Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). ⋯ Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes.
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Review
Interprofessional Implementation of a Pain/Sedation Guideline on a Trauma Intensive Care Unit.
Trauma patients experience pain and agitation during their hospitalization. Many complications have been noted both in the absence of symptom management and the in presence of oversedation/narcotization. To combat noted untoward effects of pain and sedation management, an interprofessional team convened to develop a pain and sedation guideline for use in a trauma intensive care unit. ⋯ In comparing pre- and postimplementation patient data, there was a significant decrease in mean analgesic treatment duration and an increase in the use of antipsychotics for delirium management. Following the trial period, this guideline was permanently adopted across the adult critical care service. The development of a nurse-driven analgosedation guideline was noted to be both feasible and successful.
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Because of advances in medicine and other sciences, the average human life span is longer now than any other time in history. The physiologic effects of aging as well as multimorbidity, polypharmacy, and other geriatric-specific syndromes create additional challenges when elderly patients experience a traumatic injury. However, there is a growing evidence base that can inform the clinical decision-making process. This narrative review of the literature addresses the state of the science regarding geriatric syndromes, guidelines and protocols, indices and models for prognostication, outcomes and ethical concerns in the treatment of geriatric trauma.
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The intraosseous (IO) access initiative at an urban university adult level 1 trauma center began from the need for a more expeditious vascular access route to rescue patients in extremis. The goal of this project was a multidisciplinary approach to problem solving to increase access of IO catheters to rescue patients in all care areas. The initiative became a collaborative effort between nursing, physicians, and pharmacy to embark on an acute care endeavor to standardize IO access. ⋯ Limiting IO dwell time may facilitate timely definitive venous access. Continued education and training by offering IO skill laboratory refreshers and annual e-learning didactic is optimal for maintaining proficiency and knowledge. More research opportunities exist to determine medication safety and efficacy in adult patients in the acute care setting.
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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.