J Trauma
-
Randomized Controlled Trial Comparative Study
Brief violence interventions with community case management services are effective for high-risk trauma patients.
Currently there are few data that brief violence intervention (BVI) and community case management services (CCMS) are effective for trauma patients admitted for interpersonal violence in terms of recidivism, service utilization, or alcohol abuse. The objective of this study is to assess outcomes for a cohort of young trauma patients in a prospective, randomized trial comparing BVI with BVI + CCMS. ⋯ In-hospital BVI with community wraparound case management interventions can improve hospital and community service utilization both short- and long-term for high-risk injured patients. Longer follow-up is needed to show sustained reduction.
-
Randomized Controlled Trial Comparative Study
Airway scope laryngoscopy under manual inline stabilization and cervical collar immobilization: a crossover in vivo cinefluoroscopic study.
Direct laryngoscopy along with manual inline stabilization (MIS) is currently the standard care for patients with suspected neck injuries. However, cervical collar immobilization is more commonly performed in the prehospital environment, and its early removal is necessary before intubation. We hypothesized that if usability of Airway Scope (AWS) in a difficult airway could also bring merits to intubation under cervical collar immobilization, unnecessary risk caused by the removal of a neck collar may be prevented. ⋯ When compared with cervical collar immobilization, AWS laryngoscopy along with MIS seems to be a safer and more definite method to secure airway of neck-injured trauma patients because it limits less mouth opening and upper cervical spine movement.
-
Randomized Controlled Trial Multicenter Study
Quality of life after severe trauma: results from the global trauma trial with recombinant Factor VII.
Physical disability and psychologic morbidity are frequent and important complications of severe trauma injury with serious consequences for long-term health-related quality of life (HRQOL). Little prospective data exist, however, in a global trauma population on the risk factors for poor HRQOL. ⋯ Three months after severe trauma injury, survivors report very poor HRQOL. Physical wellbeing is generally more negatively affected than mental wellbeing. A trauma-specific HRQOL instrument reveals more diverse mental health problems than generic instruments. In a global trauma population, postinjury HRQOL is predicted by demographic and socioeconomic characteristics, type of injury, and treatment received.
-
Randomized Controlled Trial Comparative Study
A survey of American Association for the Surgery of Trauma member practices in the management of blunt splenic injury.
Conflicting data exist regarding pseudoaneurysm screening (PSA-S), initial angioembolization (IE), deep venous thrombosis prophylaxis (DVT-P), and activity limitation after hemodynamically stable blunt splenic injury (BSI). To determine whether there was consensus regarding BSI management, the multi-institutional trial committee of the American Association for the Surgery of Trauma (AAST) approved a survey of member practice patterns regarding BSI management. ⋯ There is considerable variation in the opinions of AAST members regarding BSI management, particularly for high-grade injuries. These results will aid in the design of prospective observational and random trials to determine optimal BSI management.
-
Randomized Controlled Trial Comparative Study
Removing a patient from the spine board: is the lift and slide safer than the log roll?
After spine board immobilization of the trauma victim and transport to the hospital, the patient is removed from the spine board as soon as practical. Current Advanced Trauma Life Support's recommendations are to log roll the patient 90 degrees, remove the spine board, inspect and palpate the back, and then log roll back to supine position. There are several publications showing unacceptable motion in an unstable spine when log rolling. ⋯ Spine boards can be removed using a lift-and-slide maneuver with less motion and potentially less risk to the patient's long-term neurologic function than expected using the log roll.