Articles: trauma.
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A better characterization of deaths in children following emergency care is needed to inform timely interventions. This study aimed to describe the timing, location, and causes of death to 1 year among a cohort of injured and medically ill children. ⋯ The 1-year mortality of children presenting to an ED is 2.2% for injured children and 1.4% for medically ill children with most deaths occurring in the ED. Future interventional trials, quality improvement efforts, and health policy focused in the ED could have the potential to improve outcomes of pediatric patients.
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Randomized Controlled Trial
Topical Diclofenac Versus Oral Ibuprofen Versus Diclofenac + Ibuprofen for Emergency Department Patients With Acute Low Back Pain: A Randomized Study.
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are useful for a variety of musculoskeletal injuries. It is not known whether topical NSAIDs should be used for patients presenting with acute nonradicular musculoskeletal low back pain. ⋯ Among patients with nontraumatic, nonradicular acute musculoskeletal low back pain discharged from an ED, topical diclofenac was probably less efficacious than oral ibuprofen. It demonstrated no additive benefit when coadministered with oral ibuprofen.
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Polytrauma is increasingly recognized as a disease beyond anatomical injuries. Due to population growth, centralization, and slow uptake of preventive measures, major trauma presentations in most trauma systems show a slow but steady increase. The proportional contribution of polytrauma patients to this increase is unknown. ⋯ Polytrauma patients represent about 25% of the major trauma admissions, with higher injury severity, static incidence and higher but improving mortality in comparison to all major trauma patients. Separate reporting and focused research on this group are warranted as monitoring the entire major trauma cohort does not identify these specifics of this high acuity subgroup.
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Curr Opin Crit Care · Jun 2024
ReviewWhat's new in whole blood resuscitation? In the trauma bay and beyond.
Transfusion therapy commonly supports patient care during life-threatening injury and critical illness. Herein we examine the recent resurgence of whole blood (WB) resuscitation for patients in hemorrhagic shock following trauma and other causes of severe bleeding. ⋯ Whole blood may be transfused as FWB or LTOWB to support a hemostatic approach to hemorrhagic shock management. Although the bulk of WB resuscitation literature has appropriately focused on hemorrhagic shock following injury, extension to other etiologies of severe hemorrhage will benefit from focused inquiry to address cost, efficacy, approach, and patient-centered outcomes.