Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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The Glasgow Coma Scale (GCS) is an international tool used to measure the level of consciousness for traumatically injured patients. One Level I and 3 Level II Trauma Centers in our Health Care System perceived a deficiency in the documentation of the GCS. ⋯ A reaudit was performed to determine the success of these interventions. Although improvement was demonstrated, additional action was taken to enhance documentation in the electronic medical record.
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It is unclear what causes chronic pain in traumatically injured hospitalized adults. A total of 101 patients admitted to a level 1 trauma center completed interviews during their inpatient stay and at 4 months, and data on biologic, psychologic, and sociologic variables were collected. Statistical analysis used hierarchical logistical regression,χ, and independent-samples t tests. ⋯ Those with chronic pain at 4 months had more posttraumatic stress disorder, anxiety, and depression. High initial pain score was the only significant predictor of chronic pain. Initial pain intensity predicts chronic pain.
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The objectives of this study were to provide population-based incidence estimate of abusive head trauma (AHT) in children aged 0 to 5 years from inpatient and emergency department (ED) and identify risk characteristics for recognizing high-risk children to improve public health surveillance. ⋯ Incidence estimates of AHT are incomplete without including ED. Intracranial bleeding is a cardinal feature of AHT to be considered in case ascertainment to improve public health surveillance.
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Review Meta Analysis
A synthesis of research examining timely removal of cervical collars in the obtunded trauma patient with negative computed tomography: an evidence-based review.
Currently, the standard to clear the cervical spine in obtunded blunt trauma patients is computed tomography in combination with plain films, dynamic fluoroscopy, or magnetic resonance imaging. The objective of this study was to answer the question "Can computed tomography alone provide adequate clinical information to clear the cervical spine in the obtunded patient?" ⋯ The results suggest that CT alone is a reliable clinical indicator to clear the cervical spine in obtunded patients.
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A review on the role of open reduction and internal fixation of flail chest injuries is presented. A 37-year-old woman involved in a motorcycle crash sustained comminuted rib fractures on her right 3rd through 12th ribs. ⋯ Further studies are needed to definitively determine the benefits of rib plating versus conventional treatment. Through our case, we are able to demonstrate successful management of pain and chest wall instability associated with flail chest through the use of rib plating.