Injury
-
Review Meta Analysis
Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis.
Life-threatening haemorrhage accounts for 40% mortality in trauma patients worldwide. After bleeding control is achieved, circulating volume must be restored. Early in-hospital transfusion of blood components is already proven effective, but the scientific proof for the effectiveness of prehospital blood-component transfusion (PHBT) in trauma patients is still unclear. ⋯ Systematic review and meta-analysis.
-
Multicenter Study
Identification of thoracic injuries by emergency medical services providers among trauma patients.
Severe thoracic injuries are time sensitive and adequate triage to a facility with a high-level of trauma care is crucial. The emergency medical services (EMS) providers are required to identify patients with a severe thoracic injury to transport the patient to the right hospital. However, identifying these patients on-scene is difficult. The accuracy of prehospital assessment of potential thoracic injury by EMS providers of the ground ambulances is unknown. Therefore, the aim of this study is to evaluate the diagnostic accuracy of the assessment of the EMS provider in the identification of a thoracic injury and determine predictors of a severe thoracic injury. ⋯ EMS providers could identify little over half of the patients with a thoracic injury. A supplementary triage protocol to identify patients with a thoracic injury could improve prehospital triage of these patients. In this supplementary protocol, age, vital signs, and mechanism criteria could be included.
-
Multicenter Study
High on drugs: Multi-institutional pilot study examining the effects of substance use on acute pain management.
Substance use and abuse may have the significant, but unanticipated, consequence of lessening the efficacy of opioid analgesics for acute pain management. We hypothesized that pre-injury substance use increases opioid analgesic consumption following traumatic injury. ⋯ Our preliminary data suggest drug use may significantly alter acute pain management following traumatic injury, corresponding to 40% increase in opioid analgesia for substance users than non-users. These results may have broad reaching implications because of the high prevalence of substance use in the trauma population.
-
Observational Study
The association between post-concussion symptoms and health-related quality of life in patients with mild traumatic brain injury.
A subset of mild traumatic brain injury (mTBI) patients experience post-concussion symptoms. When a cluster of post-concussion symptoms persists for over three months, it is referred to as post-concussion syndrome (PCS). Little is known about the association between PCS and Health-Related Quality of Life (HRQoL) after mTBI. ⋯ All items of the RPQ were negatively correlated to all SF-36 domains and PQoL subscale scores, indicating that reporting problems on any of the RPQ symptoms was associated with a decrease on different aspects of an individuals' HRQoL. To conclude, PCS is common following mTBI and patients with PCS have a considerably lower HRQoL. A better understanding of the relationship between PCS and HRQoL and possible mediating factors in this relationship could improve intervention strategies, the recovery process for mTBI patients and benchmarking.
-
Paediatric injury impacts the entire family. Many parents experience stress and anxiety following paediatric injury, but little is known about factors that support parents' wellbeing and how they successfully manage the adversity of child injury during acute hospitalisation. ⋯ Resilience-promoting factors for parents of injured children can be used to inform development of brief online intervention modules to enhance parent resilience. Routine screening and targeted psychological first aid for parental distress are recommended.