The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Nov 2016
Incidence, risk factors, and mortality associated with acute respiratory distress syndrome in combat casualty care.
The overall incidence and mortality of acute respiratory distress syndrome (ARDS) in civilian trauma settings have decreased over the past four decades; however, the epidemiology and impact of ARDS on modern combat casualty care are unknown. We sought to determine the incidence, risk factors, resource utilization, and mortality associated with ARDS in current combat casualty care. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Nov 2016
Comparative StudyCombat MEDEVAC: A comparison of care by provider type for en route trauma care in theater and 30-day patient outcomes.
Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Nov 2016
Evaluation of respiratory volume monitoring (RVM) to detect respiratory compromise in advance of pulse oximetry and help minimize false desaturation alarms.
Monitoring respiratory function is important. By continuously monitoring respiratory volumes, respiratory depression could be identified before hypoxemia and drive earlier intervention. Here, we evaluate the temporal relationship of respiratory volume monitoring (providing real-time minute ventilation [MV], tidal volume, and respiratory rate in nonintubated patients) to hypoxemic episodes and its potential to help classify true vs false desaturations (related to patient movement/probe dislodgement). ⋯ Diagnostic study, level II.
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J Trauma Acute Care Surg · Nov 2016
Historical ArticlePosition statement of the American College of Surgeons Committee on Trauma on the National Academies of Sciences, Engineering and Medicine Report, A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury.
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J Trauma Acute Care Surg · Nov 2016
ReviewMachine learning and new vital signs monitoring in civilian en route care: A systematic review of the literature and future implications for the military.
Although air transport medical services are today an integral part of trauma systems in most developed countries, to date, there are no reviews on recent innovations in civilian en route care. The purpose of this systematic review was to identify potential machine learning and new vital signs monitoring technologies in civilian en route care that could help close civilian and military capability gaps in monitoring and the early detection and treatment of various trauma injuries. ⋯ Systematic review, level V.