J Trauma
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A prospective study of predictors of disability at 3 months after non-central nervous system trauma.
To delineate which injury-related, demographic, and psychosocial variables were predictive of severe disability (limitations in the performance of socially defined roles and tasks) at 3 months after discharge from acute hospitalization for non-central nervous system traumatic injury. ⋯ Extremity injuries, lack of high school graduation, and high level of posttraumatic psychological distress with intrusive thoughts are risk factors for severe disability at 3 months after discharge from the hospital.
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Abdominal computed tomographic (CT) scans are used in the evaluation of blunt trauma. The purpose of this study was to determine if isolated intraperitoneal fluid seen on CT scan necessitates laparotomy. ⋯ Exploratory laparotomy was therapeutic in 94% of patients. Isolated intraperitoneal fluid on CT scan after blunt trauma mandates laparotomy.
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To examine the psychosocial adjustment of survivors of massive pediatric burn injuries, the change in adjustment across time, and the impact on parents. ⋯ Children who survive massive burn injuries can achieve positive psychosocial adaptation.
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Clinical Trial Controlled Clinical Trial
Effect of the Advanced Trauma Life Support program on medical students' performance in simulated trauma patient management.
Part of the senior medical students' examination at the University of Toronto involves testing with simulated patient management. We compared the performance in these simulations of senior medical students who received Advanced Trauma Life Support (ATLS) training with those who did not receive ATLS training. ⋯ The ATLS course, both complete and audit status, prepares students more appropriately for managing trauma patients as judged by trauma simulation scenarios. Consideration should be given for including ATLS as an integral part of the senior medical student curriculum.
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The Injury Severity Score (ISS) does not take into account multiple injuries in the same body region, whereas a New ISS (NISS) may provide a more accurate measure of trauma severity by considering the patient's three greatest injuries regardless of body region. The purpose of this study was to evaluate the ISS and NISS in patients with blunt trauma. ⋯ The NISS often increases the apparent severity of injury and provides a more accurate prediction of short-term mortality. The benefit associated with using the NISS rather than the ISS must be weighed against the disadvantages of changing a scoring system and the potential for still greater improvements.