Injury
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Chest wall injury causes significant morbidity and mortality. There is uncertainty regarding many aspects of clinical care for these patients, including optimal analgesia, acuity of monitoring and surgical fixation. Our aim in this work is to [1] objectively appraise the quality and extent of heterogeneity in UK major trauma centre (MTC) clinical practice guidelines regarding the management of chest wall injury; and [2] narratively summarise clinical and care process recommendations from these guidelines to provide a comparative description of recommendations between institutions. ⋯ This work highlights the paucity of high-quality local clinical practice guidelines to inform the management of adults with chest wall injury admitted to UK MTCs. Although some degree of variation between local guidelines is acceptable, we have identified substantial heterogeneity in the clinical care recommendations between institutions.
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The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care. ⋯ The results of this trial did not support a 'one-size fits all' simple, early exercise programme for patients with blunt chest wall trauma. Future research should consider the impact of a personalised exercise programme, commenced by the patient at least one week post-injury.
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Hypothermia is known to contribute to poor outcomes in trauma patients during acute phases. The aim of our study is to evaluate the effect of hypothermia on admission, upon in-hospital complications and mortality in adult trauma patients. ⋯ Level III retrospective study.
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Paediatric trauma is a leading cause of death, with correlations between trauma outcomes and geographical locations. Certain rural regions of Norway face a higher risk of trauma-related fatalities compared to the nationwide population. Among adults, the risk of both fatal and non-fatal injuries rises with increased rurality. The study aimed to investigate whether there is an increased risk of fatal and non-fatal injuries for children in rural areas across the entire country, as well as any changes over two decades. ⋯ The mortality rate increased linearly across all levels of centrality, and the relative risk was 2.4 times higher in the most rural population compared to the most urban population. To effectively target primary prevention and enhance trauma care for paediatric patients in rural areas, a deeper epidemiological understanding and more comprehensive studies are essential.