The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Aug 2021
Physician-staffed ambulance and increased in-hospital mortality of hypotensive trauma patients following prolonged prehospital stay: A nationwide study.
The benefits of physician-staffed emergency medical services (EMS) for trauma patients remain unclear because of the conflicting results on survival. Some studies suggested potential delays in definitive hemostasis due to prolonged prehospital stay when physicians are dispatched to the scene. We examined hypotensive trauma patients who were transported by ambulance, with the hypothesis that physician-staffed ambulances would be associated with increased in-hospital mortality, compared with EMS personnel-staffed ambulances. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Aug 2021
Safety and efficacy of low-titer O whole blood resuscitation in a civilian level I trauma center.
Military experience has shown low-titer O whole blood (LTOWB) to be safe and beneficial in the resuscitation of hemorrhaging trauma patients. However, few civilian centers use LTOWB for trauma resuscitation. We evaluated the early experience and safety of a LTOWB program at a level 1 civilian trauma center. ⋯ Retrospective, therapeutic, level IV.
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J Trauma Acute Care Surg · Aug 2021
Combat-related ocular injuries in the IDF during the years 2013-2019.
Ocular injuries account for up to 13% of battle injuries, despite the implementation of advanced protective eyewear (PE). The aim of this study was to describe the extent of ocular injuries over the last years among Israel Defense Forces soldiers and to examine the change in PE policy introduced in 2013 and the effect of a high-intensity conflict on ocular injury characteristics. ⋯ Epidemiological study, level IV.
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J Trauma Acute Care Surg · Jul 2021
Comparative StudyFour-Factor Prothrombin Complex Concentrate in Adjunct to Whole Blood in Trauma-Related Hemorrhage: Does Whole Blood Replace the Need for Factors?
The use of whole blood (WB) for the treatment of hemorrhagic shock and coagulopathy is increasing in civilian trauma patients. Four-factor prothrombin complex concentrate (4-PCC) in adjunct to component therapy showed improved outcomes in trauma patients. Our study aims to evaluate the outcomes of trauma patients who received 4-PCC and WB (4-PCC-WB) compared with WB alone. ⋯ Therapeutic, level III.