The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2012
Comparative StudyBarriers to compliance with evidence-based care in trauma.
We have preciously demonstrated that trauma patients receive less than two-thirds of the care recommended by evidence-based medicine. The purpose of this study was to identify patients least likely to receive optimal care. ⋯ II.
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J Trauma Acute Care Surg · Mar 2012
Randomized Controlled Trial Comparative StudyBacteria on external fixators: which prep is best?
There are no established guidelines for the surgical prep of an external fixator in the operative field. This study investigates the effectiveness of different prep solutions and methods of application. ⋯ Although there was no increase in bacteria counts after the simulated external fixator adjustment, it did expose additional bacteria previously unseen. Although there was no difference in surgical prep solution or method of application, consideration must be given to performing an additional surgical prep of the newly exposed surface after loosening of each individual external fixator component as this may further minimize potential bacteria exposure.
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J Trauma Acute Care Surg · Mar 2012
Comparative StudySafety of prehospital intravenous fentanyl for adult trauma patients.
Little is known about the safety of intravenous fentanyl for adult trauma patients in the prehospital setting. Our objective was to study the hemodynamic effect of prehospital intravenous fentanyl in initially normotensive adult trauma patients. ⋯ III.
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J Trauma Acute Care Surg · Mar 2012
Comparative StudyHost susceptibility to gram-negative pneumonia after lung contusion.
Lung contusion (LC) induces inflammation with high local concentrations of proinflammatory mediators stimulating chemotaxis and activation of neutrophils. LC is also a risk factor for development of pneumonia; however, the reason for this increased susceptibility is not clearly identified. We hypothesize that LC creates acute changes in the host pulmonary innate immune system that leads to vulnerability from a "second" hit bacterial infection. ⋯ Acute inflammation after LC acts to modulate the presence of inflammatory cells necessary to combat gram-negative bacteria. This results in decreased bacterial clearance and increased mortality from pneumonia.