Articles: trauma.
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Attention-deficit/hyperactivity disorder (ADHD) is common among Veterans but overlapping symptoms with other prevalent psychiatric disorders (e.g., posttraumatic stress disorder [PTSD]) complicate diagnosis. This study aims to (1) assess the prevalence of ADHD, (2) evaluate the correspondence between ADHD self-report measures, and (3) examine the association between ADHD and PTSD in a sample of combat-deployed post-9/11 Veterans. ⋯ Attention-deficit/hyperactivity disorder is prevalent in this sample of Veterans and is associated with an increased risk of current and lifetime PTSD. The low correspondence across self-report ADHD measures illustrates the complexity of assessing ADHD in this highly comorbid population. When evaluating ADHD in Veterans, clinicians should carefully consider alternative and contributory symptom etiologies, such as PTSD, to ensure accurate diagnosis and treatment.
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Scand J Trauma Resus · Nov 2024
Trauma team activation and triage of severely injured patients at one non-trauma-center hospital in Stockholm.
In 2017 the Swedish public insurance company Löf published national guidelines for in-hospital trauma team activation (TTA), which are now widely adopted in Sweden. No studies have examined triage accuracy at non-trauma-center hospitals in the Stockholm trauma system since the implementation of the new TTA criteria. ⋯ Undertriage of severely injured trauma patients was 98% according to the definition specified by Swedish trauma triage guidelines, higher than reasonably acceptable. There is considerable overtriage with non-severely injured patients prompting TTA. However, the suitability of using NISS > 15 to retrospectively define the need for TTA is debatable as this does not always correlate with the fulfillment of the TTA criteria. Further investigation of adherence to trauma triage guidelines in clinical practice may be of value to improve triage accuracy in organized regional trauma systems.
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Trauma-induced coagulopathy remains a significant contributor to mortality in severely injured patients. Fibrinogen is essential for early hemostasis and is recognized as the first coagulation factor to fall below critical levels, compromising the coagulation cascade. Recent studies suggest that early administration of fibrinogen concentrate is feasible and effective to prevent coagulopathy. We conducted a scoping review to characterize the existing quantity of literature and to explore the usage of prehospital fibrinogen concentrate products in improving clinical outcomes in trauma patients. ⋯ Preliminary research suggests that prehospital fibrinogen concentrate administration in traumatic bleeding patients is both feasible and effective, improving clotting parameters. While implementing a time-saving and proactive approach with fibrinogen holds potential for enhancing trauma care, the current evidence is limited. Further studies in this novel field are warranted.