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Trauma Management (trauma + management)
Selected AbstractsDentists' management of dental injuries and dental trauma in Australia: a reviewDENTAL TRAUMATOLOGY, Issue 3 2008Thai Yeng The levels of knowledge demonstrated by surveys of dentists were not high and dentists perceive inadequate financial remuneration as the main barrier to trauma management. With only a limited number of new dental traumatic injuries occurring annually, dentists may not be competent in providing appropriate care. The management of dental trauma and any hesitations that dentists might have in terms of knowledge and skills are important to investigate to formulate an approach to overcome their reluctance. There is a deficiency of literature on this subject. [source] Dental trauma management knowledge among a group of teachers in two south European citiesDENTAL TRAUMATOLOGY, Issue 5 2005Esber Çaglar Abstract,,, The purpose of the present study is to assess the teachers' knowledge regarding dental trauma management in two south European cities. A three-part questionnaire comprised of questions on demographic data and knowledge was distributed to teachers in Porto and Istanbul. Seventy-eight teachers participated in the study; 23 had previously had formal dental trauma education. From the teachers interviewed, 58 of them admitted having no knowledge of dental trauma. Concerning knowledge, 29 teachers from Porto and 12 from Istanbul thought dental trauma emergency should be dealt with immediately. Knowledge of optimal storage media for avulsed permanent teeth was especially poor. In the present study, the majority of teachers did not know the importance of tetanus vaccine control in dental trauma. It is recommended that public education targeted at teachers should be carried out to increase dental trauma management knowledge. [source] Successful rotational thromboelastometry-guided treatment of traumatic haemorrhage, hyperfibrinolysis and coagulopathyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2010M. BRENNI Transfusion of allogeneic blood products is associated with increased morbidity and mortality. Therefore, strategies for reducing transfusion of these products during trauma management are valuable. We report a case of severe blunt abdominal trauma, successfully treated with antifibrinolytic medication and fibrinogen concentrate. Rotational thromboelastometry (ROTEM) was used to identify hyperfibrinolysis and afibrinogenaemia. In order to achieve haemostasis, over a 3-h period, the patient received a total of 1 g of tranexamic acid, 7 U of packed red blood cells, 16 g of fibrinogen concentrate (Haemocomplettan P), 3500 ml of colloids and 5500 ml of lactated Ringer's solution. Together with surgical measures, this treatment stopped the bleeding and stabilised the patient. There was no transfusion of either fresh-frozen plasma or platelets. The limited need for allogeneic blood products is of particular interest, and clinical studies of the approach used here appear to be warranted. [source] Clinical practice guidelines for the management of acute limb compartment syndrome following traumaANZ JOURNAL OF SURGERY, Issue 3 2010Christopher J. Wall Abstract Background:, Acute compartment syndrome is a serious and not uncommon complication of limb trauma. The condition is a surgical emergency, and is associated with significant morbidity if not managed appropriately. There is variation in management of acute limb compartment syndrome in Australia. Methods:, Clinical practice guidelines for the management of acute limb compartment syndrome following trauma were developed in accordance with Australian National Health and Medical Research Council recommendations. The guidelines were based on critically appraised literature evidence and the consensus opinion of a multidisciplinary team involved in trauma management who met in a nominal panel process. Results:, Recommendations were developed for key decision nodes in the patient care pathway, including methods of diagnosis in alert and unconscious patients, appropriate assessment of compartment pressure, timing and technique of fasciotomy, fasciotomy wound management, and prevention of compartment syndrome in patients with limb injuries. The recommendations were largely consensus based in the absence of well-designed clinical trial evidence. Conclusions:, Clinical practice guidelines for the management of acute limb compartment syndrome following trauma have been developed that will support consistency in management and optimize patient health outcomes. [source] The Impact of Injury Coding Schemes on Predicting Hospital Mortality After Pediatric InjuryACADEMIC EMERGENCY MEDICINE, Issue 7 2009Randall S. Burd MD Abstract Objectives:, Accurate adjustment for injury severity is needed to evaluate the effectiveness of trauma management. While the choice of injury coding scheme used for modeling affects performance, the impact of combining coding schemes on performance has not been evaluated. The purpose of this study was to use Bayesian logistic regression to develop models predicting hospital mortality in injured children and to compare the performance of models developed using different injury coding schemes. Methods:, Records of children (age < 15 years) admitted after injury were obtained from the National Trauma Data Bank (NTDB) and the National Pediatric Trauma Registry (NPTR) and used to train Bayesian logistic regression models predicting mortality using three injury coding schemes (International Classification of Disease-9th revision [ICD-9] injury codes, the Abbreviated Injury Scale [AIS] severity scores, and the Barell matrix) and their combinations. Model performance was evaluated using independent data from the NTDB and the Kids' Inpatient Database 2003 (KID). Results:, Discrimination was optimal when modeling both ICD-9 and AIS severity codes (area under the receiver operating curve [AUC] = 0.921 [NTDB] and 0.967 [KID], Hosmer-Lemeshow [HL] h-statistic = 115 [NTDB] and 147 [KID]), while calibration was optimal when modeling coding based on the Barell matrix (AUC = 0.882 [NTDB] and 0.936 [KID], HL h-statistic = 19 [NTDB] and 69 [KID]). When compared to models based on ICD-9 codes alone, models that also included AIS severity scores and coding from the Barell matrix showed improved discrimination and calibration. Conclusions:, Mortality models that incorporate additional injury coding schemes perform better than those based on ICD-9 codes alone in the setting of pediatric trauma. Combining injury coding schemes may be an effective approach for improving the predictive performance of empirically derived estimates of injury mortality. [source] |