The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyImpact of prehospital mode of transport after severe injury: a multicenter evaluation from the Resuscitation Outcomes Consortium.
There is ongoing controversy about the relative effectiveness of air medical versus ground transportation for severely injured patients. In some systems, air medical crews may provide a higher level of care but may require longer transport times. We sought to evaluate the impact of mode of transport on outcome based on analysis of data from two randomized trials of prehospital hypertonic resuscitation. ⋯ III.
-
J Trauma Acute Care Surg · Mar 2012
Multicenter Study Comparative StudyThe forgotten trauma patient: outcomes for injured patients evaluated by emergency medical services but not transported to the hospital.
Injured patients who are not transported by an ambulance to the hospital are often not included in trauma registries. The outcomes of these patients have until now been unknown. Understanding what happens to nontransports is necessary to better understand triage validity, patient outcomes, and costs associated with injury. We hypothesized that a subset of patients who were not transported from the scene would later present for evaluation and that these patients would have a nonzero mortality rate. ⋯ III, therapeutic study.
-
J Trauma Acute Care Surg · Mar 2012
Multicenter Study Comparative StudyPrehospital injury deaths--strengthening the case for prevention: nationwide cohort study.
To determine the frequency and characteristics of prehospital deaths compared with hospital deaths in different subpopulations with severe injuries. ⋯ III.
-
J Trauma Acute Care Surg · Mar 2012
Comparative StudyVentilator-associated pneumonia: bacteremia and death after traumatic injury.
The implications of bacteremia in critically ill patients are uncertain. Some reports suggest bacteremia is linked to higher mortality whereas others do not. These differences may, in part, be because of differences in patient cohorts. To address the potential independent relationship between bacteremia and outcome, we focused on critically ill trauma patients with ventilator-associated pneumonia (VAP), of whom a significant proportion had concomitant bacteremia. We tested the hypothesis that bacteremia was associated with death in trauma patients who developed VAP. ⋯ VAP with bacteremia is associated with an increased mortality in comparison with VAP alone after severe traumatic injury.
-
J Trauma Acute Care Surg · Mar 2012
Comparative StudyUtility of a point-of-care device for rapid determination of prothrombin time in trauma patients: a preliminary study.
Rapid and accurate determination of prothrombin time in trauma patients may help to faster control of bleeding induced coagulopathy. The goal of this prospective observational study was to investigate the accuracy of bedside measurements of prothrombin time by the mean of a point-of-care device (INRatio) in trauma patients. ⋯ INRatio may be a useful device in the management of trauma patients with ongoing or suspected coagulopathy that may help to save at least 60 minutes in the process of obtaining a prothrombin time result. It may allow earlier detection of coagulopathy and, together with vital sign and hemoglobin, may help to guide fresh frozen plasma transfusion.