Articles: trauma.
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J Clin Monit Comput · Apr 2024
LetterReevaluating optic nerve sheath diameter in predicting postdural puncture headache: exploring clinical implications beyond threshold values.
The study by Boyaci et al. assessed using optic nerve sheath diameter (ONSD) ultrasound to predict postdural puncture headache (PDPH) in spinal anesthesia patients. In their single-center study of 83 patients, PDPH incidence was high at 22.9%, partly due to the use of a traumatic needle. ⋯ ONSD's relationship with intracranial pressure (ICP) is acknowledged, but a definitive ONSD cutoff for PDPH is lacking. Other studies suggest ONSD changes may be linked to treatment outcomes in related conditions, emphasizing the importance of investigating risks of epidural blood patch failure.
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Pediatric emergency care · Apr 2024
Association of Designated Pediatric Trauma Center and Outcomes of Severely Injured Children Who Were Mechanically Ventilated and Underwent Tracheostomy: A Propensity-Matched Analysis.
The purpose of the study is to examine the outcomes of care delivered at the pediatric trauma center (PTC) in severely injured children who were intubated, mechanically ventilated, and underwent tracheostomy. ⋯ Care at the PTC was associated with a lower occurrence of sepsis complications. A higher number of patients were discharged home without additional services when the care was provided at PTC.
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The use of medications commonly prescribed after traumatic brain injury (TBI) has been little studied before TBI. This study examined the association between the use of medications that affect the central nervous system (CNS) and the occurrence and short-term mortality of TBI. ⋯ Thirty-seven percent of patients with TBI used at least 1 CNS-affecting drug. This proportion was significantly higher than in the control population (24%). The highest risk and lowest NNH for short-term mortality were observed with strong opioids, second-generation antipsychotics, and atypical antidepressants. The current risks underscore the importance of weighing the benefits and risks before prescribing CNS-affecting drugs in patients at risk of head injury.
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Observational Study
Predictors of mortality following electrical and lightning injuries in Malawi: A decade of experience.
Electrical injuries can be devastating, and data is lacking in low-resource settings. We aimed to identify predictors of mortality following electrical and lightning injuries (ELI) in Malawi. ⋯ ELI confers more than 13 times higher odds of mortality than burn injuries in Malawi, with mortality risk increasing over time. More efforts are needed to prevent electrical hazards and implement timely interventions for patients with ELI.
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Eur J Trauma Emerg Surg · Apr 2024
Reliability of the safety threats and adverse events in trauma (STAT) taxonomy using trauma video review.
The STAT (Safety Threats and Adverse Events in Trauma) taxonomy was developed through expert consensus, and groups 65 identified trauma resuscitation adverse events (AEs) into nine distinct categories. It provides a framework for standardized analysis of trauma resuscitations and creates a foundation for targeted quality improvement and patient safety initiatives. This study aims to evaluate the reliability of the STAT taxonomy in identifying AEs during video-recorded trauma resuscitations. ⋯ The STAT taxonomy demonstrated excellent inter-rater reliability between reviewers and can be used to identify AEs in video-recorded trauma resuscitations. These results provide a foundation for adapting video review to objectively quantify and assess AEs in the trauma bay.