Articles: trauma.
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Multicenter Study Observational Study
New Immobilization Guidelines Change EMS Critical Thinking in Older Adults With Spine Trauma.
The impact of immobilization techniques on older adult trauma patients with spinal injury has rarely been studied. Our advisory group implemented a change in the immobilization protocol used by emergency medical services (EMS) professionals across a region encompassing 9 trauma centers and 24 EMS agencies in a Rocky Mountain state using a decentralized process on July 1, 2014. We sought to determine whether implementing the protocol would alter immobilization methods and affect patient outcomes among adults ≥60 years with a cervical spine injury. ⋯ There were no differences in neurologic deficit or patient disposition in the older adult patient with cervical spine trauma despite changes in spinal restriction protocols and resulting differences in immobilization devices.
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Multicenter Study Observational Study
Assessment of the predictive value of the International Classification of Diseases Injury Severity Score for trauma mortality in urban India.
Trauma is the cause of 1.2 million deaths in India annually. Injury severity scores play an important role in trauma research and care because these scores enable the adjustment of trauma severity when comparing mortality outcomes. The generalizability of the International Classification of Diseases Injury Severity Score (ICISS) between different populations is not fully known, and the validity of the ICISS has not been assessed in the Indian context. The aim of this study was to assess the predictive performances of three international versions of the ICISS, derived from data from Australia, New Zealand and pooled data from seven different high-income countries, in trauma patients admitted to four public hospitals in urban India. ⋯ None of the international versions of the ICISS adequately predicted mortality within the study population, indicating the need for an ICISS version specifically adapted to the Indian context.
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Scand J Trauma Resus · Aug 2018
Multicenter Study Observational StudyEvaluating the ability of a trauma team activation tool to identify severe injury: a multicentre cohort study.
Sensitive decision making tools should assist prehospital personnel in the triage of injured patients, identifying those who require immediate lifesaving interventions and safely reducing unnecessary under- and overtriage. In 2014 a new trauma team activation (TTA) tool was implemented in Central Norway. The overall objective of this study was to evaluate the ability of the new TTA tool to identify severe injury. ⋯ Severe injury was infrequent and there was a substantial rate of overtriage. The ability of the TTA tool was relatively insensitive in identifying severe injury, but showed increased performance when utilizing physiologic and anatomical injury criteria. Many of the TTA mechanism of injury criteria might be considered for removal from the triage tool due to substantial rates of overtriage. This has relevance for the proposed development of national Norwegian TTA criteria.
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Eur J Trauma Emerg Surg · Aug 2018
Multicenter Study Observational StudyThe use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. ⋯ This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.
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Multicenter Study
Quality of life and health utility scores among Canadian traumatic spinal cord injury patients - A national cross-sectional study.
National, multicenter, cross-sectional study. ⋯ 1.