Injury
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Paediatric injury impacts the entire family. Many parents experience stress and anxiety following paediatric injury, but little is known about factors that support parents' wellbeing and how they successfully manage the adversity of child injury during acute hospitalisation. ⋯ Resilience-promoting factors for parents of injured children can be used to inform development of brief online intervention modules to enhance parent resilience. Routine screening and targeted psychological first aid for parental distress are recommended.
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Traumatic incidents may occur during religious mass gatherings. A lack of preparedness by the health system to respond to traumatic incidents may increase the mortality rate. This study investigated the factors that affect the preparedness of a health system to respond to traumatic incidents, and we provide appropriate suggestions for improving the response to such incidents during religious mass gatherings. ⋯ Similar to other mass gatherings, Arbaeen requires multi-sectoral and international planning, organizing, and management. The key factors that could improve the preparedness to respond to traumatic events in Arbaeen include training, increasing the perception of risk, changing the attitudes and behavior of pilgrims, developing a national strategic plan of the health system preparedness for policymakers, and implementing scenario-based exercises for executives.
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The aim of the study was to analyze helicopter emergency medical service (HEMS) in comparison to EMS, in respect to patient's mortality and morbidity. ⋯ A significant improvement for in-hospital survival for HEMS could be demonstrated. Especially in Germany, with a high number of secondary call outs (about 44%) after EMS has already reached the traumatized patient, HEMS must be the first choice for severely injured trauma patients. Dispatch criteria for immediate alarm of HEMS are recommended under practical considerations.
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The establishment of an accurate prognostic model in major trauma patients is important mainly because this group of patients will benefit the most. Clinical prediction models must be validated internally and externally on a regular basis to ensure the prediction is accurate and current. This study aims to externally validate two prediction models, the Trauma and Injury Severity Score model developed using the Major Trauma Outcome Study in North America (MTOS-TRISS model), and the NTrD-TRISS model, which is a refined MTOS-TRISS model with coefficients derived from the Malaysian National Trauma Database (NTrD), by regarding mortality as the outcome measurement. ⋯ For patients with blunt trauma mechanism, both the MTOS-TRISS and NTrD-TRISS models showed good discrimination and calibration performances. Discrimination performance for the NTrD-TRISS model was revealed to be as good as the MTOS-TRISS model specifically for patients with penetrating trauma mechanism. Overall, this validation study has ascertained the discrimination and calibration performances of the NTrD-TRISS model to be as good as the MTOS-TRISS model particularly for patients with blunt trauma mechanism.
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Observational Study
Examination of hemodynamics in patients in hemorrhagic shock undergoing Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA).
The objective of this study was to investigate the hemodynamic effects of aortic occlusion (AO) during Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) using a sophisticated continuous vital sign (CVS) monitoring tool. ⋯ Significant hemodynamic alterations occur before, during, and after AO. The effects of Zone 1 AO on blood pressure and heart rate appear different than Zone 3 AO. This may have important implications for cardiac or cerebral function and perfusion goals, particularly with concomitant injuries such as cardiac contusion or traumatic brain injury.