Trauma Commons^™

Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque

HCA Healthcare Journal of Medicine

Background

Understanding the impact of psychiatric pre-existing conditions (PsyPECs) on trauma outcomes is crucial, as trauma is the leading cause of mortality for Americans aged 1-45. Although previous regional studies have shown higher mortality rates and longer hospital length of stay (H-LOS) for injured patients with PsyPECs, this has not been studied at the national level. The purpose of this study is to identify the PsyPECs associated with mechanism of injury and other outcomes in adult patients admitted for trauma in the United States’ trauma centers.

Methods

Data were extracted from the National Trauma Data Bank (NTDB). There were 5301 …

Acute Compartment Syndrome Following Lower Leg Vascular Injury: A Big-Data Approach To Estimating Incidence And Risk Factors, Harry Moroz, Edward J. Harvey, Yasser C. Bouklouch

Journal of Shock and Hemodynamics

Acute Compartment Syndrome (ACS) is a limb- and life-threatening complication of lower leg fractures. Rapid recognition and fasciotomy can prevent irreversible ischemic injury, but ACS is often under-recognized. Vascular injury may increase the risk of ACS by impairing perfusion and exacerbating swelling. This study aimed to determine the incidence, risk factors, and outcomes of ACS in patients with lower leg fractures, with particular emphasis on the impact of vascular injury. This retrospective cohort study used data from the 2017 American College of Surgeons Trauma Quality Programs database to perform a multicenter analysis of patients with lower leg fractures. Patients were …

Improving Trauma Resuscitation Through Video Review: A Quality Improvement-Oriented Literature Review, Joshua Smith, Leena Iqbal

North Texas GME Research Forum 2026

Background Trauma resuscitation is a high-acuity, time-critical environment characterized by diagnostic uncertainty, simultaneous interventions, and complex team dynamics. Despite the widespread adoption of standardized trauma frameworks such as Advanced Trauma Life Support (ATLS), deviations from best practice and process variability remain common. Trauma video review (TVR) has emerged as a method to objectively evaluate resuscitation performance beyond traditional documentation.

Methods A narrative literature review was conducted of English-language publications examining the use of video recording and structured video review in trauma resuscitation. Peer-reviewed articles and relevant gray literature were identified through database and citation searches. Included works evaluated TVR for …

Positive Efast—Not So Fast, Barry J. Knapp, Mitchell Vallone, Megan Duggins, Matt Jones, Jacob Knapp, Lily Kauffman, Alexander Dornstauder

Department of Emergency Medicine Faculty Publications

[Patient presentation] A 68-year-old man presented via emergency medical services (EMS) with right hip pain following a traumatic fall from his bicycle. On arrival at the emergency department, he was alert and oriented. Physical examination revealed only tenderness over the greater trochanter of the left femur, with no significant pain on passive range of motion of the left hip. Plain radiography demonstrated a left acetabular fracture (Fig 1).

Changing Practice: Optimizing Head Ct-Imaging In Pediatric Trauma Patients At A Community Level Ii Pediatric Trauma Center - A Quality Improvement Initiative, Matthew Daniel, Aaron Worthley, Sarah Johnson, Daniel Saad, Antonio Pepe, Eleah Porter

South Atlantic Division GME Research Days 2026

No abstract provided.

Traumatic Left Diaphragmatic Rupture With Visceral Herniation And Volvulus: Successful Robotic-Assisted Laparoscopic Repair, Eleah Porter, Zachery Hensel

South Atlantic Division GME Research Days 2026

No abstract provided.

Implementing Daily Spontaneous Awakening And Breathing Trials In The Trauma Intensive Care Unit: A Quality Improvement Initiative, Bradley Vaughn, Lina V. Mata-Mcmurry, Eric Shaw, James Dunne

South Atlantic Division GME Research Days 2026

No abstract provided.

Dual Clinical Presentation Of A Birthmark: A Quiz, Avery H. Seward, Jacqueline E. Leyrer, Sarah H. Carlock

Department of Medicine Faculty Publications

[Introduction] A man in his early 30s presented with a longstanding birthmark on the lift thigh that was first noticed at age 12. As a teenager, the lesion was treated with a CO2 laser at an outside institution; however, the lesion continued to slowly enlarge over the past several years. The patient reported recurrent irritation and swelling from a construction safety harness with occasional bleeding and frequent bruising. Recently, the area became inflamed, prompting an ER visit, where the patient was evaluated for cellulitis, underwent a normal ultrasound and was placed on cephalexin 500 gm twice daily for 10 days.

A Comprehensive Review Of Bone Remodeling After Trauma And Operative Treatment In Orthopedic Surgery, Sarah E. Rabin, Ian P. Marshall, Benjamin A. Nelson, Justine N. Li, Madison M. Baldauf, Ashley B. Bozzay, Benjamin W. Hoyt

Department of Medicine Faculty Publications

Bone remodeling is a dynamic process involving bone resorption and formation that is regulated on a cellular level and impacted by mechanical stress. A variety of Orthopedic surgery treatment strategies can affect bone remodeling, which can in turn may have long-term impacts on skeletal stress tolerance and function. This review provides a comprehensive overview of bone remodeling involved in Orthopedic surgery. Materials related to bone remodeling principles across Orthopedic surgery domains were selected and compiled using databases including PubMed, MEDLINE, AccessMedicine, and CINAHL; case studies were not included. Relevant literature was summarized for a general review of bone remodeling and …

The Revised Risk Analysis Index Outperforms The 5-Factor Modified Frailty Index In Predicting Postoperative Morbidity After Pilon Fracture Fixation., Gabriel Deoliveira, Amber Park, Arsalaan Sayyed, Aruni Areti, Nithin Gupta, Taylor Manes, Morgan Turnow, Benjamin Taylor, Jack W Weick

Trauma and Acute Care Articles

BACKGROUND: Pilon fractures often result from high energy mechanisms resulting in long-term morbidity and postoperative complications. While there is extensive literature investigating frailty scales as tools for preoperative risk stratification in orthopedic surgery, there is no literature regarding their use in fixation of pilon fractures. The objective of this study was to compare the predictive ability and discriminative accuracy of the Revised Risk Analysis Index (RAI-rev) and the 5-Item Modified Frailty (mFI-5) in 30-day postoperative outcomes following surgical fixation of pilon fractures.

METHODOLOGY: The ACS-NSQIP database was used to identify patients undergoing surgical fixation of pilon fractures from 2015 to …

Erector Spinae Plane Block For Preserving Pulmonary Function In Patients With Traumatic Rib Fractures, Dakoda Farrington

Lynchburg Journal of Medical Science

Rib fractures are frequently seen in trauma patients and are associated with increased mortality, primarily due to pulmonary complications. This study investigates the efficacy of erector spinae plane block (ESPB) in preserving pulmonary function in patients with traumatic rib fractures. A search was conducted in PubMed using the terms "erector spinae plane" AND ("rib fracture" OR "rib fractures") AND trauma. The results were filtered to include studies within the past five years, available full-text articles, and relevancy to this research question. Ultimately, five studies were isolated and included in this review. The methodology for measuring pulmonary function varied between the …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

In A Safe-Space Of Her Own: Alice's Journey Through A Traumatized Wonderland To Find Attunement And Recovery, Cheston A. Axton

Electronic Theses and Dissertations

Throughout Alice’s Adventures in Wonderland/Through the Looking-Glass’s 160-year existence, Lewis Carroll’s seven-year-old protagonist has experienced many changes and alterations. With an ever-growing pop culture interest, Alice’s original narrative has undergone numerous adaptations, with each new variation diving deeper into the impact of trauma on Wonderland.

This thesis continues this existing discourse by examining Wonderland’s capacity to facilitate recovery in the aftermath of severe trauma. Through this research, the traumatic experiences of Alice, from Christina Henry’s The Chronicles of Alice: Alice and American McGee’s Alice: Madness Returns, are examined concerning their effect(s) on her construction of Wonderland, as …

Traumatic Cavernous Carotid Fistula Following A Motor Vehicle Accident, Alec Mirchandani

Rowan-Virtua Research Day

Traumatic cavernous carotid fistulas are a rare but serious complication following blunt trauma, such as motor vehicle accidents, where the internal carotid artery is damaged, creating an abnormal connection with the cavernous sinus. This case report describes a 32-year-old female who presented with pulsatile proptosis, conjunctival chemosis, and visual disturbances following a motor vehicle accident. Imaging confirmed the presence of a traumatic cavernous carotid fistula. The patient underwent successful endovascular embolization, resulting in resolution of her symptoms. This report highlights the importance of early diagnosis and timely intervention, particularly through endovascular techniques, as the treatment of choice is to prevent …

Portable Head Computed Tomography Protocol For Trauma, Christian Quinones, Alexander Bolufer, Cory Hewitt, Sagun Tuli

HCA Healthcare Journal of Medicine

The use of portable computed tomography (CT) scanners has been shown to reduce risks associated with intrahospital transport and to expedite imaging in critically ill patients. While their use is established in intensive care units, their utility on intraoperative trauma patients remains underexplored. This paper reviews existing literature on portable CT use, defines appropriate clinical indications, outlines contraindications, and identifies quality metrics and implementation challenges. It also presents a proposed protocol for integrating portable head CT imaging into trauma workflows, focusing on early identification of intracranial or spinal injuries in the operating room. The development and analysis of standardized protocols …

A Heart Full Of Nails: Complex Management Of Multiple Nail Gun Cardiac Injuries, Shaun Abid Md, Stuart Zarich

Posters

A 54-year-old male presented after a suicide attempt, suffering severe cardiac and extracardiac injuries from firing a nail gun into both temples (Figure 1A) and his chest. Imaging showed six 5cm nails embedded in his heart: two in the left ventricle, two in the right ventricle, one traversing the ascending aorta into the left atrium, and one entering the right ventricle from the left parasternal chest wall (Figure 1B, C, D). These injuries resulted in hemorrhagic pericardial effusion with tamponade, acute aortic regurgitation, mitral valve/pulmonary artery perforations, and a ventricular septal defect.

Risk Factors Associated With Worse Outcomes In Trauma Patients Aged 55 And Older, Hector Mendez, Ilko Luque, Nicole Yordán López, Carlos Parra, Kelvin Chan, Mariel A. Javier, Marcela Ramirez, Orlando Morejón

HCA Healthcare Journal of Medicine

Background

Prior studies have shown an increase in mortality in trauma patients after 55 years of age. However, it is less certain which pre-existing comorbidities (PECs) are associated with poorer outcomes. The purpose of this study was to identify the risk factors associated with poor outcomes and death in patients 55 years old and older admitted for trauma.

Methods

Trauma patients (age ≥ 55) were studied retrospectively from the local trauma registry at HCA Florida Kendall Hospital, a level 1 trauma center (2020–22). We collected the subject’s age, gender, PECs, and outcome data. Then we performed multiple logistic regression to …

Simplicity Is The Ultimate Sophistication: Ume Lessons From Trauma-Focused Simulation, Victoria-Marie Berlandi-Short, Kelsey Yang, Jonmark Dolendo, Grace Hwang, Brianna Kuhse, Samuel Blees, Sherli Koshy-Chenthittayil, Brad Haubrich

Annual Research Symposium

Purpose: Simulation-based training has become essential in preparing medical professionals to manage high-stakes situations effectively before encountering them in real-life clinical settings. This study aimed to evaluate the impact of Cut Suit Week (CSW), a high-stress, trauma-focused simulation training for second-year military medical students hosted by Rocky Vista College of Osteopathic Medicine in San Diego, California. As members of the 2024 cohort, our team from Touro University Nevada (TUN) and Touro University California (TUC) sought to address three questions: (1) Does CSW improve confidence in managing stressful situations? (2) Does it enhance clinical and leadership skills? (3) Would similar training …

Lessons Learned: A Multicenter Approach To A Mass-Casualty Incident, Kristen Payne, Elizabeth Kim, Luis Taveras, Morgan Collom, Danielle Pigneri

North Texas Research Forum 2025

Background: On May 6, 2023, an armed gunman opened fire at a shopping mall in Allen, Texas. Eight people including the perpetrator were killed with more injured. Medical City McKinney, a level 2 trauma center received seven patients. Medical City Plano, a level one trauma center received one patient. Medical City Dallas Children’s Hospital, a level three pediatric trauma center received one pediatric patient. Methods: Medical City North Texas Division command center engaged Emergency Department leadership at North Texas facilities to prepare for transfer of patients. Ground transport and an air medic team on standby was staged early on. Nearby …

Complete Gastric Transection After Blunt Force Trauma, Sydney Parker, Sophia Jimenez, Riley Blanton, Samprit Karra, Alejandro Garcia

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Optimizing Fluid Resuscitation: Balancing Access Efficiency And Infusion Speed In Trauma Care, Chris Robert, Enoch Wong, David Bassa, Danielle Pigneri, Paul Granet

North Texas Research Forum 2025

Study Objective: Time is a critical resource during the initial treatment of an injured patient. Fluid resuscitation is also a critical component of trauma care. Clinicians are faced with the need to actively resuscitate an injured patient while simultaneously working to provide them operative or procedural hemorrhage control as quickly as possible. In these circumstances, physicians must balance perceived flow efficiency with time required to place certain types of access devices, though little data exists to guide this decision process. This study aims to evaluate the infusion times of different sizes of peripheral and central venous catheters to optimize fluid …

There’S A Qr Code For That: Trauma Performance Improvement, Patient Safety, And Peer Review, April Miller, Luis Taveras, Elizabeth Kim, Kathy Galt

North Texas Research Forum 2025

In preparation for our facility’s initial ACS verification visit, a Trauma Consultative Site visit in 2021 identified the need for a streamlined process to communicate issues to the Trauma Program that were recognized during patient care. This was especially true on weekends and nights when issues were most likely to occur. A recent literature review revealed implementation of electronic communication tools increased reporting of performance improvement and patient safety (PIPS) events and improved tracking and resolution of events. The authors of that study used a virtual chatroom accessible from cell phone to post PIPS events. One perceived drawback to this …

Traumatic Aortic Transection, A Case Report, Jared Duval, Ernest Gonzalez

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Closed Vs Open Icu Models & Their Trauma Patient Outcomes A Level Ii Trauma Center & Community Hospital Perspective, Prabhleen Kaur, Amber Hendricks, Nicholas Druar, Roxanne Tapley, Carina Biggs

West Florida Division GME Research Day 2025

No abstract provided.

Traumatic Dislocation Of The Testis, Blake Chandler, Emily Clifton, Christopher Hulsey

South Atlantic Division GME Research Day 2025

No abstract provided.

Pediatric Carotid Artery Dissection Following Blunt Cerebrovascular Injury, Eric Friedman, Iren Shabanova, Arpit Arora

South Atlantic Division GME Research Day 2025

No abstract provided.

An Experience With A Concurrent Bilateral Tibia Interlocking Nailing: Its About Dancing With The Rhythm, Hoh Wee Liam Dr, Eyrique Goh Boay Heong, Hanif Azman

Manipal Journal of Nursing and Health Sciences

Tibial shaft fractures are the most common injuries resulting from high energy trauma such as motor vehicle accident or fall from height. Operative management options of tibia shaft fractures include intramedullary nailing, plating or external fixation or conservative by casting. Interlocking nail of tibia remains favorite among other type of surgical fixation as patient can rehabilitate post op earlier.

Interlocking nail of bilateral tibia are usually performed sequentially in view of patient needing to be properly positioned to allow easy entry and reaming of interlocking nail. Hence, this will prolong operative time, thus increasing risk of general anaethesia and surgical …

The Role Of Trauma-Related Shame In Ptsd And Dissociation, Alexis Stokes

Bakerman Student Research Awards

Dissociation commonly occurs in response to traumatic events, and a dissociative subtype of PTSD is now recognized in the DSM-5. However, researchers have not established a clear consensus as to what factors separate individuals with general PTSD and PTSD with dissociative symptoms (PTSD-D). Negative affect—specifically shame—has been increasingly examined in psychotraumatology research. There is ample evidence that shame predicts and maintains symptom severity in PTSD patients, as well as that it can induce and maintain dissociative symptoms. The clear connection of shame to PTSD and dissociation suggests that it may be an important factor for conceptualizing PTSD-D; however, there is …

Hypothermia In Patients With Traumatic Injuries: An Integrative Review, Andrew P. Gribble, David J. Saucedo

Master's Projects

Abstract

Background: An estimated 30-50% of severely injured patients with traumatic injuries will experience hypothermia. As a result of hypothermia, several clinical manifestations such as impaired coagulation, dissociation of the oxygen curve, cardiac arrhythmias, reduced cardiac output and death. Little evidence has been published promoting specific patient re-warming protocols and the best rewarming methods, active versus passive. Few studies have focused on the pre-hospitalization treatment for hypothermia and the overall effectiveness of interventions to mitigate hypothermia to reduce morbidity and mortality. Given this knowledge, the aim of this integrative review (IR) is to research and evaluate current practices regarding hypothermia …

Spontaneous Rupture Of A Splenic Artery Aneurysm With Hemoperitoneum; Case Presentation, Vlad Denis Constantin, Ion Motofei, Gelu Valentin Stefanescu, Adrian Silaghi

Journal of Mind and Medical Sciences

Aneurysms of the splenic artery are relatively rare, being found in patients with portal hypertension, multiparous, atherosclerosis, or in young people with various genetic diseases. In the uncomplicated forms, splenic artery aneurysms are often difficult to diagnose either because of the asymptomatic evolution, or because of the non-specific symptoms. In cases of trauma or large sizes, aneurysms can be complicated by rupture, which can cause hemoperitoneum with the risk of death if specific treatment is not initiated as soon as possible. Depending on the location of the splenic aneurysm, comorbidities, the patient's general condition or life-threatening complications, laparotomy, laparoscopy, endovascular …