The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2021
Comparative StudyEvaluation of statewide utilization of helicopter emergency medical services for interfacility transfer.
Helicopter emergency medical services (HEMSs) are used with increasing frequency for the transportation of injured patients from the scene and from treatment facilities to higher levels of care. Improved outcomes have been difficult to establish, and reports of overutilization and financial harm have been published. Our study was performed to evaluate statewide utilization for interfacility transfers (IFTs). ⋯ Prognostic/epidemiological study, level III; Care Management, level IV.
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J Trauma Acute Care Surg · Sep 2021
Comparative StudyVariation in Radiation Dosing Among Pediatric Trauma Patients Undergoing Head Computed Tomography Scan.
When head injured children undergo head computed tomography (CT), radiation dosing can vary considerably between institutions, potentially exposing children to excess radiation, increasing risk for malignancies later in life. We compared radiation delivery from head CTs at a level 1 pediatric trauma center (PTC) versus scans performed at referring adult general hospitals (AGHs). We hypothesized that children at our PTC receive a significantly lower radiation dose than children who underwent CT at AGHs for similar injury profiles. ⋯ Care Management/Therapeutic, level IV.
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J Trauma Acute Care Surg · Sep 2021
The impact of COVID-19 infection on outcomes after injury in a state trauma system.
The COVID-19 pandemic reshaped the health care system in 2020. COVID-19 infection has been associated with poor outcomes after orthopedic surgery and elective, general surgery, but the impact of COVID-19 on outcomes after trauma is unknown. ⋯ Level II, Prognostic Study.
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J Trauma Acute Care Surg · Sep 2021
The timing of amputation of mangled lower extremities does not predict post-injury outcomes and mortality: A retrospective analysis from the ACS TQIP database.
While limb salvage does not result in improved functional outcomes among patients with a mangled lower extremity, the impact of attempted limb salvage on mortality and complications is poorly understood. The objective of this study was to evaluate the relationship between attempted limb salvage and in-hospital outcomes among patients with a mangled lower extremity. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Aug 2021
Observational StudyImplications of the national Stop the Bleed campaign: The swinging pendulum of prehospital tourniquet application in civilian limb trauma.
Prehospital tourniquet (PHT) utilization has increased in response to mass casualty events. We aimed to describe the incidence, therapeutic effectiveness, and morbidity associated with tourniquet placement in all patients treated with PHT application. ⋯ Epidemiological, level III; Therapeutic, level IV.