J Trauma
-
Brief alcohol interventions for patients in trauma settings have demonstrated significant reductions in drinking behaviors, injury related risk behaviors, and subsequent arrests for driving while intoxicated. However, although a number of surveys have examined the knowledge and attitudes of trauma center personnel regarding alcohol problems, the knowledge and attitudes toward alcohol misuse, screening, and intervention services among various trauma care personnel within an individual trauma center have not been investigated. The purpose of this study was to examine provider knowledge and attitudes related to screening and brief intervention for alcohol problems in a single Level-I trauma center. ⋯ This limited knowledge and the neutral attitudes regarding alcohol problems may indirectly influence metrics of program success. Trauma care staff will benefit from additional training regarding alcohol problems and brief interventions.
-
Patients with traumatic brain injury (TBI) and traumatic intracranial hemorrhage are frequently admitted to the intensive care unit (ICU) but never require critical care interventions. Improved ICU triage in this patient population can improve resource utilization and decrease health care costs. We sought to identify a low-risk group of patients with TBI who do not require admission to an ICU. ⋯ Patients with TBI without a critical care intervention before admission are at low risk for requiring future critical care interventions. Future studies are required to validate if this low-risk criteria can serve as a safe, cost-effective triage tool for ICU admission.
-
Links between trauma center volumes and outcomes have been inconsistent in previous studies. This study examines the role of institutional trauma volume parameters in geriatric motor vehicle collision (MVC) survival. ⋯ There may be a risk-adjusted survival advantage for geriatric MVC patients treated at trauma centers with relatively higher volumes of geriatric MVC trauma and lower volumes of young adult non-MVC trauma. These results support consideration of age in trauma center transfer criteria.
-
The amount of free fluid that can normally be present in a pregnant patient is unknown. Evaluation of pelvic free fluid in a population of pregnant patients without early history of trauma would help determine what amount of free fluid should raise suspicion of intra-abdominal injury in those who have suffered trauma. ⋯ These results suggest that the presence of pelvic free fluid in pregnant patients without antecedent trauma is very low. After blunt abdominal trauma, the presence of free fluid in the pelvis of a pregnant patient may not be physiologic, especially if there is >2 mm to 4 mm, and there is no history of ovarian hyperstimulation syndrome or other known associations.