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Latest & greatest articles for trauma
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Palliative Care for Geriatric Trauma Patients, Trauma Center Care and Routine Processes for Care - Evidence-Based Review Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtPTSC/ubO7ynQxHVVztWt8diOe6metvPjVQIEhwIX51W on 04/05/2019 Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtPTSC/ubO7ynQxHVVztWt8diOe6metvPjVQIEhwIX51W (...) on 04/05/2019 Evidence-basedreviewoftraumacentercareandroutinepalliative care processes for geriatric trauma patients; A collaboration from the American Association for the Surgery of Trauma Patient Assessment Committee, the American Association for the Surgery of Trauma GeriatricTrauma Committee, andthe Eastern Association for the Surgeryof Trauma GuidelinesCommittee HibaAbdelAziz,MD,JohnLunde,DNP,RobertBarraco,MD,MPH,JohnJ.Como,MD,MPH, ZaraCooper,MD,MSc,ThomasHayward,III,MD,FranchescaHwang,MD,MSc
Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments The objective of the InMEDIATE study was to evaluate the change in intensity of traumatic pain over the first 20 min in adult patients treated with methoxyflurane versus standard analgesic treatment in Spain. This the first randomized, active-controlled, multicenter trial of methoxyflurane (...) in the emergency setting in Europe.This was a randomized, controlled study that enrolled adult patients with acute moderate to severe (score ≥4 on the 11-point Numeric Rating Scale) trauma-associated pain in 14 Spanish emergency departments. Patients were randomized 1:1 to methoxyflurane (up to 2×3 mL) or standard analgesic treatment. Coprimary endpoints were the change from baseline in Numeric Rating Scale pain intensity score during the first 20 minutes of treatment and time to first pain relief.Three
Impact of Affordable Care Act on Trauma and Emergency General Surgery Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtMQCRf/IzvVQaOu4uz61ZYv4n2SlVPyMQA== on 08/13/2019 Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtMQCRf/IzvVQaOu4uz61ZYv4n2SlVPyMQA== on 08/13/2019 ImpactoftheAffordableCareActontraumaandemergency (...) )patientswhoareuninsuredhaveworseoutcomesascomparedwithinsuredpatients. Partially modeledafter the 2006 Massachusetts Healthcare Reform (MHR), thePatient Protectionand Affordable Care Act was passed in 2010 with thegoal of expanding health insurance coverage, primarily through state-based Medicaid expansion (ME). We evaluatedtheimpact ofMEandMHRon outcomesfor trauma patients, EGSpatients,andtrauma systems. METHODS: ThisstudywasapprovedbytheEasternAssociationfortheSurgeryofTraumaGuidelinesCommittee.UsingGradingofRecom- mendations Assessment, Development
Pediatric Blunt Renal Trauma Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtPTSC/ubO7ynQxHVVztWt8diOe6metvPjVQIEhwIX51W on 05/01/2019 Downloaded from https://journals.lww.com/jtrauma by SHrJlXRiF9wyGdmDxC/n4ZvpFObN52W8/pJs1OP5wSe8gFsvgypyd1IoKm1sOFkZv1K8SX2R9B65BkYPRgcPtPTSC/ubO7ynQxHVVztWt8diOe6metvPjVQIEhwIX51W on 05/01/2019 Pediatricblunt renal trauma practicemanagementguidelines: Collaborationbetween (...) theEasternAssociation fortheSurgeryof Trauma andthe PediatricTrauma Society JudithC.Hagedorn,MD,NicoleFox,MD,JonathanS.Ellison,MD,RobertRussell,MD,CordelieE.Witt,MD, KristenZeller,MD,PaulaFerrada,MD, andJohnM.Draus,Jr,MD, Seattle, Washington BACKGROUND: Injurytothekidneyfromeitherbluntorpenetratingtraumaisthemostcommonurinarytractinjury.Childrenareathigherriskof renalinjuryfromblunttraumathanadults,butnopediatricrenaltraumaguidelineshavebeenestablished.Theauthorsreviewedthe literaturetoguide cliniciansin
Trauma models to identify major trauma and mortality in the prehospital setting Patients with major trauma might benefit from treatment in a trauma centre, but early identification of major trauma (Injury Severity Score (ISS) over 15) remains difficult. The aim of this study was to undertake an external validation of existing prognostic models for injured patients to assess their ability to predict mortality and major trauma in the prehospital setting.Prognostic models were identified through (...) a systematic literature search up to October 2017. Injured patients transported by Emergency Medical Services to an English hospital from the Trauma Audit and Research Network between 2013 and 2016 were included. Outcome measures were major trauma (ISS over 15) and in-hospital mortality. The performance of the models was assessed in terms of discrimination (concordance index, C-statistic) and net benefit to assess the clinical usefulness.A total of 154 476 patients were included to validate six previously
Medical Follow-up and Discharge of Individuals Receiving Electric Shock or Blunt Trauma from Non-Lethal Weapons: Guidelines Medical Follow-up and Discharge of Individuals Receiving Electric Shock or Blunt Trauma from Non-Lethal Weapons: Guidelines | CADTH.ca Find the information you need Medical Follow-up and Discharge of Individuals Receiving Electric Shock or Blunt Trauma from Non-Lethal Weapons: Guidelines Medical Follow-up and Discharge of Individuals Receiving Electric Shock or Blunt (...) Trauma from Non-Lethal Weapons: Guidelines Last updated: August 16, 2019 Project Number: RB1378-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What are the evidence-based guidelines regarding medical follow-up and discharge of people who have received an electric shock from a conducted electrical weapon or blunt trauma from a projectile-based weapon? Key Message Two evidence-based guidelines were identified regarding medical follow
Point of Care Ultrasound for Assessment of Patients with Physical Trauma in Emergency Departments: Clinical Utility and Cost-Effectiveness Point of Care Ultrasound for Assessment of Patients with Physical Trauma in Emergency Departments: Clinical Utility and Cost-Effectiveness | CADTH.ca Find the information you need Point of Care Ultrasound for Assessment of Patients with Physical Trauma in Emergency Departments: Clinical Utility and Cost-Effectiveness Point of Care Ultrasound for Assessment (...) of Patients with Physical Trauma in Emergency Departments: Clinical Utility and Cost-Effectiveness Last updated: September 16, 2019 Project Number: RB1383-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical utility of point of care ultrasound for the assessment of patients with physical trauma in the emergency department? What is the cost-effectiveness of point of care ultrasound for the assessment of patients
What Is the Diagnostic Accuracy of Point-of-Care Ultrasonography in Patients With Suspected Blunt Thoracoabdominal Trauma? What Is the Diagnostic Accuracy of Point-of-Care Ultrasonography in Patients With Suspected Blunt Thoracoabdominal Trauma? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 74, Issue 3, Pages 400–402 What Is the Diagnostic Accuracy of Point-of-Care Ultrasonography in Patients (...) With Suspected Blunt Thoracoabdominal Trauma? x Brit Long , MD (EBEM Commentator) , x Michael D. April , MD, DPhil (EBEM Commentator) Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX DOI: | Publication History Published online: February 14, 2019 Expand all Collapse all Article Outline Take-Home Message In patients with blunt trauma, a positive point-of-care ultrasonography result can identify thoracoabdominal injury with high specificity
What Is the Incidence of Intracranial Hemorrhage Among Anticoagulated Patients With Minor Head Trauma? What Is the Incidence of Intracranial Hemorrhage Among Anticoagulated Patients With Minor Head Trauma? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 74, Issue 1, Pages 98–100 What Is the Incidence of Intracranial Hemorrhage Among Anticoagulated Patients With Minor Head Trauma? x Michael Gottlieb (...) , MD (EBEM Commentator) , x Somy M. Thottathil , MD (EBEM Commentator) , x Jacob P. Holton , MD (EBEM Commentator) Department of Emergency Medicine, Rush University Medical Center, Chicago, IL DOI: | Publication History Published online: December 20, 2018 Expand all Collapse all Article Outline Take-Home Message Among anticoagulated patients presenting with minor head trauma, 9% may have an intracranial hemorrhage. Methods Data Sources PubMed, EMBASE, the Cochrane databases, and the Database
Major Blunt Trauma New 2019 ACR Appropriateness Criteria ® 1 Major Blunt Trauma American College of Radiology ACR Appropriateness Criteria ® Major Blunt Trauma Variant 1: Major blunt trauma. Hemodynamically unstable. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography trauma series Usually Appropriate ??? US FAST scan chest abdomen pelvis Usually Appropriate O CT whole body with IV contrast May Be Appropriate ???? CT whole body without IV contrast May (...) Be Appropriate ???? MRI abdomen and pelvis without and with IV contrast Usually Not Appropriate O MRI abdomen and pelvis without IV contrast Usually Not Appropriate O Variant 2: Major blunt trauma. Hemodynamically stable. Not otherwise specified. Initial imaging. Procedure Appropriateness Category Relative Radiation Level CT whole body with IV contrast Usually Appropriate ???? Radiography trauma series Usually Appropriate ??? US FAST scan chest abdomen pelvis Usually Appropriate O CT whole body without IV
Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock: A Randomized Clinical Trial Current therapies for traumatic blood loss focus on hemorrhage control and blood volume replacement. Severe hemorrhagic shock, however, is associated with a state of arginine vasopressin (AVP) deficiency, and supplementation of this hormone may decrease the need for blood products in resuscitation.To determine whether low (...) -dose supplementation of AVP in patients with trauma (hereinafter referred to as trauma patients) and with hemorrhagic shock decreases their need for transfused blood products during resuscitation.This randomized, double-blind placebo-controlled clinical trial included adult trauma patients (aged 18-65 years) who received at least 6 U of any blood product within 12 hours of injury at a single urban level 1 trauma center from May 1, 2013, through May 31, 2017. Exclusion criteria consisted
Using a Motor GCS Score or Patient Does Not Follow Commands to Replace the Glasgow Coma Scale for Predicting Severe Injury in Trauma Patients "Using a Motor GCS Score or “Patient Does Not Follow Commands” to Repla" by Jennifer Steinhaus < > > > > > Title Author Date of Graduation Summer 8-10-2019 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background : To assess an injured patient’s condition and to triage the patient (...) to the appropriate facility, out-of-hospital providers use the Glasgow Coma Scale (GCS) even though the GCS has known inconsistent results. A GSC motor (GCS-m) less than 6 or “patient does not follow commands” would be an acceptable substitution to the full GCS to simplify trauma triage. Method : An exhaustive literature search using MEDLINE-Ovid, Web Science, and CINAHL was conducted. The following search terms were used: “patient does not follow commands” and “Glasgow Coma Scale” which yielded 2 studies
Head Trauma- Child Date of origin: 2014 ACR Appropriateness Criteria ® 1 Head Trauma — Child American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Head Trauma — Child Variant 1: Minor head injury (GCS >13) =2 years of age without neurologic signs or high risk factors (eg, altered mental status, clinical evidence of basilar skull fracture). Excluding nonaccidental trauma. Radiologic Procedure Rating Comments RRL* CT head without IV contrast 3 This is a known low-yield (...) ACR Appropriateness Criteria ® 2 Head Trauma — Child Clinical Condition: Head Trauma — Child Variant 2: Minor head injury (GCS >13), 13 . Approximately 3%–5% of children with minor head trauma have identifiable abnormalities by imaging, and typically less than 1% require neurosurgical intervention [6-9]. Noncontrast CT has a central role in screening for intracranial traumatic injury due to its wide availability, speed, and ability to detect significant hemorrhage, herniation, hydrocephalus
Acute Trauma to the Foot Date of origin: 2010 Last review date: 2014 ACR Appropriateness Criteria ® 1 Acute Trauma to the Foot American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Acute Trauma to the Foot Variant 1: Adult or child >5 years old. Acute injury to the foot; positive Ottawa Rules, suspicious for fracture. First study. Radiologic Procedure Rating Comments RRL* X-ray foot 9 ? CT foot without IV contrast 1 The RRL for the adult procedure is ? . ?? CT foot (...) is ? . ?? CT foot without and with IV contrast 1 The RRL for the adult procedure is ? . ?? MRI foot without IV contrast 1 O MRI foot without and with IV contrast 1 O US foot 1 O Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Acute Trauma to the Foot Clinical Condition: Acute Trauma to the Foot Variant 4: Adult or child >5 years old. Acute injury to the foot; does not meet the Ottawa Rules; patient
Penetrating Trauma-Lower Abdomen and Pelvis. American College of Radiology End User License Agreement ACR Appropriateness Criteria is a registered trademark of the American College of Radiology. By accessing the ACR Appropriateness Criteria®, you expressly agree and consent to the terms and conditions as described at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/TermsandConditions.pdf Personal use of material is permitted for research, scientific and/or information purposes only. You (...) may not modify or create derivative works based on American College of Radiology material. No part of any material posted on the American College of Radiology Web site may be copied, downloaded, stored in a retrieval system, or redistributed for any other purpose without the expressed written permission of American College of Radiology. Date of origin: 1996 Last review date: 2013 ACR Appropriateness Criteria ® 1 Suspected Lower Urinary Tract Trauma American College of Radiology ACR Appropriateness
Intranasal sufentanil versus intravenous morphine for acute severe trauma pain: A double-blind randomized non-inferiority study Intravenous morphine (IVM) is the most common strong analgesic used in trauma, but is associated with a clear time limitation related to the need to obtain an access route. The intranasal (IN) route provides easy administration with a fast peak action time due to high vascularization and the absence of first-pass metabolism. We aimed to determine whether IN sufentanil
External validation of a clinical prediction rule for very low risk pediatric blunt abdominal trauma Computed tomography (CT) is frequently used to identify intra-abdominal injuries in children with blunt abdominal trauma (BAT). The Pediatric Emergency Care Applied Research Network (PECARN) proposed a prediction rule to identify children with BAT who are at very low risk for clinically-important intra-abdominal injuries (CIIAI) in whom CT can be avoided.To determine the sensitivity (...) of this prediction rule in identifying patients at very low risk for CIIAI in our pediatric trauma registry.Retrospective review of our institutional trauma registry to identify patients with CIIAI. CIIAI included cases resulting in death, therapeutic intervention at laparotomy, angiographic embolization of intra-abdominal arterial bleeding, blood transfusion for intra-abdominal hemorrhage, and administration of intravenous fluids for two or more nights for pancreatic or gastrointestinal injuries. Patients were
A new clinical score for cranial computed tomography in emergency department non-trauma patients: Definition and first validation Well recognized guidelines are available for the use of cranial computed tomography (CCT) in traumatic patients, while no definitely accepted standards exists to for CCT in patients without history of head injury. The aim of this study is to propose an easy clinical score to stratify the need of CCT in emergency department (ED) patients with suspect non-traumatic