Trauma Commons^™

Growing Through Adversity: The Relation Of Early Childhood Educator Post-Traumatic Growth To Young Children’S Executive Function, Caron A. C. Clark, Holly Hatton-Bowers, Kimia Akhavein, Sarah Rasby, Gilbert R. Parra

Department of Educational Psychology: Faculty Publications

Introduction: Early childhood educators (ECEs) play a critical role in supporting the development of young children’s executive functions (EF). EF, in turn, underpins lifelong resilience and well-being. Unfortunately, many ECEs report adverse childhood experiences (ACEs) that may compound high stress levels associated with an emotionally and physically demanding profession. ACEs have well-established negative implications for adult well-being and may dampen ECEs’ capacities to engage in emotionally responsive interactions with children. However, many individuals who experience ACEs also report post-traumatic growth experiences that foster empathy, self-determination, and resilience. Such post-traumatic growth may equip teachers with skills to engage in responsive …

The Effects Of Covid-19 Mrna Vaccine On Adolescence Gynecological Well-Being, Shih-Chiao Tseng, Dana Cherry, Mansoo Ko, Steven R Fisher, Michael Furtado, Shuo-Hsiu Chang

Faculty, Staff and Student Publications

PURPOSE: Evidence suggests that transcranial direct current stimulation (tDCS) can enhance motor performance and learning of hand tasks in persons with chronic stroke (PCS). However, the effects of tDCS on the locomotor tasks in PCS are unclear. This pilot study aimed to: (1) determine aggregate effects of anodal tDCS combined with step training on improvements of the neural and biomechanical attributes of stepping initiation in a small cohort of persons with chronic stroke (PCS) over a 4-week training program; and (2) assess the feasibility and efficacy of this novel approach for improving voluntary stepping initiation in PCS.

METHODS: A total …

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 …

Weight-Based Enoxaparin Thromboprophylaxis In Young Trauma Patients: Analysis Of The Clott-1 Registry, Sarah Lombardo, Marta Mccrum, M Margaret Knudson, Ernest E Moore, Lucy Kornblith, Scott Brakenridge, Brandon Bruns, Mark D Cipolle, Todd W Costantini, Bruce Crookes, Elliott R Haut, Andrew J Kerwin, Laszlo N Kiraly, Lisa Marie Knowlton, Matthew J Martin, Michelle K Mcnutt, David J Milia, Alicia Mohr, Frederick Rogers, Thomas Scalea, Sherry Sixta, David Spain, Charles E Wade, George C Velmahos, Ram Nirula, Jade Nunez

Faculty, Staff and Student Publications

INTRODUCTION: Optimal venous thromboembolism (VTE) enoxaparin prophylaxis dosing remains elusive. Weight-based (WB) dosing safely increases anti-factor Xa levels without the need for routine monitoring but it is unclear if it leads to lower VTE risk. We hypothesized that WB dosing would decrease VTE risk compared with standard fixed dosing (SFD).

METHODS: Patients from the prospective, observational CLOTT-1 registry receiving prophylactic enoxaparin (n=5539) were categorized as WB (0.45-0.55 mg/kg two times per day) or SFD (30 mg two times per day, 40 mg once a day). Multivariate logistic regression was used to generate a predicted probability of VTE for WB and …

Modified Himawari Technique For Comminuted Patella Fractures: A Case Report - An Economically Yet Rigidly Efficient Option, Leong Li Theng Dr, Eyrique Goh Boay Heong Dr

Manipal Journal of Nursing and Health Sciences

Comminuted patella fracture is a tricky and complicated case to manage and yet a common fracture. It’s often complicated with post operative pseudoarthrosis, malunion, poor rehabilitation and reduced knee range of motion. Tension band wiring, Cerclarge wiring and screw fixation are the common surgical modalities however it’s unable to hold peripherally scattered fragments in place rigidly. It is often associated with failure osteosynthesis, fracture displacement, resulting in post op osteoarthritis. Here we demonstrate a case of a modification of the original Himawari Technique as a much cost-effective method compared to the original, while being a superior treatment option with good …

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 …

Novel Method Of Using Montage® Bone Putty With Rib Plating In A Patient With Chronic Malunion Of Previous Rib Fractures, Tameem Jamal, Zahria Radford, Elliott Smith, Rachel Hemsath, Saptarshi Biswas

South Atlantic Division GME Research Day 2024

No abstract provided.

Cortisol In Elderly Trauma Patients, Sophia Jimenez, Ernest Gonzalez, Leslee Keilty, Carol Wang

Central & West Texas GME Research Day 2024

No abstract provided.

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

North Texas GME 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 …

Acute Traumatic Cataract Diagnosed By Point-Of-Care Ultrasound, Adrian Huffard, Shannon Overholt, Taryn Hoffman

South Atlantic Division GME Research Day 2024

No abstract provided.

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

North Texas GME 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 …

Late Mortality Following Severe Hypothermia In A Trauma Patient, Francheska C. Razalan-Krause, Lawson W. Blake, Alvaro H. Fonseca

South Atlantic Division GME Research Day 2024

No abstract provided.

Masquelet Technique Promotes Osteogenesis In Traumatic Open Tibial Plateau Fracture, Melanie Valencia, Paul C. Baldwin

South Atlantic Division GME Research Day 2024

No abstract provided.

A Case Of Bullet Embolization And Its Management, Emily Clifton, William Clifton, Chase Tenewitz, David Kupshik, Michael Jones

South Atlantic Division GME Research Day 2024

No abstract provided.

A Case Report: 21-Year-Old Trauma Patient With Hemoperitoneum And Discovered To Have A Ruptured Splenic Cyst, Taylor Messick-Ngo, Jordan Palmer, Nicholas Sheets

Far West Division GME Research Day 2024

No abstract provided.

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 …

‘Door-To-Prophylaxis’ As A Novel Quality Improvement Metric In Prevention Of Venous Thromboembolism Following Traumatic Injury, Jan-Michael Van Gent, Thomas W Clements, David E Lubkin, Carter W Kaminski, Jonathan K Bates, Mariela Sandoval, Thaddeus J Puzio, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVE: Venous thromboembolism (VTE) risk reduction strategies include early initiation of chemoprophylaxis, reducing missed doses, weight-based dosing and dose adjustment using anti-Xa levels. We hypothesized that time to initiation of chemoprophylaxis would be the strongest modifiable risk for VTE, even after adjusting for competing risk factors.

METHODS: A prospectively maintained trauma registry was queried for patients admitted July 2017-October 2021 who were 18 years and older and received emergency release blood products. Patients with deep vein thrombosis or pulmonary embolism (VTE) were compared to those without (no VTE). Door-to-prophylaxis was defined as time from hospital arrival to first dose of …

Impact Of Covid Status And Blood Group On Complications In Patients In Hemorrhagic Shock, Jason Bradley Brill, Krislynn M Mueck, Madeline E Cotton, Brian Tang, Mariela Sandoval, Lillian S Kao, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVE: Among critically injured patients of various blood groups, we sought to compare survival and complication rates between COVID-19-positive and COVID-19-negative cohorts.

BACKGROUND: SARS-CoV-2 infections have been shown to cause endothelial injury and dysfunctional coagulation. We hypothesized that, among patients with trauma in hemorrhagic shock, COVID-19-positive status would be associated with increased mortality and inpatient complications. As a secondary hypothesis, we suspected group O patients with COVID-19 would experience fewer complications than non-group O patients with COVID-19.

METHODS: We evaluated all trauma patients admitted 4/2020-7/2020. Patients 16 years or older were included if they presented in hemorrhagic shock and received …