Injury
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There is a global surge in blast injuries, which are associated with high morbidity and mortality. To our knowledge, there are no guidelines for the management of blast injuries in the trauma bay. ⋯ Blast injuries present unique challenges in management and demand a multidisciplinary approach and specialized resources. We present an algorithm for terror- and combat-related blast injuries treated in our trauma bay. The step-by-step procedures may be applicable to any blast injury sustained under variable conditions.
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This study aimed to evaluate the completeness and quality of information in written discharge instructions for patients with mild traumatic brain injury (mTBI) discharged from the emergency department (ED). ⋯ The completeness and quality of written discharge instructions for mTBI patients in South Korean EDs were low and varied across hospitals, suggesting a potential association to hospital resources.
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Vascular injuries are associated with high morbidity and mortality. The management is exceedingly demanding and requires involvement of senior clinician. There are known complications associated with vascular injury ranging from limb loss, stroke, and death. There are limited studies examining other injuries that are associated with vascular trauma. This study aimed to review the pattern, management and outcomes of the other injuries associated with vascular injuries. ⋯ Out of 2805 patients that were admitted in trauma ICU from 2013 to 2022, 153 (5 %) patients had vascular injuries. There were 154 documented vascular injuries and 212 associated injuries. This study found that fractures are the most common injuries to be associated with vascular injury CONCLUSION: The nature of vascular injury and delay to intervention determines outcome of patients, however associated injuries also play an important role in affecting outcomes. The presence of associated injury encourages the multi-disciplinary approach to optimise outcomes.
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Due to significant injury heterogeneity, outcome prediction following traumatic brain injury (TBI) is challenging. This study aimed to develop a simple model for high-accuracy mortality risk prediction after TBI. ⋯ The MOST model can be rapidly calculated and outperforms two widely used models for predicting mortality in TBI patients. It utilizes a larger, contemporaneous dataset that reflects modern trauma care.
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Observational Study
Accuracy of the Norwegian trauma protocol. An observational population study from South-Western Norway.
The Norwegian trauma plan was established in 2007 and renewed in 2017 defining national trauma team activation (TTA) criteria. Norwegian studies validating the performance of previous TTA protocols have found overtriage and undertriage to be out of line with the quality indicators set in the national trauma plan, but studies have not yet been published validating the new TTA protocol. ⋯ Both overtriage and undertriage are out of line with the goals set in the Norwegian trauma plan. Undertriage is often caused by older patients that do not fulfill the trauma criteria in the current TTA protocol. Mechanism of injury increases overtriage but does not reduce undertriage. The TTA protocol could be improved by changing the composition of criteria groups, removal of single criteria with low PPV, and by better compliance to the existing criteria.