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Recent opioid use and fall-related injury among older patients with trauma Evidence for an association between opioid use and risk of falls or fractures in older adults is inconsistent. We examine the association between recent opioid use and the risk, as well as the clinical outcomes, of fall-related injuries in a large trauma population of older adults.In a retrospective, observational, multicentre cohort study conducted on registry data, we included all patients aged 65 years and older who (...) were admitted (hospital stay > 2 d) for injury in 57 trauma centres in the province of Quebec, Canada, between 2004 and 2014. We looked at opioid prescriptions filled in the 2 weeks preceding the trauma in patients who sustained a fall, compared with those who sustained an injury through another mechanism.A total of 67 929 patients were retained for analysis. Mean age was 80.9 (± 8.0) years and 69% were women. The percentage of patients who had filled an opioid prescription in the 2 weeks preceding
New advances in intra-operative imaging in trauma The invention of flat-panel detectors led to a revolution in medical imaging. The major benefits of this technology are a higher image quality and dose reduction. Flat-panel detectors have proved to be superior to standard C-arms (= C-arm with radiograph source and image intensifier).Cone-beam computed tomography (cone-beam CT) is a 3D data set, which can be acquired with a flat-panel detector. The cone-shaped beam is used for 3D data generation
Pediatric self-inflicted eye trauma due to a major depressive disorder Self-inflicted eye trauma is a serious form of self-harm as it may lead to irreversible visual disability. Diagnosing self-inflicted ocular injuries, in all its forms, can be quite challenging. In this report, we are presenting a 5-year-old girl presented to Sohag University Outpatient Clinic with a history of repeated attacks of bilateral eye redness with blood-tinged strands removed from her eyes. After ocular examination
Crisis Intervention for Adults Using a Trauma-Informed Approach: Initial Four Weeks of Management Third Edition Crisis Intervention for Adults Using a Trauma-Informed Approach: Initial Four Weeks of Management Third Edition | Registered Nurses' Association of Ontario l’Association des infirmières et infirmiers autorisés de l’Ontario Speaking out for nursing. Speaking out for health. » » Crisis Intervention for Adults Using a Trauma-Informed Approach: Initial Four Weeks of Management Third
Trauma (penetrating) Trauma (penetrating) submit The College submit You're here: Trauma (penetrating) Trauma (penetrating) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Partial or full-thickness injury of outer wall of eye caused by sharp object Common causes include: assault, industrial or work-related accident, DIY injury (...) Predisposing factors Male:female = 3:1 Symptoms History of trauma Pain Visual loss Signs Lid laceration: assess depth, contamination and whether canaliculi involved Conjunctiva hyperaemia and chemosis look for foreign bodies assess depth of any conjunctival laceration Corneal laceration check depth check for signs of perforation (shallow or flat AC, Seidel test +ve) possible iris damage (iridodialysis) ± iris prolapse into wound Lens may be subluxated, dislocated, absent, or cataractous Scleral laceration
Trauma (chemical) Trauma (chemical) submit The College submit You're here: Trauma (chemical) Trauma (chemical) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology The incidence of chemical injuries to the eye has been reported to be 10.7 per 100,000 population per annum, representing an estimated 10% of ocular trauma treated in emergency (...) with eye drops or ointment Predisposing factors Domestic accidents, DIY injuries Industrial injuries Assault Riot control Warfare Symptoms Immediate pain, redness, epiphora Visual loss Severe chemical trauma may be relatively pain free (damage to superficial nerves) Signs Burns to eyelids and surrounding skin Particulate matter under lid (evert to examine) Conjunctival chemosis and hyperaemia Limbal and conjunctival blanching (cessation of blood flow in superficial vessels; may indicate poor prognosis
Trauma (blunt) Trauma (blunt) submit The College submit You're here: Trauma (blunt) Trauma (blunt) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Blow to the eye: accidental (e.g. RTA, industrial, domestic, sports) or non-accidental (e.g. fist) Also known as ocular contusion Predisposing factors Usually unexpected but may (...) , side of nose, upper lip, teeth) may indicate orbital floor fracture disturbance of ocular motility: restriction or diplopia due to tissue swelling or muscle tethering by orbital (‘blow-out’) fracture enophthalmos (sunken eye) may also indicate orbital fracture among paediatric patients, orbital floor blow-out fractures may occur with minimal soft-tissue signs (‘white-eyed blow-out fracture’) nasal bleeding (direct trauma, or could indicate skull fracture) corneal oedema or laceration AC: hyphaema
Characteristics distinguishing abusive head trauma from accidental head trauma in infants with traumatic intracranial hemorrhage in Japan To identify markers for detecting abusive head trauma (AHT) and its characteristics in the Japanese population.We retrospectively reviewed the clinical records of 166 infants with traumatic intracranial hemorrhage between 2002 and 2013 in three tertiary institutions in Japan. The infants were classified into AHT (57), suspected AHT (24), and accidental (85 (...) the likelihood of AHT. Subdural hematoma without findings of an impact to the head strongly suggested AHT. Abusive head trauma is a global problem, however, diagnosis and defensive measures likely need to be tailored to accommodate cultural risk factors.
Case Report: Pregnancy and Trauma in the Game of Thrones Case Report: Pregnancy and Trauma in the Game of Thrones - CanadiEM Case Report: Pregnancy and Trauma in the Game of Thrones In , by Will Wu April 24, 2018 This is the 3rd Episode of the Game of Thrones Case Series. Be sure to also review and . Patient Presentation and History During the wedding of Edmure and Roslin, a young pregnant woman of unknown gestational age was found unresponsive with multiple abdominal stab wounds on the floor (...) to the blood spilt in the great hall. Unfortunately, , affecting 1 in 12 pregnancies, and is the leading nonobstetric cause of maternal deaths. 1 In fact, trauma results in the highest mortality rate among any single diagnosis in pregnancy, higher than preeclampsia and hemorrhage. 1 Trauma can represent domestic abuse, motor vehicle accidents, penetrating trauma, falls, suicide, and others. In this case, the patient was stabbed multiple times in the abdomen, possibly penetrating the uterus, fetus or other
Hypertonic saline as effective as normal saline for trauma patients Hypertonic saline as effective as normal saline for trauma patients Discover Portal Discover Portal Hypertonic saline as effective as normal saline for trauma patients Published on 13 March 2018 doi: Solutions more concentrated than normal, such as hypertonic saline, are as good as those more usually given to trauma patients with severe blood loss. Survival to hospital discharge was the same in patients treated before arrival (...) at the hospital with either type of fluid. There are around 20,000 cases of major trauma per year in England. Outcomes for patients have improved in the UK over the last 25 years, but as there is still room for improvement this review sought to find evidence that supported or challenged the convention that normal saline is always best. Hypertonic solutions are given to patients in a lower volume, and so can be carried in more compact packaging. They could be preferred for transportation by emergency services
Drugs that stimulate bone marrow might save lives in critically ill trauma patients Drugs that stimulate bone marrow might save lives in critically ill trauma patients Discover Portal Discover Portal Drugs that stimulate bone marrow might save lives in critically ill trauma patients Published on 23 August 2016 doi: Erythropoiesis stimulating agents (ESAs) might improve survival of critically ill patients after trauma. These drugs are synthetic versions of erythropoietin, a natural hormone (...) produced by the kidneys. They boost production of red blood cells from the bone marrow; however the survival effect seems to be independent of the effect on red cell production. ESA’s are already commonly used to treat anaemia associated with chronic kidney disease. This systematic review of trials in critical trauma patients found the survival benefit occurred without an increase in adverse effects, such as blood clots in the leg veins. ESA’s had no effect on the chance of making a good recovery after
Predicting severe brain injuries from apparent minor head trauma without a scan Predicting severe brain injuries from apparent minor head trauma without a scan Discover Portal Discover Portal Predicting severe brain injuries from apparent minor head trauma without a scan Published on 8 March 2016 doi: Specific clinical decision rules applied to adults and adolescents with apparent minor head injury identified groups at low risk of severe internal head injuries, potentially reducing the number (...) head trauma in people presenting with minor head injuries. The clinical decision rule was compared against a reference standard, either neuroimaging or follow-up evaluation. What did this study do? This systematic review included 14 studies from eight countries (US, Japan, Korea and from continental Europe) including 23,079 adults and adolescents with minor head trauma, defined as a Glasgow Coma Scale (GCS) of 13 to 15, where 15 is completely alert. The review was carried out to a high standard
Head trauma and olfactory function Olfactory impairment is a well-established sequela of head injury. The presence and degree of olfactory dysfunction is dependent on severity of head trauma, duration of posttraumatic amnesia, injuries obtained, and as more recently established, age. Deficits in smell can be conductive or neurosensory, contingent on location of injury. The former may be amenable to medical or surgical treatment, whereas the majority of patients with neurosensory deficits
French lyophilized plasma versus fresh frozen plasma for the initial management of trauma-induced coagulopathy: a randomized open-label trial Essentials An immediate supply of plasma in case of trauma-induced coagulopathy is required. The Traucc trial compared French Lyophilised Plasma (FLyP) and Fresh Frozen Plasma (FFP). FLyP achieved higher fibrinogen concentrations compared with FFP. FLyP led to a more rapid coagulopathy improvement than FFP.Background Guidelines recommend beginning (...) hemostatic resuscitation immediately in trauma patients. We aimed to investigate if French lyophilized plasma (FLyP) was more effective than fresh frozen plasma (FFP) for the initial management of trauma-induced coagulopathy. Methods In an open-label, phase 3, randomized trial (NCT02750150), we enrolled adult trauma patients requiring an emergency pack of 4 plasma units within 6 h of injury. We randomly assigned patients to receive 4-FLyP units or 4-FFP units. The primary endpoint was fibrinogen
Blood Transfusion in Trauma: Timing and Product Ratio Emergency Medicine > Journal Club > Archive > February 2018 Toggle navigation February 2018 Blood Transfusion in Trauma: Timing and Product Ratio Vignette It's an active early spring afternoon in the city, and you're pretty sure that just about everyone and their sister have been shot at, with most of the pour souls ending up in your TCC. As these things tend to go, The GSWs thus far are to the extremities or benign grazes (...) , but the excitement of getting the trauma team to come down as you prepare everyone for a potential resuscitation has your adrenaline going despite the lack of interesting pathology. Then, the next EMS call-ahead page hits the comm center: male GSW victim, shot in abdomen. HR 145, BP 110/60. EAT 2". You prep your team. Airway ready if needed, medics and nurses squared away on who is getting access and who is getting vitals. Then the charge nurse casually walks by ans asks if you want to think about getting
The protective role of maternal post-traumatic growth and cognitive trauma processing in Palestinian mothers and infants: a longitudinal study. Women at pre partum and post partum are especially susceptible to war trauma because they struggle to protect their infants from danger. Trauma research suggests increased problems in maternal mental health and infant development. Yet many cognitive-emotional processes affect the trauma survivors' mental health, such as post-traumatic growth and post (...) at T1, 481 women at T2, and 454 women at T3. High maternal post-traumatic growth and post-traumatic cognition had protective roles. Post-traumatic growth had a protective effect on maternal mental health since severe exposure to traumatic war experiences was not associated with maternal PTSD, depression, and dissociation if women showed high post-traumatic growth, as indicated by the significant interaction effect between post-traumatic growth and war trauma on each of the three symptoms. Post
Preoperative fluid restriction for trauma patients with hemorrhagic shock decreases ventilator days In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction.From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo (...) blood pressure, 70 mmHg). The Injury Severity Score was 34 (AR) versus 38 (FR) (not significant). Preoperative infusion volume of crystalloid significantly decreased, from 2310 mL (AR) to 1025 mL (FR) (P ≤ 0.01). There was no difference in mortality (36% [AR] versus 41% [FR]). Ventilator days significantly decreased, from 8.5 days (AR) to 5.5 days (FR) (P = 0.02).Preoperative fluid restriction for trauma patients with hemorrhagic shock did not improve mortality, but it decreased ventilator days
Aerial drone misadventure: A novel case of trauma resulting in ocular globe rupture The purpose of this case report is to present the novel findings of a drone causing such a traumatic ocular injury and provide recommendations for how it might be prevented.We report on a recent case where a child presented to our Emergency Department after incurring a blow to the face by the propeller of a remote controlled drone. The patient suffered significant trauma including rupture of the right globe.As
Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation? Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation? - Evidencias en pediatría Searching, please wait Show menu Library Management You did not add any article to your library yet. | Search Evidence-Based decision making Evidence-Based decision making Show menu Library Management You did not add any article to your library yet. × User Password (...) Log in × Reset password If you need to reset your password please enter your email and click the Send button. You will receive an email to complete the process. Email Send × Library Management × December 2017. Volume 13. Number 4 Abdominal ultrasound (FAST examination) in children with blunt torso trauma. A need or overestimation? Rating: 5 (1 Votes) Reviewers: , . | Newsletter Free Subscription Regularly recieve most recent articles by e-mail Subscribe × Newsletter subscription: Email Confirm
Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective caseâ€“control study Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV).Consecutive adult patients with multiple severe injuries and blunt (...) chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart-review study. According to ventilatory time, the patients were divided into PMV (≥7 days) and shortened mechanical ventilation (SMV; <7 days) groups. Thoracic Trauma Severity Score (TTSS) was calculated. To identify risk factors for PMV, univariate and multivariate logistic analyses and receiver operating characteristic analysis were carried