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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
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
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
Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates Scientific Impact Paper No. 54 December 2016Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates 1. Background Implantation continues to be a rate-limiting step in the success of assisted conception treatments. For implantation to occur, a blastocyst must (...) of women. While there is, as yet, no universally accepted definition for RIF , it has been proposed as the failure to achieve a clinical pregnancy after transfer of at least four good quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years. 14 Thus far, the effect of endometrial trauma on pregnancy outcome in women who have experienced recurrent miscarriage (RM) has not been evaluated. 2. Evidence for endometrial trauma and improved implantation rates
The influence of sex steroid hormones on the response to trauma and burn injury Trauma and related sequelae result in disturbance of homeostatic mechanisms frequently leading to cellular dysfunction and ultimately organ and system failure. Regardless of the type and severity of injury, gender dimorphism in outcomes following trauma have been reported, with females having lower mortality than males, suggesting that sex steroid hormones (SSH) play an important role in the response of body systems (...) to trauma. In addition, several clinical and experimental studies have demonstrated the effects of SSH on the clinical course and outcomes following injury. Animal studies have reported the ability of SSH to modulate immune, inflammatory, metabolic and organ responses following traumatic injury. This indicates that homeostatic mechanisms, via direct and indirect pathways, can be maintained by SSH at local and systemic levels and hence result in more favourable prognosis. Here, we discuss the role
Thromboelastography or Rotational Thromboelastography for Trauma: A Review of the Clinical and Cost-Effectiveness and Guidelines Thromboelastography or Rotational Thromboelastography for Trauma: A Review of the Clinical and Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Thromboelastography or Rotational Thromboelastography for Trauma: A Review of the Clinical and Cost-Effectiveness and Guidelines Thromboelastography or Rotational Thromboelastography for Trauma (...) : A Review of the Clinical and Cost-Effectiveness and Guidelines Published on: September 8, 2017 Project Number: RC0924-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness evidence regarding the use of thromboelastography (TEG) or rotational thromboelastography (ROTEG) to guide transfusion requirements for trauma patients with bleeding? What is the cost-effectiveness of TEG or ROTEG to guide
Comparative analysis of gender differences in outcomes after trauma in India and the USA: case for standardised coding of injury mechanisms in trauma registries While females generally have better outcomes than males after traumatic injury, higher mortality has been shown to occur in females after intentional trauma in lower-income countries. However, gender differences in trauma outcomes in different countries have not been previously compared. We conducted a two-country comparative analysis (...) to characterise gender differences in mortality for different mechanisms of injury.Two urban trauma databases were analysed from India and the USA for fall, motor vehicle collision (MVC) and assault patients between 2013 and 2015. Coarsened exact matching was used to match the two groups based on gender, age, injury severity score, Glasgow Coma Score and type of injury (blunt vs penetrating). The primary outcome of mortality was studied by using logistic regression to calculate the odds of death in the four
Concurrent Treatment for Substance Use Disorder and Trauma-Related Comorbidities: A Review of Clinical Effectiveness and Guidelines Concurrent Treatment for Substance Use Disorder and Trauma-Related Comorbidities: A Review of Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Concurrent Treatment for Substance Use Disorder and Trauma-Related Comorbidities: A Review of Clinical Effectiveness and Guidelines Concurrent Treatment for Substance Use Disorder and Trauma
Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan Accurate evaluation of health care quality requires high-quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources.Using hospital-level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan (...) Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013. We compared the median values for trauma case volumes, numbers of deaths, and case fatality rates from both data sources, and also evaluated the variability in discrepancies for the intrahospital differences of these outcomes.The analyses included 136 hospitals. In the registry and annual evaluation data, the median case volumes were 120.5 cases and 180.5 cases, respectively; the median
Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures.The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures (...) in traumatic patients.This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity.The mean age of patients with upper and lower limb trauma were 31.43±12.32
Venous thromboembolism in major trauma patients: a singleâ€center retrospective cohort study of the epidemiology and utility of Dâ€dimer for screening Venous thromboembolism (VTE) can be a life-threatening complication after major trauma. The aim of this study was to investigate the epidemiology of VTE and to assess the usefulness of D-dimer for screening for VTE in major trauma cases among the Japanese population.We examined a single-center retrospective cohort of severely injured trauma (...) operating characteristic curve (AUROC) to predict VTE.The study cohort consisted of 204 trauma patients (median Injury Severity Score, 20). Of the 204 patients, 65 (32%) developed VTE. The median time from admission to VTE diagnosis was 10 days. In multiple logistic regression analysis, higher Injury Severity Score and the presence of lower extremity fractures were revealed to be a risk factor for VTE. D-dimer levels at day 10 showed moderate accuracy, of which the AUROC was 0.785 (95% confidence
Effect of Abdominal Ultrasound on Clinical Care, Outcomes, and Resource Use Among Children With Blunt Torso Trauma: A Randomized Clinical Trial. The utility of the focused assessment with sonography for trauma (FAST) examination in children is unknown.To determine if the FAST examination during initial evaluation of injured children improves clinical care.A randomized clinical trial (April 2012-May 2015) that involved 975 hemodynamically stable children and adolescents younger than 18 years (...) treated for blunt torso trauma at the University of California, Davis Medical Center, a level I trauma center.Patients were randomly assigned to a standard trauma evaluation with the FAST examination by the treating ED physician or a standard trauma evaluation alone.Coprimary outcomes were rate of abdominal computed tomographic (CT) scans in the ED, missed intra-abdominal injuries, ED length of stay, and hospital charges.Among the 925 patients who were randomized (mean [SD] age, 9.7 [5.3] years; 575
Self-harm and violent criminality among young people who experienced trauma-related hospital admission during childhood: a Danish national cohort study Development of a better understanding of subsequent pathways for individuals who experienced trauma during childhood might usefully inform clinicians and public health professionals regarding the causes of self-harm and interpersonal violence. We aimed to examine these risks during late adolescence and early adulthood among people admitted (...) of self-harm and violent offending, respectively, as adverse outcomes at ages 15-35 years. Sex-specific incidence rate ratios (IRRs; relative risks) and cumulative incidence percentage values (absolute risks) were estimated. The confounding influence of parental socioeconomic status was also explored.1 087 672 Danish people were included in this study. The prevalence of any trauma-related hospital admission was 10% (105 753 per 1 087 672; males: 64 454 [11%]; females: 44 299 [8%]) and for both sexes