Articles: trauma.
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Randomized Controlled Trial
Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatment of Acute Traumatic Pain: A Randomized Clinical Trial.
To evaluate if out-of-hospital administration of fentanyl and intranasal ketamine, compared to fentanyl alone, improves early pain control after injury. ⋯ In our sample, we did not detect an analgesic benefit of adding 50 mg intranasal ketamine to fentanyl in out-of-hospital trauma patients.
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Critical care clinics · Oct 2024
ReviewDisparities in Access, Management and Outcomes of Critically Ill Adult Patients with Trauma.
Despite legal protections guaranteeing care for patients with trauma, disparities exist in patient outcomes. We review disparities in patient management and outcomes related to insurance status, race and ethnicity, and gender for patients with trauma in the preadmission, in-hospital, and postdischarge settings. We highlight groups understudied and either underrepresented or unrepresented in national trauma databases-including American Indians/Alaska Natives, non-English preferred patients, and patients with disabilities. We call for more study of these groups and of upstream factors affecting the reviewed demographics to measure and improve outcomes for these vulnerable populations.
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Meta Analysis
Epidemiology of Post-traumatic Stress Disorder in Iranian Population From 2019 to 2024: A Systematic Review and Meta-analysis.
Post-traumatic stress disorder (PTSD) is a disorder that arises from experiencing traumatic events such as traffic accidents, war, natural disorders, and job incidents. This study focused on determining the epidemiology of PTSD in the Iranian population from 2019 to 2024. ⋯ The prevalence of PTSD in young Iranian men is relatively high, and there was no statistically significant decrease in PTSD prevalence between 2019 and 2024.
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Eur J Trauma Emerg Surg · Oct 2024
ReviewThe non-haemorrhagic vagal response to trauma: a review of hypotensive and bradycardic responses to injury in the absence of bleeding.
Trauma has the potential to cause haemorrhage, tissue damage, pain, visceral manipulation and psychological distress. Each of these consequences of trauma can cause changes in autonomic outflow, which dictates a patient's vital signs. Patients who are hypotensive and bradycardic due to a vagally mediated parasympathetic response to pain, psychological distress and visceral manipulation may be confused with those who exhibit bradycardia and hypotension following significant blood volume loss. ⋯ The pattern of injury, patient demographic and speed of onset / resolution associated with the non-haemorrhagic vagal response to trauma may is heterogenous. It is therefore challenging to clinically distinguish between the hypotensive bradycardia due to hypovolaemia secondary to haemorrhage, or a parasympathetic response to trauma in the absence of bleeding.