J Trauma
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Trauma centers and orthopaedic surgeons have traditionally been faced with limited operating room (OR) availability for fracture surgery. Orthopaedic trauma cases are often waitlisted and done late at night. We investigated the feasibility of having an unbooked orthopaedic trauma OR to reduce nighttime cases and improve OR flow. ⋯ The availability of an unbooked orthopaedic trauma room resulted in a measurable shift from performing "add-on" cases to daytime surgery and may reduce complications. We recommend that hospitals and orthopaedic trauma services commit resources toward having an open OR reserved for orthopaedic trauma.
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Transfusion is a cornerstone of early trauma care, but little is known regarding the consistency of transfusion practice in different regions of the world. We examined data available in the German Trauma Registry, the University of Miami Trauma Registry, and the Registry of the Shock Trauma Center in Baltimore to learn more regarding this question. We sought to identify the rate of transfusion of trauma patients during the resuscitative phase, the volume of transfusion administered, and the correlation of various levels of transfusion with clinical outcomes such as mortality, hospital length of stay, and the incidence of organ system failure. Mortality associated with transfusion was remarkably similar in all three systems, making it clear that the volume of blood received during early resuscitation is a strong predictor of outcome for patients presenting in hemorrhagic shock.