The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2015
Multicenter StudyA multi-institutional analysis of prehospital tourniquet use.
Recent military studies demonstrated an association between prehospital tourniquet use and increased survival. The benefits of this prehospital intervention in a civilian population remain unclear. The aims of our study were to evaluate tourniquet use in the civilian population and to compare outcomes to previously published military experience. We hypothesized that incorporation of tourniquet use in the civilian population will result in an overall improvement in mortality. ⋯ Epidemiologic study, level V.
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J Trauma Acute Care Surg · Jul 2015
Certified acute care surgery programs improve outcomes in patients undergoing emergency surgery: A nationwide analysis.
Differences in outcomes among trauma centers (TCs) and non-TCs (NTCs) in patients undergoing emergency general surgery (EGS) are well established. However; the impact of development of certified acute care surgery (ACS) programs on patient outcomes remains unknown. The aim of this study was to evaluate outcomes in patients undergoing EGS across TCs, NTCs, and TCs with ACS (ACS-TC). ⋯ Therapeutic/care management study, level IV.
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J Trauma Acute Care Surg · Jul 2015
Effect of ascorbic acid concentrations on hemodynamics and inflammation following lyophilized plasma transfusion.
Compared with lyophilized plasma (LP) buffered with other acids, LP with ascorbic acid (AA) attenuates systemic inflammation and DNA damage in a combat relevant polytrauma swine model. We hypothesize that increasing concentrations of AA in transfused LP will be safe, will be hemodynamically well tolerated, and will attenuate systemic inflammation following polytraumatic injury and hemorrhage in swine. ⋯ Concentrations of AA were well tolerated and did not diminish the procoagulant activity of LP. Within our tested range of concentrations, AA can safely be used to buffer LP.
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J Trauma Acute Care Surg · Jul 2015
Maintaining an open trauma intensive care unit bed for rapid admission can be cost-effective.
In 2012, we implemented a ready open trauma intensive care unit (TICU) bed process. Our hypothesis was that this process would decrease emergency department (ED) length of stay (LOS) in a cost-effective manner without worsening clinical outcomes. ⋯ Cost analysis, level III.