Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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The optimal degree of resuscitation in the initial control and resuscitative phase of trauma care remains unclear. Many attempts have been made with animal studies to determine the optimal degree and method of resuscitation. Human studies were first conducted in 1994 and the results were inconclusive and have not been replicated. The question of the volume, rate, and type of fluid to be infused for initial control and adequate resuscitation of the trauma patient remains to be answered.
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Trauma resuscitation requires a skilled trauma team with the appropriate team members. Involving a rapid response nurse to this team can help with trauma interventions and ensure the continued care of Emergency Department patients. Possessing critical care skills and critical thinking, the response nurse is beneficial to the trauma resuscitation, as well as the hospital as a whole.
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Henry Ford Hospital is undertaking multiple initiatives to reduce patient mortality. One such project is the deployment of a rapid response team (RRT). Rapid response teams contribute to reducing in-patient mortality rates by identifying and treating patients at risk for physiological deterioration outside the intensive care unit (ICU) setting. ⋯ Statistical data collected from the consult forms indicate that the greatest number of occurrences were respiratory triggers. From a sample size of 1,335 consults, 30% of the sample group had low pulse oximetry, 30% presented with respiratory distress, and 20% had respiratory rate issues. Future implications for the RRT will be along the lines of early sepsis recognition, retention and recruitment tool, education and practice links, and using families as initiators of a RRT consult.
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Atlanto-occipital dislocation, once considered rare and fatal, has become more common. Reasons for improved survival are training, efforts of prehospital care givers, improved diagnostics, and a collaborative healthcare approach to the patient. ⋯ Coupled with improved diagnostics, time to injury identification and treatment initiation is accelerated. This pediatric case study presents a coordinated plan of care demonstrating appropriate prehospital strategies and a team approach to care resulting in a positive patient outcome.
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Getting assigned to a trauma for the first time is still stressful for perioperative staff members. However, viewing the video/DVD does seem to help overcome some of the inherent anxiety. In addition, encouraging new or inexperienced staff nurses and technologists to participate on trauma cases with more seasoned staff also seems to alleviate some of those fears. ⋯ Making a video seemed like an overwhelming task at first, but the team sought out guidance and support from appropriate resources (videographer, surgeons, etc) in order to collaborate effectively, and the result was a great educational product. The Staff Development team continues to present inservices that are specialty or case specific. The "trauma" aspect of these presentations is also always included to reinforce the topics that were brought out in the video.