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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
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
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
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
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
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
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
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
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
BSRM Core standards for Major Trauma British Society of Rehabilitation Medicine, c/o Royal College of Physicians, 11 St Andrews Place, London NW1 4LE firstname.lastname@example.org tel: 01992 638865 www.bsrm.org.uk Specialist Rehabilitation in the Trauma pathway: BSRM core standards Version 2.1 November 2018 Working Party Membership Roles Affiliation Lead Author Prof Lynne Turner-Stokes Northwick Park Professor of Rehabilitation, King’s College London and Director of the Regional Rehabilitation Unit (...) Wade Professor and Consultant in Neurological Rehabilitation, Oxford Brookes University, Oxford Mrs Jacqui Wakefield Consultant Therapist, King’s College Hospital, London Dr Krystyna Walton Consultant in Rehabilitation Medicine, Salford Royal Hospital, Manchester 2 BSRM Core Standards for Specialist Rehabilitation following Major Trauma: After trauma many patients will need input from rehabilitation services including from rehabilitation consultants. Often the input may be limited to assessment
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