J Trauma
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We have previously demonstrated that the use of a daily "Quality Rounds Checklist" (QRC) can increase compliance with evidence-based prophylactic measures and decrease complications in a busy trauma intensive care unit (ICU) over a 3-month period. This study was designed to determine the sustainability of QRC use over 1 year and examine the relationship between compliance and outcome improvement. ⋯ The use of a QRC facilitates sustainable improvement in compliance rates for clinically significant prophylactic measures in a busy Level I trauma ICU. The daily use of the QRC, requiring just a few minutes per patient to complete, equates to cost-effective improvement in patient outcomes.
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A survey of all Canadian residents training in general surgery was conducted to determine the prevalence and nature of focused assessment with sonography in trauma (FAST) training. ⋯ The situation with FAST training in Canada seems inadequate with few general surgery residents being trained, and of those trained, only a few are comfortable with the technique. If FAST skills are to be expected of future surgeons, initiatives must be put in place to address barriers and improve training opportunities.
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Controlled Clinical Trial
Implementing and evaluating an injury prevention curriculum within a pediatric residency program.
Many pediatric residency programs struggle to incorporate injury prevention training into their curricula. ⋯ An injury prevention curriculum for pediatric residents can significantly increase and sustain their fund of knowledge on these important topics.
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Normal vital signs are typically associated with improved outcomes in trauma patients. Whether this association is true for geriatric patients is unclear. ⋯ Vital signs on presentation are less predictive of mortality in geriatric blunt trauma victims. Geriatric blunt trauma patients warrant increased vigilance despite normal vital signs on presentation. New trauma triage set points of HR >90 or SBP <110 mm Hg should be considered in the geriatric blunt trauma patients.
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Although brain cooling has recently been reported as effective in improving the survival after heatstroke generation in rats, the mechanisms underlying the therapeutic effects of brain cooling are not fully elucidated. This study was conducted to test whether the acute lung inflammation and damage that might occur during heatstroke could be affected by brain cooling. ⋯ These experimental data indicate that acute lung inflammation and damage is a target of brain cooling after heatstroke injury.