J Trauma
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Comparative Study
Trauma faculty and trauma team activation: impact on trauma system function and patient outcome.
To determine the impact of the presence of an attending trauma surgeon during trauma team activation on system function and patient outcome. ⋯ The presence of a trauma surgeon on the trauma team reduced resuscitation time and reduced time to incision for emergent operations, particularly in penetrating trauma. However, it had no measurable impact on mortality based on Trauma and Injury Severity Score probability of survival. Attending trauma surgeon presence on the trauma team improves in-hospital trauma system function without affecting patient outcome.
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We sought to obtain more reliable population-based data for injury epidemiology and trauma system evaluation by linking several sources. ⋯ Combining sources of data for injury victims can produce a resource more descriptive than any single source alone. However, computer-assisted record linkage still requires human review and corrections. Feedback of discrepancies to the individual data sources should further improve the quality of data available for linkage.
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Controversies regarding how urgent bowel perforation should be diagnosed and treated exist in recent reports. The approach for early diagnosis is also debatable. The purposes of this study were to evaluate the relationship between treatment delay and outcome of small bowel perforation after blunt abdominal trauma and to determine the best assessment plan for the diagnosis of this injury. ⋯ Small bowel perforation has low mortality and complication rates if it is treated earlier than 24 hours after injury. The principle of "rushing to the operation suite" for a stable blunt abdominal trauma patients without detailed systemic examination is not justified. The priority of treatment for the small bowel perforation should be lower than the limb-threatening injuries. Diagnostic peritoneal lavage provides high sensitivity and specificity rates for the diagnosis of small bowel perforation if a specially designed positive criterion is applied.