J Trauma
-
The purpose of this study was to assess the prevalence and determinants of disabilities and return to work after severe injury in a Dutch, Level I trauma center. ⋯ Severe trauma has a substantial impact on long-term functioning. Empiric quantitative data, as presented in this study, enable us to estimate the burden of injury and to evaluate the quality of trauma care programs.
-
Comparative Study
Comparison of Maryland hospital discharge and trauma registry data.
This study aimed to examine the validity of using Maryland hospital discharge data to characterize injuries sustained by trauma patients. ⋯ The Maryland hospital discharge data are a valid source for documenting the nature and severity of injuries sustained by trauma patients, except for those with a relatively minor head injury.
-
Empiric antibiotic therapy is routinely initiated for patients with presumed ventilator-associated pneumonia (VAP). The impact of inadequate empiric antibiotic therapy (IEAT) may vary among critically ill populations. The purpose of this retrospective study was to determine the effect of IEAT on the outcome for adult trauma patients with VAP. ⋯ Critically ill trauma patients experiencing multiple episodes of IEAT for VAP have increased morbidity and mortality. These findings reinforce the importance of developing and refining a unit-specific pathway for the empiric management of VAP.
-
The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality. ⋯ HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures.
-
Focused assessment with sonography for trauma (FAST) examination has been proved accurate for diagnosing trauma when performed by nonradiologist physicians. Recent reports have suggested that nonphysicians also may be able to perform the FAST examination reliably. A multipurpose ultrasound system is installed on the International Space Station as a component of the Human Research Facility. Nonphysician crew members aboard the International Space Station receive modest training in hardware operation, sonographic techniques, and remotely guided scanning. This report documents the first FAST examination conducted in space, as part of the sustained effort to maintain the highest possible level of available medical care during long-duration space flight. ⋯ It is possible to conduct a remotely guided FAST examination with excellent clinical results and speed, even with a significantly reduced video frame rate and a 2-second communication latency. A wider application of trauma ultrasound applications for remote medicine on earth appears to be possible and warranted.