Articles: trauma.
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J Paediatr Child Health · Sep 2013
Paediatric health-care professionals: relationships between psychological distress, resilience and coping skills.
To investigate the impact of regular exposure to paediatric medical trauma on multidisciplinary teams in a paediatric hospital and the relationships between psychological distress, resilience and coping skills. ⋯ Paediatric medical trauma can adversely affect a health professional's well-being, particularly those <25 years of age who make less use of positive coping strategies and more use of non-productive coping. These findings will assist the development of effective and meaningful interventions for health professionals working in paediatric hospitals.
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High-dose vancomycin is increasingly prescribed for critically ill trauma patients at risk for methicillin-resistant Staphylococcus aureus pneumonia. Although trauma patients have multiple known risk factors for acute kidney injury (AKI), a link between vancomycin and AKI or mortality has not been established. We hypothesize that high vancomycin trough concentration (VT) after trauma is associated with AKI and increased mortality. ⋯ AKI is common in trauma patients who receive intravenous vancomycin. A supratherapeutic trough level of >20 mg/L is an independent predictor of AKI and mortality in trauma patients.
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To assess the improvement of knowledge and skills of trauma management among participant of Primary Trauma Care (PTC) workshop. ⋯ Primary Trauma Care workshop could be an effective course for gaining of knowledge and skills of initial management of trauma patients. However, some modifications need to be done for training of skills components to maximize the output of this interactive workshop.
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Comparative Study
Flutamide fails to reduce resuscitation requirements in a porcine ischemia-reperfusion model.
Hemorrhagic shock and subsequent resuscitation can lead to ischemia-reperfusion injury, followed by multiorgan failure and death. Flutamide, a vasoactive nonsteroidal antiandrogen compound, is thought to improve tissue and organ perfusion. We tested whether administration of flutamide-cyclodextrin (FLU-CYD) alters physiologic parameters or resuscitation requirements in a porcine model of severe acidosis and shock secondary to combined hemorrhage + ischemia-reperfusion injury. ⋯ Flutamide failed to show any benefit to resuscitation in a model of severe injury and was associated with increased acidosis, hemodilution, and liver injury compared with standard crystalloid resuscitation.
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Imaging after blunt cervical trauma is being used increasingly to screen patients for injury of the vertebral artery (VA). There are no guidelines for imaging of the VA for nonpenetrating cervical trauma. The purpose of this study was to determine the effect of VA injury on clinical outcome after blunt cervical trauma. ⋯ The clinical outcome of patients with blunt cervical trauma was not associated with the presence of VA abnormalities. Given the rare but potentially devastating consequences of a VA injury, however, screening may still be worthwhile.