Emergency Medicine Commons^™

A Multicenter Mixed-Effects Model For Inference And Prediction Of 72-H Return Visits To The Emergency Department For Adult Patients With Trauma-Related Diagnoses, Ehsan Yaghmaei, Louis Ehwerhemuepha, William Feaster, David Gibbs, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

Objective

Emergency department (ED) return visits within 72 h may be a sign of poor quality of care and entail unnecessary use of healthcare resources. In this study, we compare the performance of two leading statistical and machine learning classification algorithms, and we use the best performing approach to identify novel risk factors of ED return visits.

Methods

We analyzed 3.2 million ED encounters with at least one diagnosis under “injury, poisoning and certain other consequences of external causes” and “external causes of morbidity.” These encounters included patients 18 years or older from across 128 emergency room facilities in the …

Defining A Research Agenda For Layperson Prehospital Hemorrhage Control: A Consensus Statement, Eric Goralnic, Chibuike Ezeib, Muhammad Ali Chaudhary, Justin Mccarty, Juan P. Herrera-Escobar, Tomas Andriotti, Elzerie De Jager, Daniel Ospina-Delgado, Craig Goolsby, Adil H. Haider

Section of General Surgery

Importance: Trauma is the leading cause of death for US individuals younger than 45 years, and uncontrolled hemorrhage is a major cause of trauma mortality. The US military's medical advancements in the field of prehospital hemorrhage control have reduced battlefield mortality by 44%. However, despite support from many national health care organizations, no integrated approach to research has been made regarding implementation, epidemiology, education, and logistics of prehospital hemorrhage control by layperson immediate responders in the civilian sector.
Objective: To create a national research agenda to help guide future work for prehospital hemorrhage control by laypersons.
Evidence review: The 2-day, …

Knowledge Gain Of The Non-Vascular Surgeons After Attending A Course On Traumatic Vascular Emergencies, Zia Ur Rehman, Muhammad Asad Moosa, Qamar Riaz

Department of Surgery Docs

Objective: To measure the effectiveness of the workshop in enhancing the knowledge and skills of the non-vascular surgeons in dealing with traumatic vascular emergencies.
Methodology: It was a Quasi-experimental pre-post design study conducted at Section of Vascular Surgery, Aga Khan University Hospital, Karachi (Pakistan) in February 2019. One-day workshop was conducted to enhance the knowledge and operative skills of the non-vascular surgeons in managing traumatic vascular emergencies. A written test and course evaluation survey were used to evaluate the effectiveness of the course in achieving the desired objectives.
Results: Total of 21 participants attended the workshop with mean age of …

Quality Of Life Of Road Traffic Injury Survivors Aged 15-44 Years Suffered From Moderate And Severe Head Injuries In Karachi, Pakistan, S A. Abbasi, Tazeen Saeed Ali, Shafquat Rozi, Uzma Rahim Khan, Rashid Jooma

Community Health Sciences

Background: Most of Road traffic injuries are predicted to be the third leading contributor to the global burden of disease by 2020 and patients end up into head injuries which leave devastating impacts on individual and society. Quality of Life After Brain Injury (QOLIBRI) is a specific tool that measures quality of life in head injury patients.
Methods: This was a cross sectional study among 300 patients aged 15-45 years, attended emergency department of the Aga khan University Hospital. Structured questionnaire included demography, injury details, QOLIBRI, GOSE and WHO Disability Assessment Scale (WHODAS 12 items). Severity of injury was determined …

Defining And Measuring Quality In Acute Paediatric Trauma Stabilisation: A Phenomenographic Study., Ralph James Mackinnon, Karin Pukk-Härenstam, Ulrica Von Thiele Schwarz, Christopher S. Kennedy, Terese Stenfors

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Trauma is the leading cause of death in children. The lack of an accepted definition of what constitutes a high-quality stabilisation of a traumatically injured child has limited the evaluation of direct interventions in simulation-based education and service-delivery models to improve trauma care. The aim of this study was to create a framework that delineates quality by exploring the perceptions of the multi-disciplinary team providing and improving this initial care.

Methods: Interviews were conducted with 36 experienced UK trauma team members and governance administrators (clinical directors to executive board level), from three standard UK trauma units. This study used …

Retrospective Review Of The Patient Cases At A Major Trauma Center In Nairobi, Kenya And Implications For Emergency Care Development, Julie Saleeby, Justin G. Myers, Karen Ekernas, Katherine Hunold, Ali Wangara, Alice Maingi, Peyton Wilson, Vincent Mutiso, Sarah Zamamiri, Daniel Bacon, Wes Davis, John Suder, Yash Agrawal, Ogar Ogar, Ian B.K. Martin, Stephen Dunlop

Faculty & Staff Scholarship

Introduction

Low- and middle-income countries (LMICs) are continuing to experience a “triple burden” of disease - traumatic injury, non-communicable diseases (NCDs), and communicable disease with maternal and neonatal conditions (CD&Ms). The epidemiology of this triad is not well characterised and poses significant challenges to resource allocations, administration, and education of emergency care providers. The data collected in this study provide a comprehensive description of the emergency centre at Kenya's largest public tertiary care hospital.

Methods

This study is a retrospective chart review conducted at Kenyatta National Hospital of all patient encounters over a four-month period. Data were collected from financial …

Risk Factors For Pneumonia Following Rib Fractures, Brittany Bowers

Scholarship in Medicine - All Papers

Objective: Pneumonia is a known complication following rib fractures. The purpose of this study is to identify factors associated with the development of pneumonia following rib fractures. Methods: In this retrospective chart review, eligible participants included trauma patients with one or more rib fractures who were admitted to Miami Valley Hospital during 2012 through 2017. Variables studied included age, gender, injury severity score (ISS), mechanism of injury, smoking status, alcohol use, administration of influenza and pneumococcal vaccine, number and side of rib fracture(s), spirometer use, blood transfusion, and intravenous fluid administration.

Results: Among 78 cases and 74 controls, matched for …

Spinal Cord Trauma: An Overview Of Normal Structure And Function, Primary And Secondary Mechanisms Of Injury, And Emerging Treatment Modalities, Daniel Morin

Senior Honors Theses

The structures of the spinal cord and vertebral column are designed to provide flexibility, while still providing ample protection for the spinal cord deep within. While it does offer remarkable protection against most routine trauma, the spinal cord is still vulnerable to high-force etiologies of trauma and may become damaged as a result. These events are referred to as primary injury. Following the initial injury, the body’s own physiological responses cause a cascade of deleterious effects, known as secondary injury. Secondary injury is a major therapeutic target in mitigating the effects of spinal cord injury (SCI), and much research is …

Uchunguzi (Journal Watch/Montre De Journal) September 2016, Benjamin Wachira

Emergency Medicine, East Africa

Most states in the USA have ‘Good Samaritan’ laws that oblige doctors to stop and render emergency treatment under certain circumstances, without incurring legal liability even if they are negligent. Whether doctors are legally obliged to stop and render assistance at road accidents in most countries across the world remains controversial. In 1978, the South African Medical and Dental Council ruled that ‘in cases of emergency a practitioner is obliged to render assistance in all circumstances’. It has therefore been said that ‘where persons are in a situation where their life or health will be seriously endangered unless they receive …

Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, Md, Zachary Sanford, Constantinous Constantinou, Md

Marshall Journal of Medicine

Posterior tibial artery pseudoaneurysms are extremely rare. They commonly present as a late complication of trauma or iatrogenic injury. Diagnosis can be elusive. Treatment has been described in the context of open primary repair, endovascular stenting, and coil embolization. There has been increasing interest in the use of endovascular treatment options for this type of injury. If left untreated, pseudoaneurysms can rupture, partially thrombose, expand and cause adjacent local compression and compartment syndrome. The following case presented is of a young gentleman with a posterior tibial pseudoaneurysm incidentally discovered after stepping on glass and the management of his posterior tibial …

Uchunguzi (Journal Watch/Montre De Journal) March 2016, Benjamin Wachira

Emergency Medicine, East Africa

Increasing demand on emergency healthcare systems throughout Africa means there is a need to develop and harmonise standards of emergency care for the benefit of African populations. This can potentially be achieved by developing guidelines for appropriate and high quality education to prepare future generations of emergency healthcare providers for their role in all regions of Africa. With this in mind, the African Emergency Nursing Curriculum was developed by emergency nurses, academics and researchers from Africa and the rest of the world to provide a consensus document to guide the development of harmonised standards of emergency nursing theory and practice …

Uchunguzi (Journal Watchmontre De Journal) March 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Outcomes Associated With Blood Component Transfusion In Adult Trauma Patients, Allison R. Jones

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with blood component (BC) transfusion in adult trauma patients. Specific aims were to: 1) explore the relationship between traumatic injury, hemorrhage, and BC transfusion, focusing on consequences of the component storage lesion through presentation of a conceptual model; 2) systematically review research literature comparing outcomes of massively transfused major trauma patients based on ratios of BCs received; 3) evaluating the relationship between type of blood transfusion trauma patients received (whole blood versus BCs) and mortality likelihood after controlling for demographic and clinical variables; 4) evaluating the relationship between volume and …

Uchunguzi (Journal Watch/Montre De Journal) September 2015, Benjamin Wachira

Internal Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Trauma Outcome: Review Of Results In Urban Hospital In Southern Pakistan, Hasnain Zafar, Fuad Abid, Asad Jamil Raja, Mushtaq Ahmed, Faheem Nanajani, Yousuf Kamal Mirza

Section of General Surgery

No abstract provided.