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Latest & greatest articles for trauma
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on trauma or other clinical topics then use Trip today.
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Mental health outcomes after major trauma in Ontario: a population-based analysis Major injury continues to be a common source of morbidity and mortality; improving the functional recovery of survivors of major trauma requires a better understanding of the mental health outcomes that may occur in this population. We assessed the association between major trauma and the development of a new mental health diagnosis or death by suicide.We completed a population-based, self-controlled, longitudinal (...) cohort analysis using linked administrative data on patients treated for major trauma in Ontario between 2005 and 2010. All survivors were included and composite rates of mental health diagnoses during inpatient admissions were compared between the 5 years after injury and the 5 years before injury, using Poisson regression with generalized estimating equations. The incidence of suicide was calculated for the 5 years after injury. Risk factors for suicide were calculated using Cox proportional hazard
What Physiologic Parameters Are Indicative of Severe Injury in Trauma? What Physiologic Parameters Are Indicative of Severe Injury in Trauma? TAKE-HOME MESSAGE Pulse rate, systolic blood pressure, shock index, respiratory rate, and lactate demonstrate poor sensitivity but high speci?city for predicting severe injury among trauma patients. No parameter in isolation is able to adequately predict the risk of severe injury. EBEM Commentators Brit Long, MD Michael D. April, MD, DPhil Department (...) trauma patients to identify those with severe injuries as measured by resource use (blood transfusion, critical care admission, lifesaving intervention), anatomic injury severity measures (eg, Injury Severity Score), mortality, or a combination of any of these parameters developed by stakeholders including the Agency for Healthcare Research and Quality and the National Highway Transportation Safety Administration. Authors did not restrict the type of trials included. Two or more authors independently
Risk of Serious Trauma with Glucose-Lowering Drugs in Older Persons: A Nested Case-Control Study To assess the risk of hospitalization for trauma associated with use of hypoglycemic glucose-lowering drugs (GLDs) in individuals aged 65 and older.Observational, nested, case-control study.The Echantillon Généraliste de Bénéficiaires claims database, a 1/97th representative sample of the population covered by French healthcare insurance.All persons with a first hospitalization for trauma between (...) 2009 and 2015 were considered as potential cases. They were selected if they had been followed for 365 days or longer at index date, were aged 65 and older, and had no diagnosed cancer. Cases (n=10,743) were matched with up to 10 randomly selected controls on age, sex, and length of follow-up (n=106,629).GLD exposure was considered globally and according to use of hypoglycemic GLDs alone, nonhypoglycemic GLDs alone, or both types of GLDs. Risk of hospitalization for trauma was estimated using
Malnutrition and the Orthopaedic Trauma Patient: A Systematic Review of the Literature To evaluate the available literature for associations between nutrition and outcomes after operative treatment of long bone and long bone periarticular fractures.Systematic review of English-language articles in the MEDLINE, Embase, PubMed, and Cochrane computerized literature databases (through December 2015) using PRISMA guidelines.Randomized controlled trials, quasi-randomized controlled trials, case (...) one of the original aims of the study was to conduct a meta-analysis, the available literature did not offer sufficient data for meta-analysis.Although our systematic review demonstrates a possible role for oral nutritional supplementation and vitamin supplementation in the orthopaedic trauma patient, there remains a need for well-designed trials to clarify this role. There is likely benefit to multidisciplinary approaches to nutritional optimization in the orthopaedic trauma patient
Novel preclinical murine model of trauma-induced elbow stiffness Peri-articular injury may result in functional deficits and pain. In particular, post-traumatic elbow stiffness is a debilitating condition, precluding patients from performing activities of daily living. As such, clinicians and basic scientists alike, aim to develop novel therapeutic interventions to prevent and treat elbow stiffness; thereby reducing patient morbidity. Yet, there is a paucity of pre-clinical models of peri (...) 29.87 ± 2.075 mm, ***, p < 0.0002). Additionally, plasminogen deficient animals developed capsule thickening, delayed skeletal muscle repair, fibrosis, chronic inflammation, and heterotopic ossification; all features characteristic of pathology observed in patients with trauma-induced elbow stiffness.A soft tissue injury to the peri-elbow soft tissue with a concomitant deficiency in plasminogen, instigates elbow stiffness and pathologic features similar to those observed in humans. This pre-clinical
If we build it, will they come? Issues of engagement with digital health interventions for trauma recovery Exposure to traumatic events is extremely common with nearly 75% reported to have experienced one or more traumatic events worldwide. A significant number of those exposed will develop posttraumatic stress disorder (PTSD) along with depression, anxiety, and substance use disorders. Globally, trauma-related mental health disorders are the leading cause of global disability burden, and many (...) is a concern and limited participation and high attrition rates are common. This may be especially true for trauma survivors who often experience symptoms of avoidance and hyperarousal. Engagement is regarded as an essential component of intervention efficacy and has been demonstrated to be associated with more positive clinical outcomes, yet theoretically based research in this area is sparse. This review focuses on the complex issue of engagement with digital health interventions (DHIs). Specifically, we
Urological Trauma Urological Trauma | Uroweb › Urological Trauma Urological Trauma To access the pdfs & translations of individual guidelines, please as EAU member. Non-EAU members can view the web versions. To become an EAU member, click . N.D. Kitrey (Chair), N. Djakovic, P. Hallscheidt, F.E. Kuehhas, N. Lumen, E. Serafetinidis, D.M. Sharma Guidelines Associates: Y. Abu-Ghanem, A. Sujenthiran, M. Waterloos TABLE OF CONTENTS REFERENCES 1. Radmayr, C., et al., EAU Guidelines on Paediatric (...) Urology. In: EAU Guidelines, edition presented at the annual EAU Congress Barcelona 2019. ISBN 978-94-92671-04-2. 2. Martinez-Pineiro, L., et al. EAU Guidelines on Urethral Trauma. Eur Urol, 2010. 57: 791. 3. Summerton, D.J., et al. EAU guidelines on iatrogenic trauma. Eur Urol, 2012. 62: 628. 4. Lumen, N., et al. Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol, 2015. 67: 925. 5. Serafetinides, E., et al. Review of the current management
Trauma-intrusive hallucinations and the dissociative state Research has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals.To further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations.The study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype (...) of PTSD Score.In total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction.This
CJEM Visual Abstract: Removing patient clothing in trauma CJEM Visual Abstract: Removing patient clothing in trauma - CanadiEM CJEM Visual Abstract: Removing patient clothing in trauma In by Alvin Chin August 10, 2018 This month we have created a visual abstract featuring our featured CJEM article is: “Cut and rip and cut alone techniques versus usual practice in the removal of trauma patient clothing” 1 In trauma patients, rapid and adequate exposure is necessary for delivering timely (...) and appropriate care. 2 This can be achieved in multiple ways but there are currently no gold standards. Sibley et al. aimed to compare two specific techniques of clothing removal versus usual practice in the management of a simulated trauma patient. 1 Their participants included advanced care paramedic (ACP) students, as well as practicing primary care paramedics (PCP) and ACPs. Their primary outcome was the total time it took to expose the anterior portion of the simulated patient, log roll and expose
Trauma Top results for trauma - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for trauma The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted
Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock. After a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from hemorrhage and shock. Data from large clinical trials are lacking to show either the efficacy or the risks associated with plasma transfusion in the prehospital setting.To (...) randomization (log-rank chi-square test, 5.70; P=0.02). The median prothrombin-time ratio was lower in the plasma group than in the standard-care group (1.2 [interquartile range, 1.1 to 1.4] vs. 1.3 [interquartile range, 1.1 to 1.6], P<0.001) after the patients' arrival at the trauma center. No significant differences between the two groups were noted with respect to multiorgan failure, acute lung injury-acute respiratory distress syndrome, nosocomial infections, or allergic or transfusion-related
Impact of emergency physicians competent in severe trauma management, surgical techniques, and interventional radiology on trauma management Despite recent advancements in trauma management following introduction of interventional radiology (IVR) and damage-control strategies, challenges remain regarding optimal use of resources for severe trauma.In October 2014, we implemented a trauma management system comprising emergency physicians competent in severe trauma management, surgical techniques (...) , and IVR. To evaluate this system, of 5,899 trauma patients admitted to our hospital from January 2011 to January 2018, we selected 107 patients with severe trauma (injury severity score ≥ 16) who presented with persistent hypotension (two or more systolic blood pressure measurements <90 mmHg), regardless of primary resuscitation. Patients were divided according to the date of admission: Conventional (January 2011-September 2014) or Current (October 2014-January 2018). The primary end-point
mHealth solutions for early interventions after trauma: improvements and considerations for assessment and intervention throughout the acute post-trauma period Interventions administered shortly after a traumatic event have the potential to prevent posttraumatic stress disorder (PTSD) and related mental health conditions. A key challenge in delivering such interventions is understanding how PTSD symptoms develop in the acute post-trauma period, defined as the first 30 days after a trauma (...) . Mobile devices have the potential to transform the way symptoms are assessed and how treatment is delivered in that they can capture the dynamic and nuanced nature of symptom progression after trauma. Symptoms can be assessed through active strategies that require user input, such as self-report, or through passive strategies, such as location information. Adaptive mobile interventions can be tailored to target PTSD symptoms as they appear and ultimately prevent more chronic courses of illness
A Two-Center Validation of "Patient Does Not Follow Commands" and Three Other Simplified Measures to Replace the Glasgow Coma Scale for Field Trauma Triage Out-of-hospital personnel worldwide calculate the 13-point Glasgow Coma Scale (GCS) score as a routine part of field trauma triage. We wish to independently validate a simpler binary assessment to replace the GCS for this task.We analyzed trauma center registries from Loma Linda University Health (2003 to 2015) and Denver Health Medical (...) Center (2009 to 2015) to compare the binary assessment "patient does not follow commands" (ie, GCS motor score <6) with GCS score less than or equal to 13 for the prediction of 5 trauma outcomes: emergency intubation, clinically significant brain injury, need for neurosurgical intervention, Injury Severity Score greater than 15, and mortality. As a secondary analysis, we similarly evaluated 3 other measures simpler than the GCS: GCS motor score less than 5, Simplified Motor Score, and the "alert
External Validation of the PediBIRN Clinical Prediction Rule for Abusive Head Trauma A 4-variable abusive head trauma (AHT) clinical prediction rule (CPR) for use in the PICU was derived and validated for children <3 years of age by the Pediatric Brain Injury Research Network (PediBIRN). We aimed to externally validate PediBIRN as designed (PICU only) as well as using broader inclusion criteria (admitted children with head injuries).This was a secondary analysis of a prospective multicenter
Trauma surgery simulation education in Japan: the Advanced Trauma Operative Management course Simulation has become an important teaching tool, in part because of changes mandated by restrictions in resident work hours. Simulation models include life-like mannequins, ex vivo tissue, cadavers, and live animal models. The Advanced Trauma Operative Management (ATOM) course teaches a standard approach for the treatment of traumatic injuries. The 1-day course includes six lectures in the morning (...) and a live animal surgery laboratory in the afternoon. The animal laboratory includes five standard injury scenarios. Advanced Trauma Operative Management was brought to Japan in 2008 and has carried out 60 courses, training more than 250 surgeons and 70 instructors at six training sites throughout Japan. There have been a number of innovations initiated by ATOM Japan including Nurse Participation Certificates and a course for Trauma Nurses that runs concurrently with the ATOM course. There are other
Prehospital spine immobilization/spinal motion restriction in penetrating trauma Prehospital spine immobilization/spinal motion restriction in penetrating trauma - Practice Management Guideline Search » Prehospital spine immobilization/spinal motion restriction in penetrating trauma Published 2018 Citation: Authors Velopulos, Catherine, G., MD, MHS; Shihab, Hasan, M., MPH; Lottenberg, Lawrence, MD; Feinman, Marcie, MD; Raja, Ali, MD, MBA, MPH; Salomone, Jeffrey; Haut, Elliott, R., MD, PhD (...) Abstract BACKGROUND Spine immobilization in trauma has remained an integral part of most emergency medical services protocols despite a lack of evidence for efficacy and concern for associated complications, especially in penetrating trauma patients. We reviewed the published evidence on the topic of prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma to structure a practice management guideline. METHODS We conducted a Cochrane style systematic review
Conservative management of penetrating ocular trauma caused by a nail gun To report the conservative management of a penetrating ocular trauma caused by a nail gun with a six-month follow up.A 21 year-old healthy female suffered an ocular penetrating trauma with a nail gun. She presented with a metallic foreign body that partially entered her left eye through the nasal sclera via pars plana, 3 mm posterior to the limbus, but did not reach the retina. Surgical removal of the foreign body (...) and closure of the scleral wound, without vitrectomy, was performed 16 h after the injury. Intravitreal prophylactic antibiotic was administered. Retinal atrophy developed in the areas that had commotio retinae at presentation, but no further complications were observed.and Importance: Pars plana vitrectomy may not be necessary in all penetrating ocular traumas with intraocular foreign body, as long as the foreign body is accessible from the exterior of the eye and there are no other conditions
CAEP FEI | Trauma Resuscitation Using In Situ Simulation Team Training (TRUST) Study CAEP FEI | Trauma Resuscitation Using In Situ Simulation Team Training (TRUST) Study - CanadiEM CAEP FEI | Trauma Resuscitation Using In Situ Simulation Team Training (TRUST) Study In , by Andrew Petrosoniak June 15, 2018 Rob is a fourth year resident who is just walking out of the resuscitation bay after working with the team on a 45 year old man hit by a car. His attending staff asks him to think about areas (...) where the resuscitation could have been improved. As Rob reflects on the experience, he wishes that there was a way to better analyze these events and find areas for improvement. Emergency medicine can often involve resuscitation and other high acuity, high stress events. Thus it is important to identify potential safety threats during these events so that we can work on improving outcomes. This Feature Educational Innovation (FEI), titled, “ Trauma Resuscitation Using In Situ Simulation Team
A retrospective cohort study to compare post-injury admissions for infectious diseases in burn patients, non-burnÂ trauma patients and uninjured people Injury triggers a range of systemic effects including inflammation and immune responses. This study aimed to compare infectious disease admissions after burn and other types of injury using linked hospital admissions data.A retrospective longitudinal study using linked health data of all patients admitted with burns in Western Australia (n (...) = 30,997), 1980-2012, and age and gender frequency matched cohorts of people with non-burn trauma (n = 28,647) and no injury admissions (n = 123,399). Analyses included direct standardisation, negative binomial regression and Cox proportional hazards regression.Annual age-standardised infectious disease admission rates were highest for the burn cohort, followed by the non-burn trauma and uninjured cohorts. Age-standardised admission rates by decade showed different patterns across major categories