The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Dec 2016
Observational StudyNoninvasive hemoglobin measurement in pediatric trauma patients.
Hemorrhage is a major cause of preventable death secondary to traumatic injury. Diagnosis often requires multiple blood draws, which are psychologically stressful in pediatric patients. The Pronto device is a pulse co-oximeter that measures the total hemoglobin level using multiple wavelengths of light. The purpose of this study was to evaluate the accuracy of the noninvasive hemoglobin measurements relative to current invasive and point of care testing methods in pediatric trauma patients. ⋯ Diagnostic test study, level II.
-
J Trauma Acute Care Surg · Dec 2016
Observational StudyAnti-Xa-guided enoxaparin thromboprophylaxis reduces rate of deep venous thromboembolism in high-risk trauma patients.
Appropriate prophylaxis against venous thromboembolism (VTE) remains undefined. This study evaluated an anti-Xa-guided enoxaparin thromboprophylaxis (TPX) protocol on the incidence of VTE in high-risk trauma patients based on Greenfield's Risk Assessment Profile (RAP) score. ⋯ Therapeutic study, level IV.
-
J Trauma Acute Care Surg · Dec 2016
Multicenter Study Observational StudyCervical spinal clearance: A prospective Western Trauma Association Multi-institutional Trial.
For blunt trauma patients who have failed the NEXUS (National Emergency X-Radiography Utilization Study) low-risk criteria, the adequacy of computed tomography (CT) as the definitive imaging modality for clearance remains controversial. The purpose of this study was to prospectively evaluate the accuracy of CT for the detection of clinically significant cervical spine (C-spine) injury. ⋯ Diagnostic tests, level II.
-
J Trauma Acute Care Surg · Dec 2016
The impact of frailty on failure-to-rescue in geriatric trauma patients: A prospective study.
Failure-to-rescue (FTR) (defined as death from a major complication) is considered as an index of hospital quality in trauma patients. However, the role of frailty in FTR events remains unclear. We hypothesized that FTR rate is higher in elderly frail trauma patients. ⋯ Prognostic study, level II.
-
J Trauma Acute Care Surg · Dec 2016
Observational StudyThe importance of empiric antibiotic dosing in critically ill trauma patients: Are we under-dosing based on augmented renal clearance and inaccurate renal clearance estimates?
An accurate assessment of creatinine clearance (CrCl) is essential when dosing medications in critically ill trauma patients. Trauma patients are known to experience augmented renal clearance (i.e., CrCl ≥130 mL/min), and the use of CrCl estimations may be inaccurate leading to under-/over-dosing of medications. As such, our Level I trauma center began using measured CrCl from timed urine collections to better assess CrCl. This study sought to determine the prevalence of augmented renal clearance and the accuracy of calculated CrCl in critically ill trauma patients. ⋯ Prognostic/epidemiologic study, level III.