J Trauma
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To improve utilization of scarce surgical resources, we changed from a single tier trauma paging system (TPS) to a three tiered TPS at a tertiary pediatric trauma center. We investigated if patients were appropriately classified into the three levels of trauma team activation. ⋯ Our results suggest that a three tiered TPS more efficiently utilizes limited surgical resources without leading to major misclassifications.
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Comparative Study
Effects of different fluid resuscitation speeds on blood glucose and interleukin-1 beta in hemorrhagic shock.
Fluid resuscitation is an important treatment for hemorrhagic shock. However, evidence of guidelines for fluid resuscitation is limited. The expressions of blood glucose and proinflammatory cytokines under different resuscitation rates are still unknown. In this study, the status of blood glucose and interleukin-1beta (IL-1beta) between rapid and slow fluid resuscitation for hemorrhagic shock were compared. ⋯ Rapid fluid resuscitation ameliorates hyperglycemia and inflammatory response after hemorrhagic shock. Knowledge of advanced treatment will facilitate optimal care delivery for patients with hemorrhagic shock.
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The surgical reduction of distal femoral fractures with minimally invasive plate osteosynthesis is difficult and the maintenance of the reduction can involve high exposures to radiation. We designed an effective fracture reduction method involving a percutaneous temporal wiring technique for the reduction of distal femoral fractures with oblique or spiral fracture components during surgery with minimally invasive plate osteosynthesis. Our method consistently reduced these fractures satisfactorily. The maintenance of reduction and plate fixation were easy with our method and the radiation exposure during the operation was reduced.
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Comparative Study
Application of electronic surveillance and global information system mapping to track the epidemiology of pediatric pedestrian injury.
To compare the epidemiology of pediatric pedestrian injury in Jacksonville, FL to national trends, to analyze geographic distribution of these injuries, and to analyze pedestrian injury severity trends over time. ⋯ Although Jacksonville is similar to national trends in terms of gender, hour, day, and location of pedestrian injury, it differs from previous reports in terms of seasonality and the high proportion of adolescents struck. The effect of enhanced education appears to have diminished injury severity, although comparison of GIS plots clearly demonstrates that effective control will require changing environmental factors. Moreover, this report mandates further investigation and prevention efforts specifically targeting adolescents in urban areas.
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Previous studies had demonstrated that injury severity and risk of death after motor-vehicle crashes are related to human body characteristics. The purpose of this study was to clarify the relationship between body mass index (BMI) and head injury severity in front seat passengers after a frontal collision. ⋯ Obese passengers are more likely to suffer a more severe head trauma after a frontal collision. Further studies with computational models are needed to determine the precise role of BMI on brain injury-related biomechanical metrics.