The Journal of surgical research
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Comparative Study
Prehospital care and transportation of pediatric trauma patients.
Despite advances in prehospital emergency medical services (EMS), most advocate "scoop-and-run" over "stay-and-play." However, there are almost no studies in children. We hypothesize that the transportation of mortally injured children is delayed and that the performance of prehospital interventions (PHIs) themselves delay transportation and worsen outcomes in pediatric trauma patients. ⋯ PHIs did not delay transportation times or worsen outcomes in pediatric trauma patients. Although mortally injured children more often required PHIs, this did not delay transportation to the trauma center.
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Video recording in the operating room (OR) has many potential applications for research, quality improvement, and education. Routine video recording is limited by patient and staff privacy concerns, but this may be overcome by creating videos that are deidentified but still retain sufficient video data for intended applications. It is unknown what effect video processing may have on staff perceptions of identifiability in video recordings; this study was designed to investigate this effect. ⋯ This study demonstrates that surgical video postprocessing affects OR staff members' perceptions of anonymity and that it is possible to produce videos that retain details about surgical activity while still being perceived as anonymous. These findings are highly relevant to any study that uses video for quality improvement or health care research by providing the first normative data on "deidentification."
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Patterns of adoption of acute care surgery (ACS) as a strategy for emergency general surgery (EGS) care are unknown. ⋯ Despite concerns over resource allocation and the definition of the specialty, from the perspective of senior surgeons deeply entrenched in executing this care delivery model, ACS represents the new face of general surgery that will likely continue to diffuse from these early adopters.
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A major factor contributing to global trauma mortality and morbidity is the lack of effective prehospital trauma services in developing settings. We developed a 2-d training course for nondoctor first responders featuring high-fidelity simulation and video-assisted debriefing, self-directed learning videos, and native language instruction. ⋯ Results suggest this approach may be effective in imparting prehospital trauma management concepts to layperson first responders. This study highlights an innovative educational avenue through which trauma management capacity can be enhanced in developing settings.
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End-to-side neurorrhaphy is a promising procedure for nerve repair in peripheral nerve injury. However, in previous studies, this technique was limited to somatic nerves. The present study was designed to investigate the feasibility of nerve regeneration after end-to-side neurorrhaphy between autonomic nerve and somatic nerve. ⋯ These results indicated that the somatic motor axons growth into autonomic nerve may be achieved through axon collateral sprouting for nerve repair and function rehabilitation after end-to-side neurorrhaphy of autonomic nerve and somatic nerve without apparent impairment of the donor somatic nerve.