Older Adults Decompensate More Rapidly After Blunt Hollow Viscus Injury Following MVCs.

Introduction: Hollow viscus injuries (HVIs) are difficult to diagnose, and delay to diagnosis negatively impacts outcome. We sought to determine the incidence of HVI, mortality, and the time to primary HVI procedure in older adult (≥65 y) trauma patients compared to adult patients (15-64 y).

Methods: This retrospective cohort study included patients age ≥15 in a motor vehicle collision included in years 2021-2023 of the Trauma Quality Improvement Program database.

Prehospital Management of the Pregnant Trauma Patient.

Obstetrical care in the United States is in crisis. As timely access to obstetric care becomes increasingly less common in the United States, the role of an emergency medical services clinician in the care of a pregnant trauma patient has become increasingly important, particularly in rural or austere environments with extended times to arrival at a trauma center with capacity to provide definitive obstetrical care. In this review, we provide considerations for the primary management of pregnant trauma patients in a prehospital setting by reviewing the essentials of immediate care by organ system, with particular emphasis on airway support and medication considerations in pregnancy.

Damage Control Surgery in the Era of Globalization of Health Care - Military and International Outcomes: A SystematicReview.

Introduction: Damage Control Surgery (DCS) is a surgical technique used to manage critically ill and injured patients. This study examines the most recent 10-y outcomes related to DCS, with the secondary goal of scrutinizing the outcomes after DCS across surgical theaters.

Methods: Studies published between 2012 and 2021 that described adult patients undergoing Abdominal DCS after traumatic injury were included.

Does Trauma Center Volume Matter? An Analysis of Trauma Center Volume on Outcome Using the TQIP/NTDB Database.

Increasing trauma center admission volume is said to decrease mortality. Evidence supporting this position is dependent upon patient groups and the time period studied, and gaps remain. We evaluated the effect of annual volume of critically injured patients on hospital mortality, comparing two time periods.

Perimortem cesarean section after severe injury: What you need to know.

When pregnant patients are involved in traumatic incidents, the trauma clinician encounters two patients-both the mother and the unborn child. Advanced trauma life support dictates that the first priority is the life of the mother; however, there are rare situations where to provide the greatest chance of survival for both the mother and baby, an emergency cesarean section (perimortem cesarean delivery [PMCD]) must be performed. The decision to perform this procedure must occur quickly, and the reality is that a board-certified obstetrician is rarely present, particularly in rural areas.

THE ROLE OF TRANEXAMIC ACID IN POSTPARTUM HEMORRHAGE: A NARRATIVE REVIEW.

Postpartum hemorrhage is the leading cause of preventable maternal illness and death globally and carries a disproportionately high burden of mortality in low- to middle-income countries. Tranexamic acid, an antifibrinolytic drug, has been widely adopted to control bleeding in trauma and other surgical conditions. Within the last decade, the World Health Organization updated their guidelines for the treatment of postpartum hemorrhage to include the use of tranexamic acid in all cases of postpartum hemorrhage.

Tranexamic Acid Use in the Surgical Arena: A Narrative Review.

Introduction: Tranexamic acid (TXA) is a potent antifibrinolytic drug that inhibits the activation of plasmin by plasminogen. While not a new medication, TXA has quickly gained traction across a variety of surgical subspecialties to prevent and treat bleeding. Knowledge on the use of this drug is essential for the modern surgeon to continue to provide excellent care to their patients.

The effects of prehospital TXA on mortality and neurologic outcomes in patients with traumatic intracranial hemorrhage: A subgroup analysis from the prehospital TXA for TBI trial.

Background: In the prehospital tranexamic acid (TXA) for traumatic brain injury (TBI) trial, TXA administered within 2 hours of injury in the out-of-hospital setting did not reduce mortality in all patients with moderate/severe traumatic brain injury (TBI). We examined the association between TXA dosing arms, neurologic outcome, and mortality in patients with intracranial hemorrhage (ICH) on computed tomography (CT).

Methods: This was a secondary analysis of the Prehospital Tranexamic Acid for TBI Trial ( ClinicalTrials.

Residual Cystine Transport Activity for Specific Infantile and Juvenile Mutations in a PTEC-Based Addback Model.

Cystinosis is a rare, autosomal recessive, lysosomal storage disease caused by mutations in the gene , leading to cystine accumulation in the lysosomes. While cysteamine lowers the cystine levels, it does not cure the disease, suggesting that CTNS exerts additional functions besides cystine transport. This study investigated the impact of infantile and juvenile mutations with discrepant genotype/phenotype correlations on CTNS expression, and subcellular localisation and function in clinically relevant cystinosis cell models to better understand the link between genotype and CTNS function.

So You Want to Do Trauma Research? A Practical Guide to Creating a Research Program at Your Home Institution.

Background: There are 3 pillars upon which the foundation of a teaching program in health care is founded: research, education, and clinical care. However, in a busy academic trauma practice, the unfortunate reality is that research is often a low priority in the frenzy of mandates for clinical productivity.

Objective: The purpose of this report is to advise hospitals on how to create a modest trauma research program that supports research interests without significantly impacting the overall clinical productivity of the department.

Brain death/death by neurologic criteria: What you need to know.

Since the beginning of time, man has been intrigued with the question of when a person is considered dead. Traditionally, death has been considered the cessation of all cardiorespiratory function. At the end of the last century a new definition was introduced into the lexicon surrounding death in addition to cessation of cardiac and respiratory function: Brain Death/Death by Neurologic Criteria (BD/DNC).

Performing Accurate Standard 12 Lead ECGs on patients with Burns to the Chest.

The use of the electrocardiogram (ECG) in critical care settings is a long-established cardiovascular monitoring tool. The effectiveness of the routine 12-lead ECG relies on accurate lead placement that is consistent and replicable. Improper lead placement may display erroneous ECG patterns and affect patient management decisions.

American Trauma Care: A System of Systems.

Objective: The benefits of organized trauma systems have been well-documented during 50 years of trauma system development in the United States. Unfortunately, despite this evidence, trauma system development has occurred only sporadically in the 50 states.

Methods: The relevant literature related to trauma system design and development was reviewed based on relevance to the study.

Intact survival from a blunt trauma cardiac arrest using intraoperative automated CPR.

Survival following a blunt traumatic cardiac arrest is rare. Current guidelines suggest that a resuscitative thoracotomy may be performed under specific circumstances. This approach is almost always futile.

American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma clinical protocol for management of acute respiratory distress syndrome and severe hypoxemia.

Therapeutic/Care Management: Level V.