Trauma surgery & acute care open
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Trauma Surg Acute Care Open · Jan 2018
Banning open carry of unloaded handguns decreases firearm-related fatalities and hospital utilization.
Since 1967, in California it has been illegal to openly carry a loaded firearm in public except when engaged in hunting or law enforcement. However, beginning January 1, 2012, public open carry of unloaded handguns also became illegal. Fatal and non-fatal (NF) firearm injuries were examined before and after adoption of the 2012 ban to quantify the effect of the new law on public health. ⋯ III, epidemiology.
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Trauma Surg Acute Care Open · Jan 2018
Introducing high-flow nasal cannula oxygen therapy at the intermediate care unit: expanding the range of supportive pulmonary care.
Non-invasive respiratory support is a frequent indication for intermediate care unit (IMCU) admission. Extending the possibilities of respiratory support at the IMCU with high-flow nasal cannula oxygen therapy (HFNC) may prevent intensive care unit (ICU) transfer and invasive ventilation. However, the safety and limitations of HFNC administration in the stand-alone IMCU setting are not yet studied. This study therefore aims to investigate to what extent and in which patients HFNC can safely be administered at a stand-alone mixed surgical IMCU. ⋯ Level VI.
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Trauma Surg Acute Care Open · Jan 2018
Optimizing critical care of the trauma patient at the intermediate care unit: a cost-efficient approach.
The aim of this study was to describe the case load, safety, and cost savings of critical care of the trauma patient provided at the surgical intermediate care unit (IMCU). ⋯ Level IV.
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Trauma Surg Acute Care Open · Jan 2018
Protocol for a randomized trial of the effect of timing of cholecystectomy during initial admission for predicted mild gallstone pancreatitis at a safety-net hospital.
There is evidence-based consensus for laparoscopic cholecystectomy during index admission for predicted mild gallstone pancreatitis, defined by the absence of organ failure and of local or systemic complications. However, the optimal timing for surgery within that admission is controversial. Early cholecystectomy may shorten hospital length of stay (LOS) and increase patient satisfaction. Alternatively, it may increase operative difficulty and complications resulting in readmissions. ⋯ The primary goal of this research is to obtain the least biased estimate of effect of timing of cholecystectomy for mild gallstone pancreatitis on clinical and PROs; the results of this trial will be used to inform patient care locally as well as to design future multicenter effectiveness and implementation trials. This trial will provide data regarding PROs including health-related quality of life that can be used in cost-utility and cost-effectiveness analyses.
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Trauma Surg Acute Care Open · Jan 2018
Point-of-care biliary ultrasound in the emergency department (BUSED): implications for surgical referral and emergency department wait times.
Patients with uncomplicated biliary disease frequently present to the emergency department for assessment. To improve bedside clinical decision making, biliary point-of-care ultrasound (POCUS) in the emergency department has emerged as a diagnostic tool. The purpose of this study is to analyze the usefulness of POCUS in predicting the need for surgical intervention in biliary disease. ⋯ Retrospective cohort study, level III.