J Trauma
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To assess whether repositioning of ambulance stations in a rural county of Alabama can improve emergency medical services (EMS) response time to motor vehicle crashes (MVCs) without adversely affecting response time to non-MVC-related emergencies. ⋯ Utilizing geographical information system software, EMS response time to MVCs could be improved in rural areas by optimal location of ambulance stations based on geographical highest concentration of MVCs and vicinity of major thoroughfares. This can be accomplished without adversely affecting response time to non-MVC-related emergencies.
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Studies from the United States report a large increase in the surgical treatment of distal radius fractures with open reduction and internal fixation using locked plates. The aim of the present study was to determine whether the same trend has occurred in a Scandinavian country by assessing the number, incidence, and surgical methods of all surgically treated distal radius fractures in Finland over a recent 11-year period. ⋯ A striking shift from external fixation to plating in the treatment of distal radius fractures has occurred in Finland over the past few years, despite the fact that the scientific literature does not support plating over external fixation. In addition, the incidence and number of surgeries for distal radius fractures doubled between 1998 and 2008. The reasons for these changes are not known.
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The epidemiology of vascular injuries in the geriatric patient population has not been described. The purpose of this study was to examine nationwide data on vascular injuries in the geriatric patients and to compare this with the nongeriatric adult patients with respect to the incidence, injury mechanisms, and outcomes. ⋯ Vascular trauma is rare in the geriatric patient population. These injuries are predominantly blunt, with the thoracic aorta being the most commonly injured vessel. Although vascular injuries occur less frequently than in the nongeriatric cohort, in the geriatric patient, vascular injury is associated with a fourfold increase in adjusted mortality.
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The face of trauma surgery is rapidly evolving with a paradigm shift toward acute care surgery (ACS). The formal development of ACS has been viewed by some general surgeons as a threat to their practice. We sought to evaluate the impact of a new division of ACS to both departmental productivity and provider satisfaction at a University Level I Trauma Center. ⋯ The ACS practice model significantly enhances provider productivity and job satisfaction when compared with trauma alone. Fears of a productivity impact to the nontrauma general surgeon were not realized.
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Work place injuries have socioeconomic and workforce health implications. Results of clinical studies on the effect of alcohol (ETOH) ingestion on short-term outcomes in trauma are varied. We performed this study to estimate the prevalence of ETOH-related injury in the workplace and its relevance to outcomes. ⋯ The incidence of ETOH-associated workplace injury is potentially significant. Despite variable effects of ETOH ingestion on trauma outcomes, the presence of a ETOH (+) screen is independently associated with complications after occupational injury.