Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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It is expected that over the next decade the population of older adults in the United States will increase dramatically. As the older adult population increases, the number of older adults involved in traumatic accidents is also expected to climb. ⋯ This article provides a clinical guideline for the assessment and management of pain in older adults with traumatic rib fractures, and an approach for pain assessment, which includes the use of the numeric rating scale as well as incentive spirometry. The modalities used for pain management include epidural analgesia, paravertebral analgesia, patient controlled analgesia, and the use of oral opioids.
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This article describes a nurse practitioner model utilized to decrease the length of stay and improve the quality of discharge planning for hospitalized trauma patients between 1999 and 2006. An observational method employing nurse practitioners to decrease length of stay for the trauma population during these years is described. ⋯ Adding nurse practitioners to the trauma team provides a core member in a revolving trauma service. Consequently, length of stay and discharge planning have been positively impacted.
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Falling from a wheelchair can result in a serious injury. Our report details injuries sustained by 30 individuals who fell from a wheelchair and presented to our level I trauma center over 5 years. ⋯ The most serious injuries were traumatic brain injuries and a vertebral fracture with resultant spinal cord injury. In the trauma setting, practitioners discharging patients using wheelchairs should be aware of this mechanism of injury and should provide education to ensure proper fit and use of the device.
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Review Case Reports
Management of embedded foreign body: penetrating stab wound to the head.
Penetrating craniocerebral trauma is an injury in which a projectile violates the skull but does not exit. The significance of penetrating injuries to the head depends largely on the circumstances of the injury, the velocity of impact, and attributes of the projectile. While most penetrating head injuries are caused by firearms, lower-velocity mechanisms of penetrating brain injury present unique challenges for the multidisciplinary team involved with the delivery of care. Appropriate management can lead to optimal outcomes and limit secondary brain injury.