The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Aug 2021
Observational StudyImplications of the national Stop the Bleed campaign: The swinging pendulum of prehospital tourniquet application in civilian limb trauma.
Prehospital tourniquet (PHT) utilization has increased in response to mass casualty events. We aimed to describe the incidence, therapeutic effectiveness, and morbidity associated with tourniquet placement in all patients treated with PHT application. ⋯ Epidemiological, level III; Therapeutic, level IV.
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J Trauma Acute Care Surg · Aug 2021
Physician-staffed ambulance and increased in-hospital mortality of hypotensive trauma patients following prolonged prehospital stay: A nationwide study.
The benefits of physician-staffed emergency medical services (EMS) for trauma patients remain unclear because of the conflicting results on survival. Some studies suggested potential delays in definitive hemostasis due to prolonged prehospital stay when physicians are dispatched to the scene. We examined hypotensive trauma patients who were transported by ambulance, with the hypothesis that physician-staffed ambulances would be associated with increased in-hospital mortality, compared with EMS personnel-staffed ambulances. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Aug 2021
Safety and efficacy of low-titer O whole blood resuscitation in a civilian level I trauma center.
Military experience has shown low-titer O whole blood (LTOWB) to be safe and beneficial in the resuscitation of hemorrhaging trauma patients. However, few civilian centers use LTOWB for trauma resuscitation. We evaluated the early experience and safety of a LTOWB program at a level 1 civilian trauma center. ⋯ Retrospective, therapeutic, level IV.
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J Trauma Acute Care Surg · Jul 2021
Geospatial assessment of helicopter emergency medical service overtriage.
Despite evidence of benefit after injury, helicopter emergency medical services (HEMS) overtriage remains high. Scene and transfer overtriage are distinct processes. Our objectives were to identify geographic variation in overtriage and patient-level predictors, and determine if overtriage impacts population-level outcomes. ⋯ Therapeutic, level IV.