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Latest & greatest articles for trauma
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on trauma or other clinical topics then use Trip today.
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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
CanadiEM MVP Infographic Series – The Canadian C-spine rule for radiography in alert and stable trauma patients CanadiEM MVP Infographic Series - The Canadian C-spine rule for radiography in alert and stable trauma patients - CanadiEM CanadiEM MVP Infographic Series – The Canadian C-spine rule for radiography in alert and stable trauma patients In , , by Kevin Lam January 25, 2019 This issue of the MVP Infographic Series is focused on “The Canadian C-spine rule for radiography in alert (...) and stable trauma patients” published by Stiell et al. 1 Prior to the use of clinical decision rules, such as the Canadian C-spine Rule (CCR), clinicians varied up to 6-fold in how often they ordered C-spine X-rays. Although such X-rays have a low individual cost, they carry a high systems-level cost due to the volume of tests ordered. As such, a good clinical decision rule with high sensitivity to rule out C-spine injuries was much needed. Prior to the development of the CCR, the NEXUS criteria
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
Suspected Spine Trauma ? Child New 2018 ACR Appropriateness Criteria ® 1 Suspected Spine Trauma–Child American College of Radiology ACR Appropriateness Criteria ® Suspected Spine Trauma–Child Variant 1: Child, 3 to 16 years of age, acute cervical spine trauma, meets low risk criteria (based on PECARN or NEXUS). Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography cervical spine Usually Not Appropriate ?? Arteriography cervicocerebral Usually Not Appropriate (...) Not Appropriate O MRI cervical spine without IV contrast Usually Not Appropriate O US cervical spine Usually Not Appropriate O Variant 2: Child, 3 to 16 years of age, acute cervical spine trauma, at least one risk factor with reliable clinical examination (based on PECARN or NEXUS). Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography cervical spine Usually Appropriate ?? CT cervical spine without IV contrast May Be Appropriate (Disagreement) ???? MRI cervical spine without
Evaluation and comparison of different prehospital triage scores of trauma patients on in-hospital mortality Several prehospital major trauma patient triage scores have been developed, the triage revised trauma score (T-RTS), Vittel criteria, Mechanism/Glasgow Coma Scale/Age/Systolic blood pressure score (MGAP) and the new trauma score (NTS). These scoring schema allow a rapid and accurate prognostic assessment of the severity of potential lesions. The aim of our study was to compare (...) these scores with in-hospital mortality predictions in a cohort of consecutive trauma patients admitted in a Level 1 trauma center.Between 2013 and 2016, 1,112 patients were admitted to the "major trauma" spinneret of a Level 1 trauma center in the south of France. All prehospital data needed to calculate the T-RTS, Vittel criteria, the MGAP score and the NTS were collected. The main evaluation criterion was in-hospital mortality at 30 days for all causes. The predictive performances of these scores were
Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial. To determine if using a parachute prevents death or major traumatic injury when jumping from an aircraft.Randomized controlled trial.Private or commercial aircraft between September 2017 and August 2018.92 aircraft passengers aged 18 and over were screened for participation. 23 agreed to be enrolled and were randomized.Jumping from an aircraft (airplane or helicopter) with a parachute versus
Point-of-care ultrasonography for diagnosing thoracoabdominal injuries in patients with blunt trauma. Point-of-care sonography (POCS) has emerged as the screening modality of choice for suspected body trauma in many emergency departments worldwide. Its best known application is FAST (focused abdominal sonography for trauma). The technology is almost ubiquitously available, can be performed during resuscitation, and does not expose patients or staff to radiation. While many authors have stressed (...) or mixed population 0.97 (95% CI 0.96 to 0.99). For abdominal trauma, POCS had a sensitivity of 0.68 (95% CI 0.59 to 0.75) and a specificity of 0.95 (95% CI 0.92 to 0.97). For chest injuries, sensitivity and specificity were calculated at 0.96 (95% CI 0.88 to 0.99) and 0.99 (95% CI 0.97 to 1.00). If we consider the results of all 34 included studies in a virtual population of 1000 patients, based on the observed median prevalence (pretest probability) of thoracoabdominal trauma of 28%, POCS would miss
Mental health outcomes after major trauma in Ontario: a population-based analysis Major injury continues to be a common source of morbidity and mortality; improving the functional recovery of survivors of major trauma requires a better understanding of the mental health outcomes that may occur in this population. We assessed the association between major trauma and the development of a new mental health diagnosis or death by suicide.We completed a population-based, self-controlled, longitudinal (...) cohort analysis using linked administrative data on patients treated for major trauma in Ontario between 2005 and 2010. All survivors were included and composite rates of mental health diagnoses during inpatient admissions were compared between the 5 years after injury and the 5 years before injury, using Poisson regression with generalized estimating equations. The incidence of suicide was calculated for the 5 years after injury. Risk factors for suicide were calculated using Cox proportional hazard
What Physiologic Parameters Are Indicative of Severe Injury in Trauma? What Physiologic Parameters Are Indicative of Severe Injury in Trauma? TAKE-HOME MESSAGE Pulse rate, systolic blood pressure, shock index, respiratory rate, and lactate demonstrate poor sensitivity but high speci?city for predicting severe injury among trauma patients. No parameter in isolation is able to adequately predict the risk of severe injury. EBEM Commentators Brit Long, MD Michael D. April, MD, DPhil Department (...) trauma patients to identify those with severe injuries as measured by resource use (blood transfusion, critical care admission, lifesaving intervention), anatomic injury severity measures (eg, Injury Severity Score), mortality, or a combination of any of these parameters developed by stakeholders including the Agency for Healthcare Research and Quality and the National Highway Transportation Safety Administration. Authors did not restrict the type of trials included. Two or more authors independently
Risk of Serious Trauma with Glucose-Lowering Drugs in Older Persons: A Nested Case-Control Study To assess the risk of hospitalization for trauma associated with use of hypoglycemic glucose-lowering drugs (GLDs) in individuals aged 65 and older.Observational, nested, case-control study.The Echantillon Généraliste de Bénéficiaires claims database, a 1/97th representative sample of the population covered by French healthcare insurance.All persons with a first hospitalization for trauma between (...) 2009 and 2015 were considered as potential cases. They were selected if they had been followed for 365 days or longer at index date, were aged 65 and older, and had no diagnosed cancer. Cases (n=10,743) were matched with up to 10 randomly selected controls on age, sex, and length of follow-up (n=106,629).GLD exposure was considered globally and according to use of hypoglycemic GLDs alone, nonhypoglycemic GLDs alone, or both types of GLDs. Risk of hospitalization for trauma was estimated using
Malnutrition and the Orthopaedic Trauma Patient: A Systematic Review of the Literature To evaluate the available literature for associations between nutrition and outcomes after operative treatment of long bone and long bone periarticular fractures.Systematic review of English-language articles in the MEDLINE, Embase, PubMed, and Cochrane computerized literature databases (through December 2015) using PRISMA guidelines.Randomized controlled trials, quasi-randomized controlled trials, case (...) one of the original aims of the study was to conduct a meta-analysis, the available literature did not offer sufficient data for meta-analysis.Although our systematic review demonstrates a possible role for oral nutritional supplementation and vitamin supplementation in the orthopaedic trauma patient, there remains a need for well-designed trials to clarify this role. There is likely benefit to multidisciplinary approaches to nutritional optimization in the orthopaedic trauma patient
Novel preclinical murine model of trauma-induced elbow stiffness Peri-articular injury may result in functional deficits and pain. In particular, post-traumatic elbow stiffness is a debilitating condition, precluding patients from performing activities of daily living. As such, clinicians and basic scientists alike, aim to develop novel therapeutic interventions to prevent and treat elbow stiffness; thereby reducing patient morbidity. Yet, there is a paucity of pre-clinical models of peri (...) 29.87 ± 2.075 mm, ***, p < 0.0002). Additionally, plasminogen deficient animals developed capsule thickening, delayed skeletal muscle repair, fibrosis, chronic inflammation, and heterotopic ossification; all features characteristic of pathology observed in patients with trauma-induced elbow stiffness.A soft tissue injury to the peri-elbow soft tissue with a concomitant deficiency in plasminogen, instigates elbow stiffness and pathologic features similar to those observed in humans. This pre-clinical
If we build it, will they come? Issues of engagement with digital health interventions for trauma recovery Exposure to traumatic events is extremely common with nearly 75% reported to have experienced one or more traumatic events worldwide. A significant number of those exposed will develop posttraumatic stress disorder (PTSD) along with depression, anxiety, and substance use disorders. Globally, trauma-related mental health disorders are the leading cause of global disability burden, and many (...) is a concern and limited participation and high attrition rates are common. This may be especially true for trauma survivors who often experience symptoms of avoidance and hyperarousal. Engagement is regarded as an essential component of intervention efficacy and has been demonstrated to be associated with more positive clinical outcomes, yet theoretically based research in this area is sparse. This review focuses on the complex issue of engagement with digital health interventions (DHIs). Specifically, we
Urological Trauma Urological Trauma | Uroweb › Urological Trauma Urological Trauma To access the pdfs & translations of individual guidelines, please as EAU member. Non-EAU members can view the web versions. To become an EAU member, click . N.D. Kitrey (Chair), N. Djakovic, P. Hallscheidt, F.E. Kuehhas, N. Lumen, E. Serafetinidis, D.M. Sharma Guidelines Associates: Y. Abu-Ghanem, A. Sujenthiran, M. Waterloos TABLE OF CONTENTS REFERENCES 1. Radmayr, C., et al., EAU Guidelines on Paediatric (...) Urology. In: EAU Guidelines, edition presented at the annual EAU Congress Barcelona 2019. ISBN 978-94-92671-04-2. 2. Martinez-Pineiro, L., et al. EAU Guidelines on Urethral Trauma. Eur Urol, 2010. 57: 791. 3. Summerton, D.J., et al. EAU guidelines on iatrogenic trauma. Eur Urol, 2012. 62: 628. 4. Lumen, N., et al. Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol, 2015. 67: 925. 5. Serafetinides, E., et al. Review of the current management
Trauma-intrusive hallucinations and the dissociative state Research has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals.To further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations.The study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype (...) of PTSD Score.In total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction.This
Trauma Top results for trauma - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for trauma The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted
Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock. After a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from hemorrhage and shock. Data from large clinical trials are lacking to show either the efficacy or the risks associated with plasma transfusion in the prehospital setting.To (...) randomization (log-rank chi-square test, 5.70; P=0.02). The median prothrombin-time ratio was lower in the plasma group than in the standard-care group (1.2 [interquartile range, 1.1 to 1.4] vs. 1.3 [interquartile range, 1.1 to 1.6], P<0.001) after the patients' arrival at the trauma center. No significant differences between the two groups were noted with respect to multiorgan failure, acute lung injury-acute respiratory distress syndrome, nosocomial infections, or allergic or transfusion-related
Impact of emergency physicians competent in severe trauma management, surgical techniques, and interventional radiology on trauma management Despite recent advancements in trauma management following introduction of interventional radiology (IVR) and damage-control strategies, challenges remain regarding optimal use of resources for severe trauma.In October 2014, we implemented a trauma management system comprising emergency physicians competent in severe trauma management, surgical techniques (...) , and IVR. To evaluate this system, of 5,899 trauma patients admitted to our hospital from January 2011 to January 2018, we selected 107 patients with severe trauma (injury severity score ≥ 16) who presented with persistent hypotension (two or more systolic blood pressure measurements <90 mmHg), regardless of primary resuscitation. Patients were divided according to the date of admission: Conventional (January 2011-September 2014) or Current (October 2014-January 2018). The primary end-point
mHealth solutions for early interventions after trauma: improvements and considerations for assessment and intervention throughout the acute post-trauma period Interventions administered shortly after a traumatic event have the potential to prevent posttraumatic stress disorder (PTSD) and related mental health conditions. A key challenge in delivering such interventions is understanding how PTSD symptoms develop in the acute post-trauma period, defined as the first 30 days after a trauma (...) . Mobile devices have the potential to transform the way symptoms are assessed and how treatment is delivered in that they can capture the dynamic and nuanced nature of symptom progression after trauma. Symptoms can be assessed through active strategies that require user input, such as self-report, or through passive strategies, such as location information. Adaptive mobile interventions can be tailored to target PTSD symptoms as they appear and ultimately prevent more chronic courses of illness