Trauma Commons^™

Blunt Cerebrovascular Injury (Bcvi): Universal Cta Neck Screening At Level 2 Trauma Center, Tamine Gogel

Doctor of Nursing Practice Projects

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years …

Evaluation Of Sleep Outcomes After Traumatic Brain Injury In Children Using Questionnaires And Actigraphy, Connie Tran, Sydney Weese, Cydni Williams Md

Student Research Symposium

Traumatic brain injuries are the result of a sudden external blunt force to the brain and can result in long-term complications or death. In pediatrics, it is the leading cause of acute and chronic sleep wake disturbances, as well as cognitive deficits, which can lead to a reduction in the quality of life. These impairments can later result in lowered performance in work and school settings or decreased psychosocial function. Although there is sufficient evidence that traumatic brain injuries contribute to is that it is unknown whether or not sleep wake disturbances contribute to an increase in the mentioned cognitive …

The Impact Of Traumatic Brain Injury On Noradrenergic Innervation Of The Prefrontal Cortex, Jil P. Modi, Christopher P. Knapp, Rachel L. Navarra

Rowan-Virtua Research Day

Traumatic Brain Injury (TBI) is a common cause of death and disability in the United States, and it can occur due to varied reasons including motor vehicle accidents, gunshot wounds, and falls. Following TBIs, patients are often left with lifelong disabilities and cognitive problems that can lead to increased risk-taking behaviors. The main goal of my research was to understand the neural mechanisms that drive increased risk-taking behaviors due to TBIs. The specific areas of the brain I was interested in looking at were the medial prefrontal cortex (mPFC), orbitofrontal cortex (OFC), and/or anterior cingulate cortex (ACC) of the prefrontal …

Management Strategies For Traumatic Injuries In Pregnant Women: A Comprehensive Literature Review, Jaylyn D. Thompson, Jenna Zappetti, Clarence Julian Clark Ii

Rowan-Virtua Research Day

Introduction: Traumatic injuries in pregnant women are the leading cause of non-obstetric death and affect 6% to 8% of all pregnancies. Therefore, it is imperative to maintain updated guidelines to construct a framework for the optimal management strategies for traumatic injuries in pregnant women, considering the perspectives of obstetrics/gynecology, emergency medicine, and orthopedics.

Methods: To conduct this study, research was done via a database search through the Rowan-Virtua School of Osteopathic Medicine’s research library. PubMed was the sole database used to review 8 peer-reviewed sources. Articles that were published within the last 10 years were chosen.

Results: Every woman with …

An Atypical Mechanism Of Thyroid Cartilage Fracture, Jack Grossweiler, Andrew Friedman, Michael Scharf, Matthew K. Nguyen, Jory P. Parson, Alexander Axelrad

Tower Health Research Day

No abstract provided.

Investigating Markers For Intracranial Hemorrhage Severity: Insights From Cbc Changes And Beyond, Mckenzie Locker, Kasey Chelemedos, Nataly Apollonsky

Tower Health Research Day

No abstract provided.

A Case Report On A Personal Watercraft Induced Large Traumatic Rectal Injury, Sujay Deshpande, Jakob Nypaver, Bernice Yu, Abigail Coots, Adrian W. Ong, Christopher A Butts

Tower Health Research Day

No abstract provided.

Probabilistic Workflow Modeling Of Transfused Injured Children And Adolescents At A Level 1 Trauma Center, Megan Krentsa, Travis M. Sullivan, Keyi Li, Elizabeth Matison, Waverly Gestrich-Thompson, Genevieve J. Sippel, Randall S. Burd, Aleksandra Sarcevic

Tower Health Research Day

No abstract provided.

The Long-Term Economic Implications Of Burn Injury For Burn Survivors, Jacob M. Dougherty Bs, Hannan A. Maqsood Mbbs, Zhaohui Fan Md Mph, Stewart C. Wang Md Phd, Mark R. Hemmila Md, Naveen F. Sangji Md Mph

Medical Student Research Symposium

Introduction: The long-term economic implications of burn injury on patients and payors has not been well described. Burn injury can be costly due to prolonged intensive care, wound care, rehabilitation, psychological care, and reconstructive surgery that may be required well after the initial injury. We investigated index and post-acute payor and out-of-pocket (OOP) costs related to burn injury for in-patient care at 30 days, and up to 36 months post-discharge to understand the long-term economic implications for burn survivors.

Methods: An observational cohort study was conducted using a commercial claims database from IBM Watson Health® Marketscan. Patients age ≤ …

Interventions To Optimize Spinal Cord Perfusion In Patients With Acute Traumatic Spinal Cord Injury: An Updated Systematic Review, Nathan Evaniew, Benjamin Davies, Farzin Farahbakhsh, Michael G. Fehlings, Mario Ganau, Daniel E. Graves, James D. Guest, Radha Korupolu, Allan R. Martin, Stephen L. Mckenna, Lindsay A. Tetreault, Aditya Vedantam, Erika D. Brodt, Andrea C. Skelly, Brian K. Kwon

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Systematic review update.

OBJECTIVES: Interventions that aim to optimize spinal cord perfusion are thought to play an important role in minimizing secondary ischemic damage and improving outcomes in patients with acute traumatic spinal cord injuries (SCIs). However, exactly how to optimize spinal cord perfusion and enhance neurologic recovery remains controversial. We performed an update of a recent systematic review (Evaniew et al, J. Neurotrauma 2020) to evaluate the effects of Mean Arterial Pressure (MAP) support or Spinal Cord Perfusion Pressure (SCPP) support on neurological recovery and rates of adverse events among patients with acute traumatic SCI.

METHODS: We …

Validation Of A Novel, Rapid Sepsis Diagnostic For Emergency Department Use, Hollis R. O'Neal, Roya Sheybani, David R. Janz, Robert Scoggins, Tonya Jagneaux, James E. Walker, Daniel J. Henning, Elizabeth Rosenman, Simon A. Mahler, Hariharan Regunath, Christopher S. Sampson, D. Clark Files, Richard D. Fremont, Michael J. Noto, Erica E. Schneider, Wesley R. Shealey, Matthew S. Berlinger, Thomas C. Carver, Morgan K. Walker, Nathan A. Ledeboer, Ajay M. Shah, Henry T.K. Tse, Dino Dicarlo, Todd W. Rice, Christopher B. Thomas

School of Medicine Faculty Publications

OBJECTIVES: To assess the in vitro IntelliSep test, a microfluidic assay that quantifies the state of immune activation by evaluating the biophysical properties of leukocytes, as a rapid diagnostic for sepsis. DESIGN: Prospective cohort study. SETTING: Five emergency departments (EDs) in Louisiana, Missouri, North Carolina, and Washington. PATIENTS: Adult patients presenting to the ED with signs (two of four Systemic Inflammatory Response Syndrome criteria, where one must be temperature or WBC count) or suspicion (provider-ordered culture) of infection. INTERVENTIONS: All patients underwent testing with the IntelliSep using ethylene diamine tetraacetic acid-anticoagulated whole blood followed by retrospective adjudication for sepsis by …

Pseudotumoral Hemicerebellitis In A Young Male Sailor With Complete Recovery After Steroid Therapy, Khizer Masroor Anns, Faheem Ullah Khan, Muhammad Aman, Anwar Ahmad, Kumail Khandwala, Zainab Aslam Saeed Memon, Izaz Ahmad, Muhammad Ismail Safi

Medical College Documents

Pseudotumoral hemicerebellitis is a rare presentation of acute cerebellitis, which involves the inflammation of a single cerebellar hemisphere and most commonly affects children. It mimics a tumor on imaging, hence given the name. In this report, we present a case of pseudotumoral hemicerebellitis in a 30-year-old male who presented to the emergency room (ER) with complaints of vertigo, vomiting, and a headache.

Whole Blood In Trauma, Jason P. Prevelige

Pacific Journal of Health

Abstract: Hemorrhage is a leading cause of death in trauma patients. Whole blood administration in trauma has gained a renewed interest in recent years, however the concept is not new at all, with its origins spanning over 100 years. Field experience in United States’ military conflicts has provided important data on the efficacy of whole blood in reducing mortality and amount of blood product administration. Civilian trials however have not necessarily shown similar results. The safety of whole blood however does not seem to be in question given the available data, and is an acceptable option for blood replacement in …

The Challenges Of Implementing And Documenting Ottawa Ankle Rules In The Pediatric Emergency Department: A Retrospective Study, Emmalee M. Kugler, Michael Gillman, Olivia Toner

Cooper Rowan Medical Journal

INTRODUCTION
Acute ankle sprains account for nearly 2% of visits to the pediatric emergency department (PED). The Ottawa Ankle Rules (OAR) were developed as a safe and effective clinical decision-making tool for detecting the need for radiographs in adults with acute ankle pain. OAR state radiographs are required with at least one of the following:

1. Inability to bear weight immediately following the injury and for four steps in the ED 2. Bony tenderness at the posterior edge of the lateral or medial malleolus

OBJECTIVE
Few prospective cohort studies have attempted to assess OAR pediatric populations. This study investigates the …

Multidisciplinary Simulation-Based Trauma Education For General Surgery Interns, Jennifer Austin, April Miller, Jeremiah Avarana, Alicia Lay

North Texas Research Forum 2024

Introduction: According to the American Society of Gastroenterology Endoscopy (ASGE), choledocholithiasis is defined as the presence of gallstones in biliary tree. Choledocholithiasis is concomitantly present in approximately 1 to 10 percent of patients with cholelithiasis. Choledocholithiasis can be described as small <15 mm, large >15 mm, and difficult due to anatomic location, impaction, or unusual hardness/ shape. Choledocholithiasis is managed endoscopically with large balloon papillary dilation, cholangioscopy-guided intraductal laser and electrohydraulic lithotripsy (EHL), and escalation to laparoscopic common bile duct exploration, if endoscopic procedures fail. Thus far, there are sparse studies that show the requirement of choledochotomy in large and difficult choledocholithiasis …

Survival After Emergency Clamshell Thoracotomy With Bilateral Atrial Appendage Injuries, Jennifer Austin, Enrique Alvarez, Alicia Lay, Christian Minshall

North Texas Research Forum 2024

INTRODUCTION: The probability of survival is poor in patients who require a resuscitative thoracotomy, reported in the literature to be 9-20%. Outcomes are worse in patients who have suffered blunt trauma compared to penetrating trauma reported between 2-7%. Many studies have been done to evaluate clinical predictors of survival versus mortality. We present a case of high-mechanism blunt trauma with a high injury severity score of 34 who survived after an emergency clamshell thoracotomy with full neurological recovery. CASE PRESENTATION: This case highlights a 28-year-old male who arrived as a transfer to a level 1 trauma center following high mechanism …

Analysis Of Ecmo Usage In Trauma Patients At A Major Level 1 Trauma Center, April Miller, Megan Post, Crescens Pellachia, John Bini

North Texas Research Forum 2024

INTRODUCTION: ECMO has been used for decades in patients where adequate oxygenation could not be achieved using traditional efforts. Despite its increasing use in the trauma setting, there is a lack of published data to support its use and safety. This review will seek to answer among trauma patients who receive ECMO what their common demographics, injuries, co-morbidities, outcomes and adverse events are. METHODS: This is a single-center retrospective chart review conducted at an Level 1 trauma center between 2020 and 2023. Designation as trauma and ECMO utilization were the inclusion criteria. Patients under age 18 and non-trauma ECMO patients …

Improving Knowledge, Confidence, And Competency Among Icu Nurses Concerning The Benefits Of Using The Uk Ventilator Separation Protocol, Brittany Monroe

DNP Projects

Background: The trauma intensive care unit (ICU) at University of Kentucky (UK) Healthcare uses a ventilator separation protocol which provides specific guidelines on the successful weaning of patients from mechanical ventilation. However, many of the nurses are not aware of this protocol as formal education is not included in their orientation or training. This lack of knowledge can lead to risks such as increased patient morbidity, mortality, ICU length of stay, and healthcare-related costs. Research shows that using structured mechanical ventilator weaning tools in the ICU can shorten the duration of mechanical ventilation, which in turn, lowers these associated risks. …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Konsep Diagnosis Dan Penatalaksanaan Fraktur Osteoporosis Terkini, I Gusti Ngurah Wien Aryana, Febyan Febyan

Jurnal Penyakit Dalam Indonesia

Osteoporosis is a metabolic bone disease that is caused by a decreased amount of bone mass, and microarchitectural damage to bone tissue that affects the bone to break easily. Osteoporosis can be divided into primary and secondary etiologies. Vertebral, hip, distal radius, and proximal humerus are the most common predilection of fracture complication due to osteoporosis. The diagnosis of osteoporotic fractures is established based on the identification of risk factors, general clinical manifestations, specific manifestation from each fracture predilection, and advanced examinations, including radiology imaging and dual-energy x-ray absorptiometry. The purpose of osteoporotic fractures management in elderly is a stable …