The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jan 2019
Risk factors for avoidable transfer to a pediatric trauma center among patients 2 years and older.
Effective and sustainable pediatric trauma care requires systems of regionalization and interfacility transfer. Avoidable transfer, also known as secondary overtriage, occurs when a patient is transferred to a regional trauma center after initial evaluation at another facility that is capable of providing definitive care. The purpose of this study was to identify risk factors for avoidable transfer among pediatric trauma patients in southwest Florida. ⋯ Therapeutic/care management, level IV.
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J Trauma Acute Care Surg · Jan 2019
Prehospital tourniquet use in penetrating extremity trauma: Decreased blood transfusions and limb complications.
Despite increasing popularity of prehospital tourniquet use in civilians, few studies have evaluated the efficacy and safety of tourniquet use. Furthermore, previous studies in civilian populations have focused on blunt trauma patients. The objective of this study was to determine if prehospital tourniquet use in patients with major penetrating trauma is associated with differences in outcomes compared to a matched control group. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Jan 2019
Aortic branch vessel flow during resuscitative endovascular balloon occlusion of the aorta.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a torso hemorrhage control adjunct. Aortic branch vessel flow (BVF) during REBOA is poorly characterized and has implications for ischemia-reperfusion injury. The aim of this study is to quantify BVF in hypovolemic shock with and without REBOA. ⋯ REBOA not only abolishing BVF during occlusion, but appears to have a post-REBOA effect, reducing visceral perfusion. This may be a source of REBOA associated ischemia-reperfusion injury and warrants further investigation in order to mitigate this effect.