Guidelines for Enhanced Recovery After Trauma and Intensive Care (ERATIC): Enhanced Recovery After Surgery (ERAS) Society and International Association of Trauma Surgery and Intensive Care (IATSIC) Recommendations: Paper 1: Initial Care-Pre and Intraoperative Care Until ICU, Including Non-Operative Management.

Background: Enhanced recovery after surgery (ERAS) protocols reduce length of stay, complications, and costs for elective surgical procedures. It remains challenging to implement ERAS concepts in the acute trauma patient due to deranged physiological reserve from the penetrating or blunt trauma producing altered physiology. However, systems of care improve access to early intervention and potentially reduce mortality.

Guidelines for Enhanced Recovery After Trauma and Intensive Care (ERATIC): Enhanced Recovery After Surgery (ERAS) and International Association for Trauma Surgery and Intensive Care (IATSIC) Society Recommendations: Paper 2: Postoperative and Intensive Care Recommendations.

Background: Enhanced recovery after surgery (ERAS) protocols reduce length of stay, complications, and costs for elective surgical procedures. It remains challenging to implement ERAS concepts in the acute trauma patient due to deranged physiological reserve from the penetrating or blunt trauma producing altered physiology. However, systems of care improve access to early intervention and potentially reduce mortality.

Guidelines for Enhanced Recovery After Trauma and Intensive Care (ERATIC): Enhanced Recovery After Surgery (ERAS) and International Association for Trauma Surgery and Intensive Care (IATSIC) Society Recommendations: Part 3: Trauma Ethics and Systems Aspects.

Background: Enhanced recovery after surgery (ERAS) protocols reduce length of stay, complications, and costs for elective surgical procedures. It remains challenging to implement ERAS concepts in the acute trauma patient due to deranged physiological reserve from the penetrating or blunt trauma producing altered physiology. However, systems of care improve access to early intervention and potentially reduce mortality.

Prospective Evaluation of Missed Musculoskeletal Injuries in Trauma Prevent Study.

Background: Physiotherapists are not routinely involved in tertiary survey of trauma patients but are well equipped to perform the musculoskeletal component of the tertiary survey (MSK tertiary survey) to detect any injuries that are missed during primary and secondary surveys.

Aim: To observe and evaluate MSK tertiary surveys completed by physiotherapists in the early identification of missed musculoskeletal injuries in trauma patients.

Methods: The study included a convenience sample of patients over 18 years old admitted under the Trauma team.

International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome.

Background: The Abdominal Compartment Society (WSACS) established consensus definitions and recommendations for the management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in 2006, and they were last updated in 2013. The WSACS conducted an international survey between 2022 and 2023 to seek the agreement of healthcare practitioners (HCPs) worldwide on current and new candidate statements that may be used for future guidelines.

Methods: A self-administered, online cross-sectional survey was conducted under the auspices of the WSACS to assess the level of agreement among HCPs over current and new candidate statements.

A randomized, controlled, blinded evaluation of augmenting point-of-care ultrasound and remote telementored ultrasound in inexperienced operators.

Background: Handheld ultrasound devices present an opportunity for prehospital sonographic assessment of trauma, even in the hands of novice operators commonly found in military, maritime, or other austere environments. However, the reliability of such point-of-care ultrasound (POCUS) examinations by novices is rightly questioned. A common strategy being examined to mitigate this reliability gap is remote mentoring by an expert.

The Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y) program: An interactive injury prevention initiative in South-Western Sydney.

Background: The Prevent Alcohol and Risk Related Trauma in Youth (P.A.R.

Variation in use of damage control laparotomy for trauma by trauma centers in the United States, Canada, and Australasia.

Background: It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy.

Methods: A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted.

Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty.

Background: Given the increasing numbers of older patients presenting with trauma, and the potential influence of delirium on outcomes, we sought to investigate the proportion of such patients who were diagnosed with delirium during their stay-and patient factors associated therewith-and the potential associations between delirium and hospital length of stay (LOS). We hypothesized that delirium would be common, associated with certain patient characteristics, and associated with long hospital LOS (highest quartile).

Methods: We conducted a retrospective observational cohort study of all trauma patients aged ≥65 years presenting in September to October 2019, interrogating medical records and the institutional trauma database.

Ten-year evolution of a massive transfusion protocol in a level 1 trauma centre: have outcomes improved?

Background: We aimed to evaluate the evolution and implementation of the massive transfusion protocol (MTP) in an urban level 1 trauma centre. Most data on this topic comes from trauma centres with high exposure to life-threatening haemorrhage. This study examines the effect of the introduction of an MTP in an Australian level 1 trauma centre.

A Prospective Evaluation of the Utility of a Hybrid Operating Suite for Severely Injured Patients: Overstated or Underutilized?

Objective: The primary objective of this study was to evaluate the utility, clinical impact, and work flow of a new trauma hybrid operating theater.

Summary Background Data: The potential utility and clinical benefit of hybrid operating theaters are increasingly postulated. Unfortunately, the clinical outcomes and efficiencies of these environments remain unclear.

Transoceanic Telementoring of Tube Thoracostomy Insertion: A Randomized Controlled Trial of Telementored Versus Unmentored Insertion of Tube Thoracostomy by Military Medical Technicians.

nnpn

Methodological background and strategy for the 2012-2013 updated consensus definitions and clinical practice guidelines from the abdominal compartment society.

The Abdominal Compartment Society (www.wsacs.org) previously created highly cited Consensus Definitions/Management Guidelines related to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS).

Indications for Use of Damage Control Surgery in Civilian Trauma Patients: A Content Analysis and Expert Appropriateness Rating Study.

Objectives: To characterize and evaluate indications for use of damage control (DC) surgery in civilian trauma patients.

Background: Although DC surgery may improve survival in select, severely injured patients, the procedure is associated with significant morbidity, suggesting that it should be used only when appropriately indicated.

Methods: Two investigators used an abbreviated grounded theory method to synthesize indications for DC surgery reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications.

Indications for use of thoracic, abdominal, pelvic, and vascular damage control interventions in trauma patients: A content analysis and expert appropriateness rating study.

Background: The use of abbreviated or damage control (DC) interventions may improve outcomes in severely injured patients when appropriately indicated. We sought to determine which indications for DC interventions have been most commonly reported in the peer-reviewed literature to date and evaluate the opinions of experts regarding the appropriateness (expected benefit-to-harm ratio) of the reported indications for use in practice.

Methods: Two investigators used an abbreviated grounded theory method to synthesize indications for 16 different DC interventions reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications.

Identifying patients at risk for high-grade intra-abdominal hypertension following trauma laparotomy.

Background: Abdominal Compartment Syndrome (ACS) is an uncommon but deleterious complication after trauma laparotomy. Early recognition of patients at risk of developing ACS is crucial for their outcome. The aim of this study was to compare the characteristics of patients who developed high-grade intra-abdominal hypertension (IAH) (i.

Prehospital fluid resuscitation in hypotensive trauma patients: do we need a tailored approach?

Aim: The ideal strategy for prehospital intravenous fluid resuscitation in trauma remains unclear. Fluid resuscitation may reverse shock but aggravate bleeding by raising blood pressure and haemodilution. We examined the effect of prehospital i.

Intra-abdominal hypertension in postoperative cardiac surgery patients.

Objective: To investigate screening variables identifying patients at risk of developing intra-abdominal hypertension (IAH) after cardiac surgery.

Design And Setting: Prospective observational study in a tertiary general intensive care unit.

Participants: One hundred and eight patients admitted to the ICU after cardiac surgery, with measurements of intraabdominal pressure (IAP).

The injury profile and acute treatment costs of major trauma in older people in New South Wales.

Aims: To Describe injury profile and costs of older person trauma in New South Wales; quantify variations with peer group costs; and identify predictors of higher costs.

Methods: Nine level 1 New South Wales trauma centres provided data on major traumas (aged ≥ 55 years) during 2008-2009 financial year. Trauma register and financial data of each institution were linked.

Timeliness in obtaining emergent percutaneous procedures in severely injured patients: how long is too long and should we create quality assurance guidelines?

Background: Modern trauma care relies heavily on nonoperative, emergent percutaneous procedures, particularly in patients with splenic, pelvic and hepatic injuries. Unfortunately, specific quality measures (e.g.

Utility of simultaneous interventional radiology and operative surgery in a dedicated suite for seriously injured patients.

Purpose Of Review: In recent years, combined interventional radiology and operative suites have been proposed and are now becoming operational in select trauma centres. Given the infancy of this technology, this review aims to review the rationale, benefits and challenges of hybrid suites in the management of seriously injured patients.

Recent Findings: No specific studies exist that investigate outcomes within hybrid trauma suites.