The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2012
Comparative StudyA web-based model to support patient-to-hospital allocation in mass casualty incidents.
In a mass casualty situation, evacuation of severely injured patients to the appropriate health care facility is of critical importance. The prehospital stage of a mass casualty incident (MCI) is typically chaotic, characterized by dynamic changes and severe time constraints. As a result, those involved in the prehospital evacuation process must be able to make crucial decisions in real time. This article presents a model intended to assist in the management of MCIs. The Mass Casualty Patient Allocation Model has been designed to facilitate effective evacuation by providing key information about nearby hospitals, including driving times and real-time bed capacity. These data will enable paramedics to make informed decisions in support of timely and appropriate patient allocation during MCIs. The model also enables simulation exercises for disaster preparedness and first response training. ⋯ The dynamic and evolving nature of MCIs requires that decisions regarding prehospital management be made under extreme time pressure. This model provides tools for these decisions to be made in an informed fashion with continuously updated hospital capacity information. In addition, it permits complex MCI simulation for response and preparedness training.
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J Trauma Acute Care Surg · May 2012
Comparative StudyPrehospital nausea and vomiting after trauma: Prevalence, risk factors, and development of a predictive scoring system.
Nausea and vomiting are common problems in trauma patients and potentially dangerous during trauma resuscitation. These symptoms are present in up to 10% of ambulance patients, but their prevalence in trauma patients is largely unknown. The aim of this study was to determine the prevalence of prehospital nausea and vomiting in trauma patients and evaluate antiemetic usage. ⋯ V, epidemiological study.
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J Trauma Acute Care Surg · May 2012
Comparative StudyLong-term survival after major trauma in geriatric trauma patients: the glass is half full.
The objective is to examine the long-term survival status of geriatric trauma patients (GTPs) after major trauma. ⋯ III, prognostic/epidemiological study.
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J Trauma Acute Care Surg · May 2012
Case ReportsProlonged heparin-free extracorporeal membrane oxygenation in multiple injured acute respiratory distress syndrome patients with traumatic brain injury.
Extracorporeal membrane oxygenation (ECMO) can be used as an "ultima ratio" strategy in multiple injured patients with severe thoracic trauma. However, systemic anticoagulation during ECMO is recommended and thus traumatic brain injury (TBI) and intracranial bleeding are well-accepted contraindications for ECMO therapy. ⋯ IV, therapeutic study.
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J Trauma Acute Care Surg · May 2012
Comparative StudyThe first 72 hours of brain tissue oxygenation predicts patient survival with traumatic brain injury.
Utilization of brain tissue oxygenation (pBtO(2)) is an important but controversial variable in the treatment of traumatic brain injury. We hypothesize that pBtO(2) values over the first 72 hours of monitoring are predictive of mortality. ⋯ III, prognostic study.