Scand J Trauma Resus
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Scand J Trauma Resus · Feb 2017
The number of displaced rib fractures is more predictive for complications in chest trauma patients.
Traumatic rib fractures can cause chest complications that need further treatment and hospitalization. We hypothesized that an increase in the number of displaced rib fractures will be accompanied by an increase in chest complications. ⋯ The number of displaced rib fractures could be a strong predictor for developing pulmonary complications. For patients with fewer than three rib fractures without rib displacement and initial lung or other organ injuries, outpatient management could be safe and efficient.
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Subarachnoid hemorrhage (SAH) is associated with higher mortality in the acute phase than other stroke types. There is a particular risk of early and devastating re-bleeding. Patients therefore need urgent assessment in a neurosurgical department, and the shorter the time from symptom onset to diagnosis the better. ⋯ The Norwegian MSU model staffed with anesthesiologists can rapidly establish an exact diagnosis of SAH, which in a rural area significantly reduces time to neurosurgical care.
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As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes trauma system safety and human factors. There is no published, evidence-informed standardised tool that considers these factors for use in adult or paediatric trauma case peer-review. The aim of this research was to develop and validate a trauma case review tool to facilitate clinical review of paediatric trauma patient care in extracting information to facilitate monitoring, inform change and enable loop closure. ⋯ This tool can be used to identify opportunities for improvement in trauma care and guide quality assurance activities. Validation is required in the adult population.
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Scand J Trauma Resus · Feb 2017
Observational StudyThe impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study.
Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit. ⋯ Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved labour market affiliation compared to patients transported by a ground unit.
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Scand J Trauma Resus · Feb 2017
Potential benefits of an integrated military/civilian trauma system: experiences from two major regional conflicts.
Although differences of opinion and controversies may arise, lessons learned from military conflicts often translate into improvements in triage, resuscitation strategies, and surgical technique. Our fully integrated national trauma system, providing care for both military and civilian casualties, necessitates close cooperation between all aspects of both sectors. We theorized that lessons learned from two regional conflicts over 8 years, with resultant improved triage, reduced hospital length of stay, and sustained low mortality would aid performance improvement and provide evidence of overall trauma system maturation. ⋯ Despite more severe injuries in the most recent regional conflict, there was increased direct triage via helicopter to level 1 centers, reduced inter-hospital transfers, reduced hospital length of stay, and persistent low mortality. Although further assessment is required, these data suggest that via ongoing cooperation in a culture of improved preparedness, an integrated military/civilian national trauma network has also positively impacted civilian results via reduced mortality in ISS ≥ 16 and reduced late inter-hospital transfers. These findings support continued maturation of the system as a whole.