The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyEffectiveness of clinical guidelines for deep vein thrombosis prophylaxis in reducing the incidence of venous thromboembolism in critically ill children after trauma.
Historically, 6% of critically ill children developed clinically apparent venous thromboembolism (VTE) after trauma at our Level I pediatric trauma center. We hypothesized that implementation of clinical guidelines for thrombosis prophylaxis incorporating both VTE risk and bleeding risk would reduce VTE incidence without increased bleeding. ⋯ II, therapeutic study.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyMortality pattern of the 26/11 Mumbai terror attacks.
Mumbai, one of the industrial capitals cities of the world, has witnessed a series of terror attacks over the last two decades. The 2008 Mumbai terror attacks referred as "26/11" drew widespread global condemnation and killed 166 people, in addition to wounding more than 300 people. The mortality pattern and the pathophysiology of organ injuries are presented. The objective of this study was to determine the different patterns of injury in a terrorist attack of such magnitude and clinical implications in reducing mortality. ⋯ V, epidemiological study.
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J Trauma Acute Care Surg · May 2012
Multicenter Study Comparative StudyInjury pattern, injury severity, and mortality in 33,495 hospital-admitted victims of motorized two-wheeled vehicle crashes in The Netherlands.
Road traffic accidents involving motorized two-wheeled vehicle (MTV) riders often result in severe morbidity and mortality. The aim of this nationwide study is to describe the influence of the type of motorized two-wheeled vehicle on the patient injury severity and mortality on hospitalization, after MTV accidents in The Netherlands. ⋯ II, epidemiological study.
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J Trauma Acute Care Surg · May 2012
Randomized Controlled Trial Comparative StudyProtocol-directed versus physician-directed weaning from noninvasive ventilation: the impact in chronic obstructive pulmonary disease patients.
Noninvasive ventilation (NIV), a technique widely used in intensive care units (ICUs), eliminates the need for many patients in respiratory failure to undergo intubation. However, few articles have described how to wean patients from NIV. Herein, we put forward a protocol to be performed by respiratory therapists to wean patients from NIV. ⋯ II.
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J Trauma Acute Care Surg · May 2012
Multicenter StudyDeciphering the use and predictive value of "emergency medical services provider judgment" in out-of-hospital trauma triage: a multisite, mixed methods assessment.
"Emergency medical services (EMS) provider judgment" was recently added as a field triage criterion to the national guidelines, yet its predictive value and real world application remain unclear. We examine the use and independent predictive value of EMS provider judgment in identifying seriously injured persons. ⋯ Among this multisite cohort of trauma patients, EMS provider judgment was the most commonly used field trauma triage criterion, independently associated with serious injury, and useful in identifying high-risk patients missed by other criteria. However, there was variability in predictive value between sites.