Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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Comparative Study
Peripheral intravenous catheters started in prehospital and emergency department settings.
The purpose of this study was to determine the rates of phlebitis in trauma patients according to where the peripheral intravenous catheter (PIVC) was inserted in a prehospital setting or in an emergency department setting. Variables investigated also included where the catheter was anatomically placed, the gauge of the catheter, and the patients' Injury Severity Score. The overall phlebitis rate was 5.79%. ⋯ In addition, no variables predicted phlebitis no matter where the PIVC was started when a regression analysis was conducted. Even though the Centers for Disease Control and Prevention suggests removing the PIVC within 48 hours if placed under emergency situations, the phlebitis rates of trauma patients in this study meet the benchmark of best practice. Perhaps removing the PIVC within 48 hours of placement should be reconsidered.
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An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. ⋯ Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, trauma centers need to provide the TNC with adequate resources if trauma care systems are to be optimally effective.
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The human core temperature is maintained by highly controlled regulatory mechanisms that balance heat production and heat loss. When this balance is interrupted, there are consequences for human physiology that are not yet fully understood. ⋯ In some instances, such as cardiac arrest, traumatic brain injury, and organ transplantation, controlled hypothermia can be physiologically beneficial, but hypothermia in traumatic injury is distinctly different. In trauma, hypothermia often begins at the time of injury as a result of increased heat loss by conduction and convection due to exposure and reduced heat production due to decreased motor activity.
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Cases of open pneumothorax have been documented as early as 326 BC. Until the last 50 years, understanding of the epidemiology and treatment of penetrating chest trauma has arisen from military surgery. ⋯ This case study presents an adolescent who sustained a large open pneumothorax as a result of being run over by a car. Early and appropriate surgical intervention coupled with coordinated efforts by all members of the trauma team resulted in a positive outcome for this patient.