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Latest & greatest articles for trauma
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Impact of Electronic Versus Paper Vital Sign Observations on Length of Stay in Trauma Patients: Stepped-Wedge, Cluster Randomized Controlled Trial. Electronic recording of vital sign observations (e-Obs) has become increasingly prevalent in hospital care. The evidence of clinical impact for these systems is mixed.The objective of our study was to assess the effect of e-Obs versus paper documentation (paper) on length of stay (time between trauma unit admission and "fit to discharge") for trauma (...) patients.A single-center, randomized stepped-wedge study of e-Obs against paper was conducted in two 26-bed trauma wards at a medium-sized UK teaching hospital. Randomization of the phased intervention order to 12 study areas was computer generated. The primary outcome was length of stay.A total of 1232 patient episodes were randomized (paper: 628, e-Obs: 604). There were 37 deaths in hospital: 21 in the paper arm and 16 in the e-Obs arm. For discharged patients, the median length of stay was 5.4 (range
Monitoring modalities and assessment of fluid status: a practice management guideline from the Eastern Association for the Surgery of Trauma. Monitoring modalities and assessment of fluid status: a practice management guideline from the Eastern Association for the Surgery of Trauma. | National Guideline Clearinghouse success fail May JUN 09 2017 2018 2019 08 Jun 2018 - 12 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive (...) NGC:011327 2018 Jan NEATS Assessment Monitoring modalities and assessment of fluid status: a practice management guideline from the Eastern Association for the Surgery of Trauma. Plurad DS, Chiu W, Raja AS, Galvagno SM, Khan U, Kim DY, Tisherman SA, Ward J, Hamill ME, Bennett V, Williams B, Robinson B. Monitoring modalities and assessment of fluid status: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2018 Jan;84(1):37-49. [74
Eye trauma Eye trauma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Eye trauma Last reviewed: February 2019 Last updated: March 2018 Summary A leading cause of visual loss and blindness that frequently affects young people. Worldwide, there are approximately 1.6 million people blind from eye injuries, 2.3 million with bilateral visual impairment, and 19 million with unilateral visual loss. The injuries may be due (...) to mechanical trauma (blunt or penetrating), chemical agents, or ultraviolet and ionising radiations. In the absence of severe ocular compromise, most conservative treatments for standard eye complaints produce healing within 48 to 72 hours. It is important to make the public aware of the benefits of using protective equipment because most eye injuries are preventable. Definition Refers to any injury to the eye. The injury may have been due to mechanical trauma (blunt or penetrating), chemical agents
Acute cervical spine trauma Acute cervical spine trauma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Acute cervical spine trauma Last reviewed: February 2019 Last updated: January 2018 Summary Mechanism of injury is highly variable, ranging from seemingly innocuous falls to high-energy motor vehicle accidents. Possible presentations include neck pain, limited range of motion, and/or neurological deficit. A high (...) interventions. The use of methylprednisolone, while certainly time-sensitive, is an intervention whose efficacy is debated among professionals. Early consultation with a specialist is advisable to avoid delays that may affect patient outcome. This monograph concentrates on cervical spine trauma in adults. Definition Acute cervical spine trauma encompasses a wide range of potential injuries to ligaments, muscles, bones, and spinal cord that follow acute incidents ranging from a seemingly innocuous fall
Thoracolumbar spine trauma Thoracolumbar spine trauma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Thoracolumbar spine trauma Last reviewed: February 2019 Last updated: March 2018 Summary Usually occurs as a result of high-energy trauma (e.g., road traffic accidents, falls from heights). May occur spontaneously in patients with osteoporotic, neoplastic, or metabolic disorders of the spine. Initial on-the-scene (...) or compression of neural structures. Thoracolumbar fractures are the usual outcome of thoracolumbar trauma. Other outcomes include traumatic disc prolapse, ligamentous injury, and epidural haematoma causing pressure on the spinal cord or nerve roots; these occur very rarely without a fracture. This monograph focuses on thoracolumbar spine fracture. History and exam presence of risk factors back pain bruising acute numbness/paraesthesia weakness muscle spasticity/clonus (hypertonicity) or hypotonia
Assessment of abdominal trauma Assessment of abdominal trauma - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Assessment of abdominal trauma Last reviewed: February 2019 Last updated: August 2018 Summary Trauma is a physical injury caused by transfer of energy to and within the person involved. Abdominal trauma is best categorised by mechanism as blunt or penetrating abdominal injury. The mechanism of injury (...) dictates the diagnostic work-up. As there is a broad spectrum of abdominal injuries, abdominal trauma patients are often difficult to assess. Confounding factors, such as associated extra-abdominal injuries or altered mental status (either from a head injury or intoxication), further complicate the evaluation. Enderson BL, Reath DB, Meadors J, et al. The tertiary trauma survey: a prospective study of missed injury. J Trauma. 1990 Jun;30(6):666-9. http://www.ncbi.nlm.nih.gov/pubmed/2352294?tool
Abusive head trauma in infants Abusive head trauma in infants - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Abusive head trauma in infants Last reviewed: February 2019 Last updated: April 2018 Summary Abusive head trauma refers to the constellation of cranial, spinal cord, and brain injuries which result from inflicted injury in infants and young children. Diagnosis rests on the finding of unexplained injury (...) to the skull, brain, and/or spinal cord in an infant who has no other medical explanation for their clinical presentation. Frequently, there are other associated findings such as widespread retinal haemorrhaging, unexplained bruising, fractures and/or abdominal trauma. These additional findings are not necessary to make the diagnosis of abusive head trauma. The clinical presentation and degree of injury occur on a spectrum from mild to severe. Around 16% to 38% of victims die from their injuries. Most
Treating and Assessing Chronic Pain Patients who have Suffered Physical Trauma: Clinical Evidence and Guidelines Treating and Assessing Chronic Pain Patients who have Suffered Physical Trauma: Clinical Evidence and Guidelines | CADTH.ca Find the information you need Treating and Assessing Chronic Pain Patients who have Suffered Physical Trauma: Clinical Evidence and Guidelines Treating and Assessing Chronic Pain Patients who have Suffered Physical Trauma: Clinical Evidence and Guidelines Last (...) updated: August 23, 2018 Project Number: RB1247-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical evidence regarding the usefulness of taking medical history for trauma when treating and assessing chronic pain patients who have suffered physical trauma? What are the evidence-based guidelines regarding treating and assessing chronic pain patients who have suffered physical trauma? Key Message One systematic review
Trauma-Informed Care for Adults Involved in the Correctional System: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines Trauma-Informed Care for Adults Involved in the Correctional System: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Trauma-Informed Care for Adults Involved in the Correctional System: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines Trauma-Informed Care (...) for Adults Involved in the Correctional System: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: October 5, 2018 Project Number: RC1028-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of trauma-informed care for adults involved in the correctional system? What is the cost-effectiveness of trauma-informed care for adults involved in the correctional
Trauma-Informed Practice for Adults: Clinical and Cost-Effectiveness Trauma-Informed Practice for Adults: Clinical and Cost-Effectiveness | CADTH.ca Find the information you need Trauma-Informed Practice for Adults: Clinical and Cost-Effectiveness Trauma-Informed Practice for Adults: Clinical and Cost-Effectiveness Last updated: November 12, 2018 Project Number: RA0984-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What (...) is the clinical effectiveness of trauma-informed practice for adults? What is the cost-effectiveness of trauma-informed practice for adults? What are the evidence-based guidelines regarding the use of trauma-informed practice for adults? Key Message One meta-analysis, nine randomized controlled trials, one non-randomized study, one economic evaluation, and one evidence-based guideline were identified regarding the trauma-informed practice for adults. Files Rapid Response Reference List Published : November 12
Validation of the trauma mortality prediction scores from a Malaysian population Well-known trauma mortality prediction scores such as New Injury Severity Score (NISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) have been externally validated from high-income countries with established trauma databases. However, these scores were never used in Malaysian population. In this current study, we attempted to validate these scoring systems using our regional trauma (...) surgery database.A retrospective analysis of the regional Malaysian Trauma Surgery Database was performed over a period of 3 years from May 2011 to April 2014. NISS, RTS, Major Trauma Outcome Study (MTOS)-TRISS, and National Trauma Database (NTrD)-TRISS scores were recorded and calculated. Individual scoring system's performance in predicting trauma mortality was compared by calculating the area under the receiver operating characteristic (AUC) curve. Youden index and associated optimal cutoff values
Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial. To determine whether a behavioral intervention delivered through a video game can improve the appropriateness of trauma triage decisions in the emergency department of non-trauma centers.Randomized clinical trial.Online intervention in national sample of emergency medicine physicians who make triage decisions at US hospitals.368 emergency (...) medicine physicians primarily working at non-trauma centers. A random sample (n=200) of those with primary outcome data was reassessed at six months.Physicians were randomized in a 1:1 ratio to one hour of exposure to an adventure video game (Night Shift) or apps based on traditional didactic education (myATLS and Trauma Life Support MCQ Review), both on iPads. Night Shift was developed to recalibrate the process of using pattern recognition to recognize moderate-severe injuries (representativeness
Triage tools for detecting cervical spine injury in pediatric trauma patients. Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR). Both tools are proven to be accurate in deciding whether or not diagnostic imaging (...) is needed in adults presenting for blunt trauma screening at the emergency department. However, little information is known about the accuracy of these triage tools in a pediatric population.To determine the diagnostic accuracy of the NEXUS criteria and the Canadian C-spine Rule in a pediatric population evaluated for CSI following blunt trauma.We searched the following databases to 24 February 2015: CENTRAL, MEDLINE, MEDLINE Non-Indexed and In-Process Citations, PubMed, Embase, Science Citation Index
Pay for performance â€“ motivation to succeed in Advanced Trauma Life Support courses â€“ a question of background or funding? Objective: To correlate students' performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli). Design: We present a non (...) -blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding
Acetaminophen or Nonsteroidal Anti-Inflammatory Drugs in Acute Musculoskeletal Trauma: A Multicenter, Double-Blind, Randomized, Clinical Trial We determine whether pain treatment with acetaminophen was not inferior to nonsteroidal anti-inflammatory drugs or the combination of both in minor musculoskeletal trauma.The Paracetamol or NSAIDs in Acute Musculoskeletal Trauma Study was a double-blind, randomized, clinical trial conducted in 2 general practices and 2 emergency departments (...) in the Netherlands. A total of 547 adults, aged 18 years and older, with acute blunt minor musculoskeletal extremity trauma were randomly assigned in a 1:1:1 ratio to acetaminophen 4,000 mg/day, diclofenac 150 mg/day, or acetaminophen 4,000 mg/day+diclofenac 150 mg/day during 3 consecutive days. Patients, health care staff, and outcome assessors were blinded for treatment allocation. Follow-up for each patient was 30 days. Primary outcome measures were between-group differences in mean numeric rating scale (NRS
Trauma Prevention Approved by: Director, Fellowship and Standards Version: 2 Approval date: April 2017 Document owner: Manager, Fellowship Services Review date: April 2020 Reference number: FES-FEL-047 Trauma Prevention INTRODUCTION The Royal Australasian College of Surgeons has a proud history with regard to trauma prevention. The Road Trauma Committee of the College was established in 1970 in response to the escalating road toll and the recognition that death and disability from road crashes (...) represented a public health issue which needed urgent attention. The College Trauma Committee is based on a tradition of research, the application of fact to a defined problem, inter-disciplinary organisation, and an integrated cooperative approach with other organisations and the community to achieve successful outcomes in reducing the tragic effects from injury. The College has been influential with policy makers and legislators and was a major contributor in the 1960s and 70s towards mandatory seat
Long-term disabilities after traumatic head injury (THI): a retrospective analysis from a large level-I trauma center in Saudi Arabia Traumatic head injuries (THI) are a critical public health problem worldwide, with more than 10 million individuals affected every year. In Saudi Arabia (SA), the burden of THI is unknown even though injury is the leading cause of death and a major cause of disability. Therefore, we aim to estimate the prevalence of long-term of disabilities among survivors (...) of THI treated at a large level-I trauma center in Riyadh.The study included 258 patients, who were hospitalized due to a non-fatal THI between years 2005-2014. Patients (age = 16-60 years) were contacted via the phone and information about their Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) was ascertained. Univariate analyses were performed to examine patients' characteristics and to estimate the prevalence of any disability. Logistic regression was used
Exploring Nursesâ€™ Knowledge and Experiences Related to Trauma-Informed Care Trauma-informed care is an emerging concept that acknowledges the lasting effects of trauma. Nurses are uniquely positioned to play an integral role in the advancement of trauma-informed care. However, knowledge related to trauma-informed care in nursing practice remains limited. The purpose of this article is to present the results of a qualitative study which explored nurses' understandings and experiences related (...) to trauma-informed care. Seven semistructured interviews were conducted with nurses and four categories emerged from the analysis: (a) Conceptualizing Trauma and Trauma-Informed Care, (b) Nursing Care and Trauma, (c) Context of Trauma-Informed Care, and (d) Dynamics of the Nurse-Patient Relationship in the Face of Trauma. These findings highlight important considerations for trauma-informed care including the complex dynamics of trauma that affect care, the need to push knowledge about trauma beyond
Eye-related trauma and infection in dentistry Despite numerous technological and medical developments achieved in recent years, a significant amount of occupational health problems still exist in modern dentistry. The risk of eye injury is mostly attributed to the use of high-speed hand pieces and ultrasonic devices. A dental clinic may be the source of eye-related infection and injury because of mechanical, chemical, microbiological and electromagnetic irritants. Accidents may cause facial