Journal of trauma management & outcomes
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J Trauma Manag Outcomes · Jan 2014
PHTLS ® (Prehospital Trauma Life Support) provider courses in Germany - who takes part and what do participants think about prehospital trauma care training?
The goal of this study was to examine PHTLS Provider courses in Germany and to proof the assumption that formation of physicians and paramedics in prehospital trauma care can be optimized. ⋯ The evaluation of PHTLS courses in Germany indicates the necessity for special prehospital trauma care training. Paramedics and physicians criticize deficits in their professional training, which can be compensated by PHTLS. With respect to relevant items like confidence and knowledge PHTLS leads to a statistically significant increase in ratings on a visual analogue scale. PHTLS should be integrated into the curriculum at Medical School.
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J Trauma Manag Outcomes · Jan 2014
Abdominal injuries in a major Scandinavian trauma center - performance assessment over an 8 year period.
Damage control surgery and damage control resuscitation have reduced mortality in patients with severe abdominal injuries. The shift towards non-operative management in haemodynamically stable patients suffering blunt abdominal trauma has further contributed to the improved results. However, in many countries, low volume of trauma cases and limited exposure to trauma laparotomies constitute a threat to trauma competence. The aim of this study was to evaluate the institutional patient volume and performance for patients with abdominal injuries over an eight-year period. ⋯ Even in a high volume trauma center the exposure to abdominal injuries and trauma laparotomies is limited. Due to increasing NOM, an increasing number of patients with abdominal injuries was not accompanied by an increase in number of laparotomies. However, we have demonstrated a stable performance throughout the study period as visualized by VLAD without an increase in missed injuries or failures of NOM.
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J Trauma Manag Outcomes · Jan 2014
Diagnostic significance of rib series in minor thorax trauma compared to plain chest film and computed tomography.
Rib series (RS) are a special radiological technique to improve the visualization of the bony parts of the chest. ⋯ Rib series does not seem to be an useful examination in evaluating minor thorax trauma. CT seems to be the method of choice to detect rib fractures, but the clinical value of the radiological proof has to be discussed and investigated in larger follow up studies.
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J Trauma Manag Outcomes · Jan 2014
Management of intra-abdominal hypertension and abdominal compartment syndrome: a review.
Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). ⋯ This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function.
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J Trauma Manag Outcomes · Jan 2014
A necessary evil? Intra-abdominal hypertension complicating burn patient resuscitation.
Severe burns are devastating injuries that result in considerable systemic inflammation and often require resuscitation with large volumes of fluid. The result of massive resuscitation is often raised intra-abdominal pressures leading to Intra-abdominal hypertension (IAH) and the secondary abdominal compartment syndrome. The objective of this study is to conduct (1) a 10 year retrospective study to investigate epidemiological factors contributing to burn injuries in Alberta, (2) to characterize fluid management and incidence of IAH and ACS and (3) to review fluid resuscitation with a goal to identify optimal strategies for fluid resuscitation. ⋯ Further evaluation of IAP monitoring is needed to further characterize IAP and fluid resuscitation in patients with burn injuries.