Articles: trauma.
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Pediatric emergency care · Feb 2025
Minor Head Trauma in Children Younger Than 3 Months and Clinical Predictors of Clinically Important Traumatic Brain Injuries.
Major studies have defined clinical rules to regulate the use of computed tomography in children after head trauma. Infants younger than 3 months are considered at higher risk of brain injuries than older children and at the same time at higher risk of radiation-induced damage. Hence, it would be desirable to have clinical decision rules more adapted to this subset of patients. The objectives of this study are to compare the rate of brain injuries in children younger than 3 months or 3 to 24 months and to assess predictors of clinically important traumatic brain injuries (ciTBIs) (the ones causing death, neurosurgical intervention, long intubation, or hospitalization for 2 days or more) in the former group. ⋯ Children younger than 3 months presenting after minor head trauma constitute a relevant population. Available clinical predictors well correlate with ciTBIs in this age group.
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Boxing is a sport well-known for the risk of injury. However, the epidemiology of boxing-associated fractures has not been well studied. This study aims to report the characteristics of boxing fractures that lead to presentation to the emergency room and evaluate the demographics and practices of the patients to prevent these injuries. ⋯ Hand fractures were the most common type of BAF. Males had significantly more BAFs, although the incidence of BAFs in females increased significantly since 2013. Fractures mainly occurred in recreational places, but from 2020-2022, most occurred at home. This shift coincided with the COVID-19 pandemic, suggesting increased home sparring. These findings emphasize the need for further research into protective measures and injury prevention in boxing.
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The "July Effect" hypothesizes increased morbidity and mortality after the addition of inexperienced physicians at the beginning of an academic year. However, the impact of newer members on neurosurgical teams managing patients with traumatic brain injury (TBI) has yet to be examined. This study conducted a nationwide analysis to evaluate the existence of the "July Effect" in the setting of patients with TBI. ⋯ The findings suggested that there is no "July Effect" on patients with TBI treated at teaching hospitals in the United States.
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Observational Study
Clinical presentations, management, and outcomes of trauma in pregnancy: A retrospective observational study.
Trauma poses significant risks during pregnancy, leading to adverse outcomes. We aimed to evaluate the impact of trauma during pregnancy on maternal and fetal outcomes. ⋯ This study revealed that trauma during pregnancy is associated with adverse pregnancy outcomes, therefore, these patients should be monitored carefully. Further research is needed to explore how trauma impacts pregnancy progression and fetal well-being, and public health interventions/awareness campaigns highlighting the importance of preventive measures should target pregnant women.
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Trauma care frequently happens in emergency departments (ED) outside of major trauma centers. Many injuries often exceed the specialty capabilities of referring hospitals, requiring transfer to larger trauma centers. However, the proportion of patients discharged home without admission from receiving facilities remains unclear, suggesting potential overutilization of transfers. We sought to determine the proportion of transfer patients that are discharged home from the receiving ED. ⋯ We found that approximately 1 in 9 patients transferred to a higher level of care are discharged home from the ED, with most requiring neurosurgical, ophthalmologic, dental and craniomaxillofacial services. These findings suggest that virtual communication technology could reduce unnecessary transfers and associated costs.