Injury
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Review Meta Analysis
Meta-analysis of predictive factors and outcomes for failure of non-operative management of blunt splenic trauma.
This study aimed to analyse predictive factors and outcomes of failure of non-operative management (NOM) following blunt splenic trauma. ⋯ fNOM leads to increased resource use and increased mortality. Methods of preventing fNOM, such as angioembolisation, warrant further assessment. Patients with increasing age, AAST scores and moderate or large haemoperitoneums may benefit from closer monitoring.
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Review Meta Analysis
Meta-analysis of predictive factors and outcomes for failure of non-operative management of blunt splenic trauma.
This study aimed to analyse predictive factors and outcomes of failure of non-operative management (NOM) following blunt splenic trauma. ⋯ fNOM leads to increased resource use and increased mortality. Methods of preventing fNOM, such as angioembolisation, warrant further assessment. Patients with increasing age, AAST scores and moderate or large haemoperitoneums may benefit from closer monitoring.
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Review Comparative Study
Self harm is an independent predictor of mortality in trauma and burns patients admitted to ICU.
Patients with mental illness or depression may sustain self-inflicted injuries that require admission to an Intensive Care Unit (ICU). It is unknown whether the intent of injury leads to a greater likelihood of dying over and above the severity of the initial injury. Given the economic and societal burden of injury of self-harm, we designed this study to compare hospital outcomes of intentionally injured patients presenting to a tertiary ICU compared to unintentional injuries. ⋯ Our study is the first paper in the literature to describe an increased the risk of death within a group of patients admitted to a trauma and burns ICU following deliberate self-harm.
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Despite the establishment of evidence-based guidelines for the resuscitation of critically injured patients who have sustained cardiopulmonary arrest, rapid decisions regarding patient salvageability in these situations remain difficult even for experienced physicians. Regardless, survival is limited after traumatic cardiopulmonary arrest. One applicable, well-described resuscitative technique is the emergency department thoracotomy-a procedure that, when applied correctly, is effective in saving small but significant numbers of critically injured patients. By understanding the indications, technical details, and predictors of survival along with the inherent risks and costs of emergency department thoracotomy, the physician is better equipped to make rapid futile versus salvageable decisions for this most severely injured subset of patients.
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Timely and appropriate pain management in the pre-hospital environment is paramount to effective patient care. Experts agree that there are many factors that hinder the delivery of adequate pain management to patients with pain. The purpose of this study was to use the Theory of Planned Behaviour (TPB) model to identify the factors influencing Ambulance Paramedics' intention to administer morphine to patients with pain. ⋯ Whilst participants reported strong intentions to administer morphine they also reported negative attitudes towards the behaviour. The constructs of the TPB explained 26% of the variance in intention to administer morphine with subjective norm being the strongest significant predictor. The findings related to specific attitudes and normative pressures provide an understanding into Paramedic's pain management behaviour.