The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2020
Extraperitoneal packing in unstable blunt pelvic trauma: A single-center study.
Hemodynamically unstable pelvic fractures often require a multi-modal approach including both operative and endovascular management. While an important adjunct in hemorrhage control, time to angioembolization even at the most advanced trauma centers may take hours. Extraperitoneal packing (EPP) is a fast and effective procedure that can immediately address pelvic hemorrhage from the retroperitoneal space in severe pelvic injuries. The aim of this study was to evaluate the efficacy of early EPP, looking at 24 hours and overall mortality, and the hemodynamic impact of EPP in unstable blunt pelvic trauma. ⋯ Therapeutic, Level III.
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J Trauma Acute Care Surg · May 2020
Comparative StudyOutcomes following penetrating neck injury during the Iraq and Afghanistan conflicts: A comparison of treatment at US and United Kingdom medical treatment facilities.
The United States and United Kingdom (UK) had differing approaches to the surgical skill mix within deployed medical treatment facilities (MTFs) in support of the military campaigns in Iraq and Afghanistan. ⋯ Retrospective cohort study, level III.
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J Trauma Acute Care Surg · May 2020
Natural language processing of prehospital emergency medical services trauma records allows for automated characterization of treatment appropriateness.
Incomplete prehospital trauma care is a significant contributor to preventable deaths. Current databases lack timelines easily constructible of clinical events. Temporal associations and procedural indications are critical to characterize treatment appropriateness. Natural language processing (NLP) methods present a novel approach to bridge this gap. We sought to evaluate the efficacy of a novel and automated NLP pipeline to determine treatment appropriateness from a sample of prehospital EMS motor vehicle crash records. ⋯ Diagnostic tests or criteria, level III.
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J Trauma Acute Care Surg · May 2020
Effectiveness of the combat application tourniquet for arterial occlusion in young children.
Tourniquet use for extremity hemorrhage has become a mainstay in adult trauma care in last 15 years. The efforts of the Stop the Bleed campaign have increased the distribution and use of tourniquets in civilian settings in response to mass shootings and as part of disaster preparedness. Little research or published experience exists regarding the use of tourniquets in the pediatric population. This study sought to determine the minimum patient age on which the combat application tourniquet (CAT) is able to control extremity hemorrhage. ⋯ Therapeutic, level II.
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J Trauma Acute Care Surg · May 2020
Mapping the increasing interest in acute care surgery-Who, why and which fellowship?
Interest in acute care surgery (ACS) has increased over the past 10 years as demonstrated by the linear increase in fellowship applicants to the different fellowships leading to ACS careers. It is unclear why interest has increased, whether various fellowship pathways attract different applicants or whether fellowship choice correlates with practice patterns after graduation. ⋯ Descriptive, mixed methods, Level IV.