Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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Traumatic brain injury (TBI) is a leading cause of injury, disability, and death in the United States. Amantadine is an established dopamine agonist that supports neurological function. The purpose of this literature review was to determine whether amantadine improves cognitive function post-TBI. ⋯ Outcomes were summarized and the evidence was appraised. Although earlier studies from 1994 to 2003 were lower-level studies and recommended further research on treatment of cognitive dysfunction in TBI, the literature from 2004 to present generally concluded that amantadine improved cognitive function related to arousal, memory, and aggression. It can be started days to months postinjury and still produces benefits.
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To identify the scope, context, and impact on patient and health service outcomes of the specialist trauma nurse. Integrative review with data sourced from CINAHL, OvidSP, Scopus, and hand searching of references. ⋯ This international review shows a widely varied scope and context of practice with positive impacts on patient and health service outcomes. Further research and exploration are recommended to develop a consistent model of care and further ascertain the benefits of the specialist trauma nurse role.
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Comparative Study
Risk factors for ventilator-associated pneumonia: among trauma patients with and without brain injury.
Ventilator-associated pneumonia (VAP) rates remain highest among trauma and brain injured patients; yet, no research compares VAP risk factors between the 2 groups. This retrospective, case-controlled study identified risk factors for VAP among critically ill trauma patients with and without brain injury. Data were abstracted on trauma patients with (cases) and without (controls) brain injury. ⋯ Trauma patients with brain injury had more emergent and field intubations. Age was strongest predictor of VAP in cases, and ventilator days predicted VAP in controls. Trauma patients with brain injury may be at higher risk for VAP.
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Bedside surgical procedures such as percutaneous dilatational tracheostomy (PDT) and percutaneous endoscopic gastrostomy (PEG) placement in ICU settings are widely accepted; however, these procedures often require the addition of bulky equipment into the patient's room, which consumes valuable space and restrict workflow. A practice modification was developed in our trauma program, which reduces clutter in the patient's room, streamlines workflow, and results in better patient care and teaching. Simple and cost-effective, this has become the standard in our trauma center and could be of benefit to other institutions as well.
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A mass casualty simulation was developed and implemented for senior-level nursing students in a large baccalaureate program. This simulation was developed to introduce students to rapid triage in an interactive and immersive experience. The purpose of the simulation was to provide students with a realistic, hands-on experience in a safe environment. ⋯ The students worked in small groups and assigned each victim an appropriate Simple Triage and Rapid Treatment triage category on the basis of what they learned in lecture. Participating students performed well on their final examinations on questions covering the triage content they learned in this unit and feedback regarding the simulated experience was overwhelmingly positive. This simulation could be adapted for the education of other health care providers who may be involved in a future mass casualty incident.