The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Nov 2013
Multicenter Study Comparative StudyS.T.A.R.T.T.: development of a national, multidisciplinary trauma crisis resource management curriculum-results from the pilot course.
Most medical errors are nontechnical and include failures in team communication, situational awareness, resource use, and leadership. Other high-risk industries have adopted team-based crisis resource management (CRM) training strategies to address "nontechnical" skills and to improve human error and safety. Here, we describe the development and evaluation of a national multidisciplinary trauma CRM curriculum. ⋯ Creation of a national multidisciplinary trauma CRM curriculum is feasible, has high satisfaction among participants, and can improve attitudes toward the importance of simulation and CRM principles with the ultimate goal of improving patient safety and care.
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J Trauma Acute Care Surg · Nov 2013
Multicenter Study Comparative StudyThe deleterious effect of red blood cell storage on microvascular response to transfusion.
The transfusion of relatively older red blood cells (RBCs) has been associated with both morbidity and mortality in trauma patients in observational studies. Although the mechanisms responsible for this phenomenon remain unclear, alterations in the microcirculation as a result of the transfusion of relatively older blood may be a causative factor. To assess this hypothesis, we evaluated microvascular perfusion in trauma patients during RBC transfusion. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Nov 2013
Multicenter Study Comparative StudyBurden of hospitalizations for bicycling injuries by motor vehicle involvement: United States, 2002 to 2009.
Bicycling and bicycling injuries have increased during the past decade in the United States, but research on the extent and outcomes of injuries has lagged behind. This study aimed to estimate the current burden of injury from bicycling injury hospitalizations by motor vehicle crash (MVC) and non-MVC in the United States. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Oct 2013
Multicenter StudyTranslation of alcohol screening and brief intervention guidelines to pediatric trauma centers.
As part of the American College of Surgeons verification to be a Level 1 trauma center, centers are required to have the capacity to identify trauma patients with risky alcohol use and provide an intervention. Despite supporting scientific evidence and national policy statements encouraging alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT), barriers still exist, which prevent the integration of SBIRT into clinical care. Study objectives of this multisite translational research study were to identify best practices for integrating SBIRT services into routine care for pediatric trauma patients, to measure changes in practice with adoption and implementation of a SBIRT policy, and to define barriers and opportunities for adoption and implementation of SBIRT services at pediatric trauma centers. ⋯ This model may serve as method for translating SBIRT services into practice within pediatric trauma centers.
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J Trauma Acute Care Surg · Sep 2013
Multicenter StudyDelayed formation of splenic pseudoaneurysm following nonoperative management in blunt splenic injury: multi-institutional study in Osaka, Japan.
Delayed rupture is well-known as a severe complication after splenic injury treated with nonoperative management (NOM). The incidence and timing of splenic pseudoaneurysm (SPA) formation, which is a cause of delayed rupture following splenic injury, have not been thoroughly investigated, and the timing of follow-up computed tomography (CT) is controversial. The objective of this study was to clarify the incidence and timing of both the delayed formation and spontaneous resolution of SPA following splenic injuries treated with NOM in several trauma centers in Japan. ⋯ Epidemiologic study, level III.