Articles: trauma.
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Background: Tissue trauma and hemorrhage result in pronounced activation of the innate immune system. Given known crosstalk between inflammation and coagulation, soluble inflammatory mediators could be associated with venous thromboembolisms (VTEs) after major trauma. Objectives : This study aimed to identify plasma inflammatory mediators that are independent predictors of VTE risk in trauma patients. ⋯ We identified significant correlations between inflammation and markers of coagulation and endothelial activation. Conclusion: Sustained systemic inflammation is a key driver of VTE risk after major trauma. Therapeutics targeting innate immune activation should be considered for development of future multimodal strategies to augment current VTE prophylaxis.
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Creating meaningful and engaging learning opportunities can be challenged by budgets, time, and learning management systems with limited methods of interaction. An innovative method was necessary to meet competency evaluation and continuing education needs for emergency department staff. ⋯ Nurse educators can "escape" the monotony of passive learning by using active learning strategies including the fun of gamification to improve clinical skills and confidence.
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Older trauma patients have a higher mortality yet are more likely to be under-triaged compared to younger patients. Studies have suggested that current trauma team activation criteria are suboptimal for older patients. ⋯ We identified five factors associated with increased 30-day mortality in older trauma patients: GCS < 15, ISS > 15, age ≥ 85 years, anticoagulation, and multimorbidity. These factors should be considered when developing modified trauma team activation criteria for older adults.
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JNMA J Nepal Med Assoc · Nov 2023
Observational StudySurgical Management among Patients with Acetabular-Pelvis Fractures in a Trauma Care Centre.
Surgical management of pelvic and acetabular fractures due to high-energy trauma is one of the most challenging in orthopaedics. Most patients are often associated with other life-threatening injuries. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcomes. The aim of the study was to find out the prevalence of the surgical management among patients with acetabular-pelvis fractures in a trauma care centre. ⋯ acetabulum; fracture fixation; pelvis.
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Pulmonary embolism (PE) is a recognized cause of death in hospitalized trauma patients, yet less is known about PE after discharge. ⋯ Fatal PE after discharge typically occurred following activity-limiting lower extremity injuries with an ISS<16.