Articles: trauma.
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Eur J Trauma Emerg Surg · Feb 2025
Observational StudyAnti-xa guided enoxaparin thromboprophylaxis is associated with less thromboembolism than fixed dose dalteparin in trauma patients admitted to intensive care.
Venous Thromboembolism (VTE) is a common, preventable complication in trauma. Low-molecular-weight heparin (LMWH) is recommended for VTE prophylaxis (VTEp). We investigated whether switching from fixed-dose dalteparin to anti-Xa-guided enoxaparin prophylaxis reduces VTE without increasing the risk of bleeding among hospitalized trauma patients. ⋯ Among adult patients in the trauma ICU, compared to a fixed dose dalteparin, enoxaparin prophylaxis with dose calibration according to peak anti-Xa levels was associated with lower VTE rates without increasing the risk of bleeding. About 40% of patients who received initial enoxaparin doses of 30 mg twice daily had anti-Xa levels suggestive of inadequate prophylaxis. Calibrating LMWH dosing may improve VTEp following traumatic injury.
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Pediatric emergency care · Feb 2025
Pediatric Golf Cart Injuries and Morbidity: A Single-Center Trauma Experience.
The primary aim of this study was to characterize pediatric golf cart injuries at our center including demographic, clinic, and outcome data. The secondary outcomes explored were associations between patient and driver age and mechanism of injury with hospital admission, length of stay, and surgical interventions. ⋯ Golf carts are a considerable source of injury for our pediatric population, with some accidents leading to serious morbidity. There is a need for consistent safety regulation of golf carts and increased public knowledge of the hazards they pose to children.
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Scand J Trauma Resus · Feb 2025
Implementation of prehospital point-of-care ultrasound using a novel continuous feedback approach in a UK helicopter emergency medical service.
There has been increased use of prehospital point-of-care ultrasound (PoCUS) by helicopter emergency medical services (HEMS) in recent years. Lack of governance structure and evidence of benefit have been described as major barriers to its implementation. This paper describes a novel approach to implementation of prehospital PoCUS and clinical governance framework in a UK HEMS. ⋯ Introduction of prehospital PoCUS in a HEM service utilizing high quality training, user-friendly workflow and image archiving system, robust governance framework and continuous feedback may be feasible allowing high quality ultrasound examinations. The bespoke PPPB protocol in prehospital may improve diagnosis of life-threatening injuries.