Articles: trauma.
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Multicenter Study Observational Study
Accuracy of early warning scores for predicting serious adverse events in pre-hospital traumatic injury.
Traumatically injured patients are at higher risk of serious adverse events. Numerous physiological scoring systems are employed as diagnostic and/or prognostic tools. The objective of this study was to evaluate the scales most commonly used by emergency medical services for the early detection of prehospital serious adverse events. ⋯ All scoring systems were able to detect prehospital serious adverse events early in traumatic injury; therefore, any of the scoring systems could be useful and represent an ideal tool for routine use by emergency medical services in cases of traumatic injury.
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Scand J Trauma Resus · Jun 2020
Multicenter StudyResuscitative endovascular balloon occlusion of the aorta may contribute to improved survival.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an increasingly used trauma resuscitation procedure, however, there are no reports of whether or not the survival of patients treated with REBOA increases over time. ⋯ Survival of patients treated with REBOA during the late-period improved compared with survival during the early-period, after adjustment for characteristics, trauma severity, and therapeutic choices. REBOA may be one of the important factors related to progression of modern trauma treatment.
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Multicenter Study
Variations in access to specialty care for children with severe burns.
Pediatric burns account for 120,000 emergency department visits and 10,000 hospitalizations annually. The American Burn Association has guidelines regarding referrals to burn centers; however there is variation in burn center distribution. We hypothesized that disparity in access would be related to burn center access. ⋯ The majority of children who met criteria were treated at burn centers. There was no significant difference between geographical regions. Of those who were treated at burn centers, more severe injury patterns were noted, but there was no significant mortality difference. Further study of optimal referral of pediatric burn patients is needed.
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Multicenter Study
Impact of trauma level designation on survival of patients arriving with no signs of life to US trauma centers.
Trauma level designation and verification are examples of healthcare regionalization aiming at improving patient outcomes. This study examines impact of Trauma Levels on survival of patients arriving with "no signs of life" to US trauma centers. ⋯ Patients presenting without signs of life to Level II trauma centers had higher survival to hospital discharge compared to Level I and Level III centers. These findings can guide future prehospital triage criteria of trauma patients in organized Emergency Medical Services (EMS) systems and highlight the need for more outcome research on trauma systems.
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Multicenter Study
Nonfatal horse-related injuries treated in emergency departments in the United States, 1990-2017.
Horse-related injuries can cause severe morbidity and mortality. The objective of this study is to investigate the epidemiological features of horse-related injuries treated in emergency departments (EDs) in the United States. ⋯ Despite the recent decline in horse-related injuries, these injuries are still common. Clinicians should be aware of the spectrum of ED presentations of horse-related injuries. Prevention efforts focused on older adults and concussions and closed head injuries warrant special attention.