of-treatment-delay-in-acute-limb-ischemia-an-investigation-of-pre-and-in-hospital-time-delay
#23
JOURNAL ARTICLE
Louise S Londero, Birgitte Nørgaard, Kim Houlind
BACKGROUND: The prognosis of acute limb ischemia is severe, with amputation rates of up to 25% and in-hospital mortality of 9-15%. Delay in treatment increases the risk of major amputation and may be present at different stages, including patient delay, doctors´ delay and waiting time in the emergency department. It is important to identify existing problems in order to reduce time delay. The aim of this study was to collect data for patients with acute limb ischemia and to evaluate the time delay between the different events from onset of symptoms to specialist evaluation and further treatment with focus on pre-hospital and in-hospital time delays...
2014: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/25371408/the-mersey-burns-app-evolving-a-model-of-validation
#24
COMPARATIVE STUDY
Jamie Barnes, Annie Duffy, Nathan Hamnett, Jane McPhail, Chris Seaton, Kayvan Shokrollahi, M Ian James, Paul McArthur, Rowan Pritchard Jones
INTRODUCTION: 'Mersey Burns App' is a smartphone/tablet application that aids in the assessment of total burn surface area (TBSA) and calculation of fluid resuscitation protocols in burns. This paper presents two studies assessing the speed and accuracy of calculations using Mersey Burns (App) in comparison with a Lund and Browder chart (paper) when a burn is assessed by medical students and clinicians. METHODS: The first study compared the speed and accuracy of TBSA and resuscitation calculation for a photograph of a burn with App and paper using burns and plastics and emergency medicine trainees and consultants...
August 2015: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/25261057/annals-of-emergency-medicine-journal-club-speed-does-matter-police-scoop-and-run-transport-of-critical-trauma-victims-answers-to-the-may-2014-journal-club-questions
#25
COMMENT
Samuel J Stratton, Atilla Uner
No abstract text is available yet for this article.
October 2014: Annals of Emergency Medicine
https://read.qxmd.com/read/25228286/towards-evidence-based-emergency-medicine-best-bets-from-the-manchester-royal-infirmary-bet-1-does-restrictive-fluid-resuscitation-in-penetrating-chest-injury-affect-outcome
#26
REVIEW
Elizabeth Bateman, Stuart Maitland-Knibb
A short cut review was carried out to establish whether restrictive fluid administration in penetrating thoracic trauma impacted on patients' mortality. 143 papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these are tabulated. It is concluded that there is paucity of relevant research and there is limited scientific evidence to inform fluid administration in these patients...
October 2014: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/25216281/support-and-assessment-for-fall-emergency-referrals-safer-1-cluster-randomised-trial-of-computerised-clinical-decision-support-for-paramedics
#27
RANDOMIZED CONTROLLED TRIAL
Helen Anne Snooks, Ben Carter, Jeremy Dale, Theresa Foster, Ioan Humphreys, Philippa Anne Logan, Ronan Anthony Lyons, Suzanne Margaret Mason, Ceri James Phillips, Antonio Sanchez, Mushtaq Wani, Alan Watkins, Bridget Elizabeth Wells, Richard Whitfield, Ian Trevor Russell
OBJECTIVE: To evaluate effectiveness, safety and cost-effectiveness of Computerised Clinical Decision Support (CCDS) for paramedics attending older people who fall. DESIGN: Cluster trial randomised by paramedic; modelling. SETTING: 13 ambulance stations in two UK emergency ambulance services. PARTICIPANTS: 42 of 409 eligible paramedics, who attended 779 older patients for a reported fall. INTERVENTIONS: Intervention paramedics received CCDS on Tablet computers to guide patient care...
2014: PloS One
https://read.qxmd.com/read/25125535/saving-the-critically-injured-trauma-patient-a-retrospective-analysis-of-1000-uses-of-intraosseous-access
#28
JOURNAL ARTICLE
Pip Lewis, Chris Wright
OBJECTIVES & BACKGROUND: Intraosseous (IO) access is becoming increasingly accepted in adult populations as an alternative to peripheral vascular access, however there is still insufficient evidence in large patient groups supporting its use. METHODS: Retrospective review. This paper reports on the use of intraosseous devices over a 7 year period from August 2006 to August 2013 during combat operations in Afghanistan. A search of the Joint Theatre Trauma Registry (JTTR-UK), a database of all trauma patients treated by Defence Medical Services in Iraq and Afghanistan, was carried out looking for all the incidences of intraosseous access use during this time...
September 2014: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/25125522/presenting-gcs-in-elderly-patients-with-isolated-traumatic-brain-injury-is-higher-than-in-younger-adults
#29
JOURNAL ARTICLE
Anthony D Kehoe, Jason E Smith, Fiona Lecky, David Yates
OBJECTIVES & BACKGROUND: The relationship between age and presenting Glasgow Coma Scale (GCS) in adults with traumatic brain injury (TBI) has not so far been explored in detail. We have previously reported a trend for higher GCS in elderly patients presenting to our major trauma centre with isolated TBI compared with younger adults. The aim of this study was to confirm and define this relationship using a national trauma registry and to evaluate potential contributory factors. emermed;31/9/775-c/SA2EMERMED2014204221TB1T1sa2-EMERMED2014204221TB1 Table 1 Isolated Head AIS 3+ patients 1988-2014 N(total 13547) Adults*mean (95% CI), **median (IQR) N(total 2485) Elderly*mean (95% CI), **median (IQR) Male 10410 76...
September 2014: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/25125525/hip-7-using-a-bundle-of-care-to-streamline-the-management-of-patients-with-a-fractured-neck-of-femur
#30
JOURNAL ARTICLE
Jacques Kerr, Mary Bishop, Alastair Meikle, Kirk Lakie, Jane Davidson
OBJECTIVES & BACKGROUND: SIGN guideline 111 makes recommendations on the optimal management of patients with a hip fracture.(1) It is clear from the use of care bundles in other conditions, eg sepsis, that these perform very well in time-critical settings and ensure that all necessary actions for person-centred care are achieved timeously. Given the success of our Emergency Department (ED) compliance with the Sepsis 6 bundle (100%-unpublished data) the principal author (JK) rationalised that a bundle applied to the SIGN hip fracture recommendations would ensure that all actions were achieved in a timely manner...
September 2014: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/25113292/impact-locations-and-concussion-outcomes-in-high-school-football-player-to-player-collisions
#31
JOURNAL ARTICLE
Zachary Y Kerr, Christy L Collins, Jason P Mihalik, Stephen W Marshall, Kevin M Guskiewicz, R Dawn Comstock
BACKGROUND: Little research has examined concussion outcomes in terms of impact location (ie, the area on the head in which the impact occurred). This study describes the epidemiology of concussions resulting from player-to-player collision in high school football by impact location. METHODS: National High School Sports-Related Injury Surveillance Study data (2008/2009-2012/2013) were analyzed to calculate rates and describe circumstances of football concussion (eg, symptomology, symptom resolution time, return to play) resulting from player-to-player collisions by impact location (ie, front-, back-, side-, and top-of-the-head)...
September 2014: Pediatrics
https://read.qxmd.com/read/25092798/the-necksafe-head-articulation-control-system-a-novel-cervical-immobilisation-device
#32
JOURNAL ARTICLE
Alison Sparke, Karina Torlei, Sarah Voss, Mike Page, Jonathan Benger, Ed Matthews, Michael Hillman, Darren Hart, Ella McLaughlin, Jane Carter, Nigel Harris
INTRODUCTION: The early application of a semirigid disposable cervical collar following trauma is considered a routine practice. The aim of these devices is to immobilise the cervical spine and minimise the risk of additional neurological damage. However, these collars provide only partial immobilisation, are uncomfortable and are associated with a number of complications. Our team designed and tested a novel cervical immobilisation device that aims to improve immobilisation with reduced complications: the 'Necksafe'...
July 2015: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/25050135/phtls-%C3%A2-prehospital-trauma-life-support-provider-courses-in-germany-who-takes-part-and-what-do-participants-think-about-prehospital-trauma-care-training
#33
JOURNAL ARTICLE
Christian B Frank, Christoph G Wölfl, Aidan Hogan, Arnold J Suda, Thorsten Gühring, Bernhard Gliwitzky, Matthias Münzberg
BACKGROUND: The goal of this study was to examine PHTLS Provider courses in Germany and to proof the assumption that formation of physicians and paramedics in prehospital trauma care can be optimized. METHODS: PHTLS participants were asked to fill out standardized questionnaires during their course preparation and directly after the course. There were some open questions regarding their professional background and closed questions concerning PHTLS itself. Further questions were to be answered on an analog scale in order to quantify subjective impressions of confidence, knowledge and also to describe individual levels of education and training...
2014: Journal of Trauma Management & Outcomes
https://read.qxmd.com/read/25035754/comparison-of-three-prehospital-cervical-spine-protocols-for-missed-injuries
#34
COMPARATIVE STUDY
Rick Hong, Molly Meenan, Erin Prince, Ronald Murphy, Caitlin Tambussi, Rick Rohrbach, Brigitte M Baumann
INTRODUCTION: We wanted to compare 3 existing emergency medical services (EMS) immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based); the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria); and the Hankins' criteria (immobilization for patients <12 or >65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness).To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance...
July 2014: Western Journal of Emergency Medicine
https://read.qxmd.com/read/23962031/prehospital-use-of-cervical-collars-in-trauma-patients-a-critical-review
#35
REVIEW
Terje Sundstrøm, Helge Asbjørnsen, Samer Habiba, Geir Arne Sunde, Knut Wester
The cervical collar has been routinely used for trauma patients for more than 30 years and is a hallmark of state-of-the-art prehospital trauma care. However, the existing evidence for this practice is limited: Randomized, controlled trials are largely missing, and there are uncertain effects on mortality, neurological injury, and spinal stability. Even more concerning, there is a growing body of evidence and opinion against the use of collars. It has been argued that collars cause more harm than good, and that we should simply stop using them...
March 15, 2014: Journal of Neurotrauma
https://read.qxmd.com/read/11406043/spinal-immobilisation-for-trauma-patients
#36
REVIEW
I Kwan, F Bunn, I Roberts
BACKGROUND: Spinal immobilisation involves the use of a number of devices and strategies to stabilise the spinal column after injury and thus prevent spinal cord damage. The practice is widely recommended and widely used in trauma patients with suspected spinal cord injury in the pre-hospital setting. OBJECTIVES: To quantify the effect of different methods of spinal immobilisation (including immobilisation versus no immobilisation) on mortality, neurological disability, spinal stability and adverse effects in trauma patients...
2001: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/15331475/spinal-immobilisation-for-unconscious-patients-with-multiple-injuries
#37
REVIEW
C G Morris, E P McCoy, G G Lavery, E McCoy
No abstract text is available yet for this article.
August 28, 2004: BMJ: British Medical Journal
https://read.qxmd.com/read/22962052/a-re-conceptualisation-of-acute-spinal-care
#38
JOURNAL ARTICLE
Mark Hauswald
The emergency care of patients who may have spinal injuries has become highly ritualised. There is little scientific support for many of the recommended interventions and there is evidence that at least some methods now used in the field and emergency department are harmful. Since prospective clinical trials are not likely to resolve these issues I propose a reconceptualisation of spinal trauma to allow a more rational approach to treatment. To do this I analyse the basic physics, biomechanics and physiology involved...
September 2013: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/23080314/sports-prehospital-immediate-care-and-spinal-injury-not-a-car-crash-in-sight
#39
REVIEW
Jonathan R Hanson, Brian Carlin
The prehospital management of serious injury is a key skill required of pitch-side medical staff. Previously, specific training in sports prehospital-immediate care was lacking or not of a comparable standard to other aspects of emergency care. Many principles have been drawn from general prehospital care or in-hospital training courses. This article discusses sports prehospital-immediate care as a niche of general prehospital care, using spinal injury management as an illustration of the major differences...
December 2012: British Journal of Sports Medicine
https://read.qxmd.com/read/12954698/comparison-of-a-long-spinal-board-and-vacuum-mattress-for-spinal-immobilisation
#40
COMPARATIVE STUDY
M D Luscombe, J L Williams
OBJECTIVES: This study was designed to compare the stability and comfort afforded by the long spinal board (backboard) and the vacuum mattress. METHODS: Nine volunteers wearing standardised clothing and rigid neck collars were secured on to a backboard and vacuum mattress using a standard strapping arrangement. An operating department table was used to tilt the volunteers from 45 degrees head up to 45 degrees head down, and additionally 45 degrees laterally. Movements of the head, sternum, and pubic symphysis (pelvis) from a fixed position were then recorded...
September 2003: Emergency Medicine Journal: EMJ
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