The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2021
Geospatial assessment of helicopter emergency medical service overtriage.
Despite evidence of benefit after injury, helicopter emergency medical services (HEMS) overtriage remains high. Scene and transfer overtriage are distinct processes. Our objectives were to identify geographic variation in overtriage and patient-level predictors, and determine if overtriage impacts population-level outcomes. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Jun 2021
Multicenter Study Comparative StudyA multicenter investigation of the hemodynamic effects of induction agents for trauma rapid sequence intubation.
Several options exist for induction agents during rapid sequence intubation (RSI) in trauma patients, including etomidate, ketamine, and propofol. These drugs have reported variable hemodynamic effects (hypotension with propofol and sympathomimetic effects with ketamine) that could affect trauma resuscitations. The purpose of this study was to compare the hemodynamic effects of these three induction agents during emergency department RSI in adult trauma. We hypothesized that these drugs would display a differing hemodynamic profile during RSI. ⋯ Therapeutic, Level IV.
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J Trauma Acute Care Surg · Jun 2021
Prehospital tourniquet use: An evaluation of community application and outcome.
There is substantial investment in layperson and first responder training involving tourniquet use for hemorrhage control. Little is known however about prehospital tourniquet application, field conversion, or outcomes in the civilian setting. We describe the experience of a metropolitan region with prehospital tourniquet application. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Jun 2021
Multicenter StudySurgical stabilization of rib fractures in octogenarians and beyond-what are the outcomes?
Prospective studies of surgical stabilization of rib fractures (SSRF) have excluded elderly patients, and no study has exclusively addressed the ≥80-year-old subgroup. We hypothesized that SSRF is associated with decreased mortality in trauma patients 80 years or older. ⋯ Therapeutic, Level IV.
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J Trauma Acute Care Surg · May 2021
Isolated traumatic brain injury: Routine intubation for Glasgow Coma Scale 7 or 8 may be harmful!
Despite strong recommendations, there is no direct evidence supporting routine intubation of trauma patients with Glasgow Coma Scale (GCS) score of 7 or 8. We hypothesized that routine intubation may not be beneficial in isolated blunt head injury. ⋯ Therapeutic, level III.