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Sample records for introducing trauma team

  1. Trauma teams and time to early management during in situ trauma team training

    PubMed Central

    Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine

    2016-01-01

    Objectives To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. Design In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. Setting An emergency room in an urban Scandinavian level one trauma centre. Participants A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. Primary outcome HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Results Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Conclusions Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. PMID:26826152

  2. Improving Trauma Care in India: the Potential Role of the Rural Trauma Team Development Course (RTTDC).

    PubMed

    Ali, Jameel; Kumar, Subodh; Gautam, Subash; Sorvari, Anne; Misra, Mahesh C

    2015-12-01

    The Rural Trauma Team Development Course (RTTDC) was devised to optimize trauma resuscitation training in under-resourced rural institutions. This program appears ideal for India because of its dense traffic, large population, and high frequency of rural trauma. We report on the feasibility and desirability of introducing RTTDC in India. An instructor course for 20 faculties and a provider course for 23 were conducted in New Delhi, India. The courses were evaluated by multiple choice question (MCQ) performance, by rating the modules on a three-point scale (1 = very relevant, 2 = relevant, and 3 = not relevant) for communication skills, principles of performance improvement and patient safety (PIPS), and clinical scenarios. Evaluation questionnaires including desirability of promulgation in India were completed using a five-point Likert Scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). Overall written comments were also provided. Both faculty and providers improved post-course MCQ scores (p < 0.05) with lower scores in the provider group. Seventy-eight percent faculty and 74 % providers rated the communication module very relevant. PIPS was rated very relevant by 72 % faculty and 65 % providers. There were over 150 comments, generally positive with over 90 % of both faculty and providers rating strongly agree to agree that the course be promulgated widely in India. The RTTDC including plans for promulgation was enthusiastically received in India, and its potential for improving trauma care including communication skills and PIPS appears excellent. PMID:26729998

  3. Dental and General Trauma in Team Handball.

    PubMed

    Petrović, Mateja; Kühl, Sebastian; Šlaj, Martina; Connert, Thomas; Filippi, Andreas

    2016-01-01

    Handball has developed into a much faster and high-impact sport over the past few years because of rule changes. Fast sports with close body contact are especially prone to orofacial trauma. Handball belongs to a category of sports with medium risk for dental trauma. Even so, there is only little literature on this subject. The aim of this study was to examine the prevalence and the type of injuries, especially the occurrence of orofacial trauma, habits of wearing mouthguards, as well as degree of familiarity with the tooth rescue box. For this purpose, 77.1% (n=542/703) of all top athletes and coaches from the two highest Swiss leagues (National League A and National League B), namely 507 professional players and 35 coaches, were personally interviewed using a standardized questionnaire. 19.7% (n=100/507) of the players experienced dental trauma in their handball careers, with 40.8% (n=51/125) crown fractures being the most frequent by far. In spite of the relatively high risk of lip or dental trauma, only 5.7% (n=29/507) of the players wear mouthguards. The results of this study show that dental trauma is common among Swiss handball players. In spite of the high risk of dental trauma, the mouthguard as prevention is not adequately known, and correct procedure following dental trauma is rarely known at all. PMID:27622524

  4. Evaluation of a university hospital trauma team activation protocol

    PubMed Central

    2011-01-01

    Background Admission with a multidisciplinary trauma team may be vital for the severely injured patient, as this facilitates rapid diagnosis and treatment. On the other hand, patients with minor injuries do not need the trauma team for adequate care. Correct triage is important for optimal resource utilization. The aim of the study was to evaluate our criteria for activating the trauma team, and identify suboptimal criteria that might be changed in the interest of precision. Methods The study is an observational, retrospective cohort-study. All patients admitted with the trauma team (n = 382), all severely injured (Injury Severity Score (ISS) >15) (n = 161), and all undergoing an emergency procedure aimed at counteracting compromised airways, respiration or circulation at our hospital (n = 142) during 2006-2007 were included. Data were recorded from the admission records and the electronic patient records. The trauma team activation protocol was evaluated against the occurrence of severe injury and the occurrence of emergency procedures. Results A total of 441 patients were included. The overtriage was 71% and undertriage 32% when evaluating against ISS >15 as the standard of reference. When occurrence of emergency procedures was held as the standard of standard of reference, the over- and undertriage was 71% and 21%, respectively. Mechanism of injury-criteria for trauma team activation contributed the most to overtriage. The emergency procedures performed were mostly endotracheal intubation and external fixation of fractures. Less than 3% needed haemostatic laparotomy or thoracotomy. Approximately 2/3 of the overtriage represented isolated head or cervical spine injuries, and/or interhospital transfers. Conclusions The over- and undertriage of our protocol are both too high. To decrease overtriage we suggest omissions and modifications of some of the criteria. To decrease undertriage, transferred patients and patients with head injuries should be more thoroughly

  5. Communication in interdisciplinary teams: exploring closed-loop communication during in situ trauma team training

    PubMed Central

    Härgestam, Maria; Lindkvist, Marie; Brulin, Christine; Jacobsson, Maritha; Hultin, Magnus

    2013-01-01

    Objectives Investigate the use of call-out (CO) and closed-loop communication (CLC) during a simulated emergency situation, and its relation to profession, age, gender, ethnicity, years in profession, educational experience, work experience and leadership style. Design Exploratory study. Setting In situ simulator-based interdisciplinary team training using trauma cases at an emergency department. Participants The result was based on 16 trauma teams with a total of 96 participants. Each team consisted of two physicians, two registered nurses and two enrolled nurses, identical to a standard trauma team. Results The results in this study showed that the use of CO and CLC in trauma teams was limited, with an average of 20 CO and 2.8 CLC/team. Previous participation in trauma team training did not increase the frequency of use of CLC while ≥2 structured trauma courses correlated with increased use of CLC (risk ratio (RR) 3.17, CI 1.22 to 8.24). All professions in the trauma team were observed to initiate and terminate CLC (except for the enrolled nurse from the operation theatre). The frequency of team members’ use of CLC increased significantly with an egalitarian leadership style (RR 1.14, CI 1.04 to 1.26). Conclusions This study showed that despite focus on the importance of communication in terms of CO and CLC, the difficulty in achieving safe and reliable verbal communication within the interdisciplinary team remained. This finding indicates the need for validated training models combined with further implementation studies. PMID:24148213

  6. The Trauma Response Team: a Community Intervention for Gang Violence.

    PubMed

    Jennings-Bey, Timothy; Lane, Sandra D; Rubinstein, Robert A; Bergen-Cico, Dessa; Haygood-El, Arnett; Hudson, Helen; Sanchez, Shaundel; Fowler, Frank L

    2015-10-01

    While violent crime has decreased in many cities in the USA, gang-related violence remains a serious problem in impoverished inner city neighborhoods. In Syracuse, New York, gang-related murders and gun shots have topped other New York state cities. Residents of the high-murder neighborhoods suffer trauma similar to those living in civil conflict zones. The Trauma Response Team was established in 2010, in collaboration with the Police Department, health care institutions, and emergency response teams and with the research support of Syracuse University faculty. Since its inception, gang-related homicides and gun shots have decreased in the most severely affected census tracts. PMID:26282564

  7. Intraosseous access in trauma by air medical retrieval teams.

    PubMed

    Sheils, Mark; Ross, Mark; Eatough, Noel; Caputo, Nicholas D

    2014-01-01

    Trauma accounts for a significant portion of overall mortality globally. Hemorrhage is the second major cause of mortality in the prehospital environment. Air medical retrieval services throughout the world have been developed to help improve the outcomes of patients suffering from a broad range of medical conditions, including trauma. These services often utilize intraosseous (IO) devices as an alternative means for access of both medically ill and traumatically injured patients in austere environments. However, studies have suggested that IO access cannot reach acceptable rates for massive transfusion. We review the subject to find the answer of whether IO access should be performed by air medical teams in the prehospital setting, or would central venous (CVC) access be more appropriate? We decided to assess the literature for capacity of IO access to meet resuscitation requirements in the prehospital management of trauma. We also decided to compare the insertion and complication characteristics of IO and CVC access. PMID:25049187

  8. Multidisciplinary Team Treatment of Penetrating Head and Neck Trauma.

    PubMed

    Li, Lili; Li, Hongxing; Yang, Kongbin

    2016-09-01

    Penetrating head and neck trauma could cause significant mortality because of many important structures located in the brain and neck. Although high-velocity penetrating brain injury is often reported, reports of low-velocity, combined head and neck penetrating injury are rare. Hereby, the authors present a case of an old man who had encountered a serious accident, a 29-cm iron fork penetrated into his neck, through the skull base and into brain. After treatment by multidisciplinary team, the patient was in rehabilitation. The multidisciplinary team assists rapid diagnosis and treatment of penetrating neck and head injury is the key to ensure a good outcome. Therefore, as the authors face such patients again, a multidisciplinary team is needed. PMID:27428914

  9. TeamSTEPPS(®) simulation-based training: an evidence-based strategy to improve trauma team performance.

    PubMed

    Harvey, Ellen M; Wright, Andrea; Taylor, Dallas; Bath, Jennifer; Collier, Bryan

    2013-11-01

    Initial assessment and treatment of critically injured patients is time sensitive, creating a high-stress environment for trauma team members and patients. Effective leadership, communication, and clinical acumen are essential team dynamics for best patient outcomes. Innovative multidisciplinary TeamSTEPPS(®) simulation-based training is an effective model for teams in high-risk health care settings. Use of this simulation model has led to improved trauma team performance and patient outcomes while incorporating new physician and nursing personnel into a time-sensitive, high-stress environment. PMID:24199639

  10. The effect of introducing a Trauma Network on patient flow, hospital finances and trainee operating.

    PubMed

    Hipps, Daniel; Jameson, Simon; Murty, An; Gregory, Rob; Large, David; Gregson, Jackie; Refaie, Ramsay; Reed, Mike

    2015-02-01

    In April 2012 the National Health Service in England introduced the Trauma Network system with the aim of improving the quality of trauma care. In this study we wished to determine how the introduction of the Trauma network has affected patient flow, hospital finances and orthopaedic trauma training across our region. The overall pattern of trauma distribution was not greatly affected, reflecting the relative rarity of major trauma in the UK. A small decrease in the total number of operations performed by trainees was noted in our region. Trainees at units designated as Major Trauma Centres gained slightly more operative experience in trauma procedures overall, and specifically in those associated with high energy, such as long bone nail insertion and external fixation procedures. However, there have been no significant changes in this pattern since the introduction of the Trauma Networks. Falling operative numbers presents a challenge for delivering high quality training within a surgical training programme, and each case should be seen as a vital educational opportunity. Best practice tariff targets for trauma were delivered for 99% of cases at our MTCs. Future audit and review to analyse the evolving role of the MTCs is desirable. PMID:25697735

  11. Training forward surgical teams for deployment: the US Army Trauma Training Center.

    PubMed

    Valdiri, Linda A; Andrews-Arce, Virginia E; Seery, Jason M

    2015-04-01

    Since the late 1980s, the US Army has been deploying forward surgical teams to the most intense areas of conflict to care for personnel injured in combat. The forward surgical team is a 20-person medical team that is highly mobile, extremely agile, and has relatively little need of outside support to perform its surgical mission. In order to perform this mission, however, team training and trauma training are required. The large majority of these teams do not routinely train together to provide patient care, and that training currently takes place at the US Army Trauma Training Center (ATTC). The training staff of the ATTC is a specially selected 10-person team made up of active duty personnel from the Army Medical Department assigned to the University of Miami/Jackson Memorial Hospital Ryder Trauma Center in Miami, Florida. The ATTC team of instructors trains as many as 11 forward surgical teams in 2-week rotations per year so that the teams are ready to perform their mission in a deployed setting. Since the first forward surgical team was trained at the ATTC in January 2002, more than 112 forward surgical teams and other similar-sized Department of Defense forward resuscitative and surgical units have rotated through trauma training at the Ryder Trauma Center in preparation for deployment overseas. PMID:25834016

  12. Trauma Non-Technical Training (TNT-2): the development, piloting and multilevel assessment of a simulation-based, interprofessional curriculum for team-based trauma resuscitation.

    PubMed

    Doumouras, Aristithes G; Keshet, Itay; Nathens, Avery B; Ahmed, Najma; Hicks, Christopher M

    2014-10-01

    Medical error is common during trauma resuscitations. Most errors are nontechnical, stemming from ineffective team leadership, nonstandardized communication among team members, lack of global situational awareness, poor use of resources and inappropriate triage and prioritization. We developed an interprofessional, simulation-based trauma team training curriculum for Canadian surgical trainees. Here we discuss its piloting and evaluation. PMID:25265111

  13. Characteristics of Team-Based Organization Introduced to Academic Libraries in South Korea

    ERIC Educational Resources Information Center

    Yoon, Hye-Young

    2005-01-01

    This study was performed to analyze characteristics of a team-based organization introduced lately to many academic libraries in South Korea. The major areas of exploration included the introduction of the team approach, team empowerment, leadership of team leaders, open communication, and the director's commitment. The study used a survey design…

  14. The advantages of early trauma team activation in the management of major trauma patients who underwent exploratory laparotomy

    PubMed Central

    Yoo, Youngsun

    2014-01-01

    Purpose Trauma team activation (TTA) has been shown to have fundamental impact on trauma patients' outcomes. The purpose of this study was to evaluate the short-term outcomes of use of a new TTA protocol in the management of major trauma patients who underwent exploratory laparotomy. Methods The medical records of trauma patients who had been treated by the new TTA protocol (NT) over 18 months were compared with those of trauma patients treated by the old TTA protocol (OT) over 18 months. Comparisons between the two groups in terms of the time interval between accident and emergency room (ER) arrival, between ER arrival and CT scanning, between ER arrival and operating room (OR) presentation, between accident and OR presentation, mean intensive care unit (ICU) stay, mean hospital stay, mortality within 24 hours, mean mortality within one month, and overall mortality were performed using the Pearson chi-squared test and Student t-test. Results The time interval between accident and ER arrival, between ER arrival and CT scanning, between ER arrival and OR presentation, and between accident and OR presentation was found to have decreased significantly with the use of NT compared to OT. However, the mean ICU stay, mean hospital stay, mortality within 24 hours, mortality within one month, and overall mortality were found not to have improved. Conclusion While initiation of early TTA can shorten the time interval in the management of trauma patients, it may not improve patient outcomes. PMID:25485240

  15. Introducing a Short Measure of Shared Servant Leadership Impacting Team Performance through Team Behavioral Integration.

    PubMed

    Sousa, Milton; Van Dierendonck, Dirk

    2015-01-01

    The research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioral integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to collect data in two similar studies. Study 1 included 244 undergraduate students in 61 teams following an intense HRM business simulation of 2 weeks. The following year, study 2 included 288 students in 72 teams involved in the same simulation. The most important findings were that (1) shared servant leadership was a strong determinant of team behavioral integration, (2) information exchange worked as the main mediating process between shared servant leadership and team performance, and (3) the essence of servant leadership can be captured on the key dimensions of empowerment, humility, stewardship and accountability, allowing for a new promising shortened four-dimensional measure of shared servant leadership. PMID:26779104

  16. Introducing a Short Measure of Shared Servant Leadership Impacting Team Performance through Team Behavioral Integration

    PubMed Central

    Sousa, Milton; Van Dierendonck, Dirk

    2016-01-01

    The research reported in this paper was designed to study the influence of shared servant leadership on team performance through the mediating effect of team behavioral integration, while validating a new short measure of shared servant leadership. A round-robin approach was used to collect data in two similar studies. Study 1 included 244 undergraduate students in 61 teams following an intense HRM business simulation of 2 weeks. The following year, study 2 included 288 students in 72 teams involved in the same simulation. The most important findings were that (1) shared servant leadership was a strong determinant of team behavioral integration, (2) information exchange worked as the main mediating process between shared servant leadership and team performance, and (3) the essence of servant leadership can be captured on the key dimensions of empowerment, humility, stewardship and accountability, allowing for a new promising shortened four-dimensional measure of shared servant leadership. PMID:26779104

  17. Leadership is the essential non-technical skill in the trauma team - results of a qualitative study

    PubMed Central

    Hjortdahl, Magnus; Ringen, Amund H; Naess, Anne-Cathrine; Wisborg, Torben

    2009-01-01

    Background Trauma is the leading cause of death for young people in Norway. Studies indicate that several of these deaths are avoidable if the patient receives correct initial treatment. The trauma team is responsible for initial hospital treatment of traumatized patients, and team members have previously reported that non-technical skills as communication, leadership and cooperation are the major challenges. Better team function could improve patient outcome. The aim of this study was to obtain a deeper understanding of which non-technical skills are important to members of the trauma team during initial examination and treatment of trauma patients. Methods Twelve semi-structured interviews were conducted at four different hospitals of various sizes and with different trauma load. At each hospital a nurse, an anaesthesiologist and a team leader (surgeon) were interviewed. The conversations were transcribed and analyzed using systematic text condensation according to the principles of Giorgi's phenomenological analysis as modified by Malterud. Results and conclusion Leadership was perceived as an essential component in trauma management. The ideal leader should be an experienced surgeon, have extensive knowledge of trauma care, communicate clearly and radiate confidence. Team leaders were reported to have little trauma experience, and the team leaders interviewed requested more guidance and supervision. The need for better training of trauma teams and especially team leaders requires further investigation and action. PMID:19781093

  18. A Consensus-Based Criterion Standard Definition for Pediatric Patients Who Needed the Highest-Level Trauma Team Activation

    PubMed Central

    Lerner, E. Brooke; Drendel, Amy L.; Falcone, Richard A.; Weitze, Keith C.; Badawy, Mohamed K.; Cooper, Arthur; Cushman, Jeremy T.; Drayna, Patrick C.; Gourlay, David M.; Gray, Matthew P.; Shah, Manish I.; Shah, Manish N.

    2014-01-01

    Background Verbal prehospital reports on an injured patient’s condition are typically used by trauma centers to determine if a trauma team should be present in the emergency department prior to patient arrival (i.e., trauma team activation). Efficacy studies of trauma team activation protocols cannot be conducted without a criterion standard definition for which pediatric patients need a trauma team activation. Objective To develop a consensus-based criterion standard definition for pediatric patients who needed the highest-level trauma team activation. Methods Ten local and national experts in emergency medicine, emergency medical services, and trauma were recruited to participate in a Modified Delphi survey process. The initial survey was populated based on outcomes that had been used in previously published literature on trauma team activation. The criterion standard definition for trauma team activation was refined iteratively based on survey responses until at least 80% agreement was achieved for each criterion. Results After five voting rounds a consensus-based definition for pediatric trauma team activation was developed. Twelve criteria were identified along with a corresponding time interval in which each criterion had to occur. The criteria include receiving specific surgery types, interventional radiology, advanced airway management, thoracostomy, blood products, spinal injury, emergency cesarean section, vasopressors, burr hole or other procedure to relieve intracranial pressure, pericardiocentesis, thoracotomy, and death in the emergency department. All expert panel members voted in all 5 voting rounds, except 1 member missed rounds 1 and 2. Each criterion had greater than 80% agreement from the panel. Conclusion A criterion standard definition for the highest-level pediatric trauma team activation was developed. This criterion standard definition will advance trauma research by allowing investigators to determine the accuracy and effectiveness of

  19. Advancing critical care: joint combat casualty research team and joint theater trauma system.

    PubMed

    Bridges, Elizabeth; Biever, Kimberlie

    2010-01-01

    Despite the severity and complexity of injuries, survival rates among combat casualties are equal to or better than those from civilian trauma. This article summarizes the evidence regarding innovations from the battlefield that contribute to these extraordinary survival rates, including preventing hemorrhage with the use of tourniquets and hemostatic dressings, damage control resuscitation, and the rapid evacuation of casualties via MEDEVAC and the US Air Force Critical Care Air Transport Teams. Care in the air for critically injured casualties with pulmonary injuries and traumatic brain injury is discussed to demonstrate the unique considerations required to ensure safe en route care. Innovations being studied to decrease sequelae associated with complex orthopedic and extremity trauma are also presented. The role and contributions of the Joint Combat Casualty Research Team and the Joint Theater Trauma System are also discussed. PMID:20683227

  20. Exposing Compassion Fatigue and Burnout Syndrome in a Trauma Team: A Qualitative Study.

    PubMed

    Berg, Gina M; Harshbarger, Jenni L; Ahlers-Schmidt, Carolyn R; Lippoldt, Diana

    2016-01-01

    Compassion fatigue (CF) and burnout syndrome (BOS) are identified in trauma, emergency, and critical care nursing practices. The purpose of this qualitative study was to measure CF and BOS in a trauma team and allow them to share perceptions of related stress triggers and coping strategies. Surveys to measure CF and BOS and a focus group allowed a trauma team (12 practitioners) to share perceptions of related stress triggers and coping strategies. More than half scored at risk for CF and BOS. Stress triggers were described as situation (abuse, age of patient) versus injury-related. Personal coping mechanisms were most often reported. Both CF and BOS can be assessed with a simple survey tool. Strategies for developing a program culturally sensitive to CF and BOS are provided. PMID:26745533

  1. Predeployment mass casualty and clinical trauma training for US Army forward surgical teams.

    PubMed

    Pereira, Bruno M T; Ryan, Mark L; Ogilvie, Michael P; Gomez-Rodriguez, Juan Carlos; McAndrew, Patrick; Garcia, George D; Proctor, Kenneth G

    2010-07-01

    Since the beginning of the program in 2002, 84 Forward Surgical Teams (FSTs) have rotated through the Army Trauma Training Center (ATTC) at the University of Miami/Ryder Trauma Center including all those deployed to Iraq and Afghanistan. The purpose of this study was to provide the latest updates of our experience with FSTs at the ATTC. Before deployment, each FST participates in a 2-week training rotation at the ATTC. The rotation is divided into 3 phases. Phase 1 is to refresh FST knowledge regarding the initial evaluation and management of the trauma patient. Phase 2 is the clinical phase and is conducted entirely at the Ryder Trauma Center. The training rotation culminates in phase 3, the Capstone exercise. During the Capstone portion of their training, the entire 20-person FST remains at the Ryder Trauma Center and is primarily responsible for the evaluation and resuscitation of all patients arriving over a 24-hour period. Subject awareness concerning their role within the team improved from 71% to 95%, indicating that functioning as a team in the context of the mass casualty training exercise along with clinical codes was beneficial. The clinical component of the rotation was considered by 47% to be the most valuable aspect of the training. Our experience strongly suggests that a multimodality approach is beneficial for preparing a team of individuals with minimal combat (or trauma) experience for the rigors of medical care and triage on the battlefield. The data provided by participants rotating through the ATTC show that through clinical exposure and simulation over a 2-week period, FST performance is optimized by defining provider roles and improving communication. The mass casualty training exercise is a vital component of predeployment training that participants feel is valuable in preparing them for the challenges that lay ahead. PMID:20613574

  2. Recent Advances in Forward Surgical Team Training at the U.S. Army Trauma Training Department.

    PubMed

    Allen, Casey J; Straker, Richard J; Murray, Clark R; Hannay, William M; Hanna, Mena M; Meizoso, Jonathan P; Manning, Ronald J; Schulman, Carl I; Seery, Jason M; Proctor, Kenneth G

    2016-06-01

    U.S. Army Forward Surgical Teams (FSTs) are elite, multidisciplinary units that are highly mobile, and rapidly deployable. The mission of the FST is to provide resuscitative and damage control surgery for stabilization of life-threatening injuries in austere environments. The Army Trauma Training Center began in 2001 at the University of Miami Ryder Trauma Center under the direction of COL T. E. Knuth, MC USA (Ret.), as a multimodality combination of lectures, laboratory exercises, and clinical experiences that provided the only predeployment mass casualty and clinical trauma training center for all FSTs. Each of the subsequent five directors has restructured the training based on dynamic feedback from trainees, current military needs, and on the rapid advances in combat casualty care. We have highlighted these evolutionary changes at the Army Trauma Training Center in previous reviews. Under the current director, LTC J. M. Seery, MC USA, there are new team-building exercises, mobile learning modules and simulators, and other alternative methods in the mass casualty exercise. This report summarizes the latest updates to the state of the art training since the last review. PMID:27244065

  3. Evaluation of introducing the team approach to the care of the amputee: the Dulwich study.

    PubMed

    Ham, R; Regan, J M; Roberts, V C

    1987-04-01

    The effects of introducing the Team Approach to the management of the lower limb amputee has been assessed in a consecutive series of 233 patients over a five year period. During the first year, baseline data was collected and during the subsequent yearly phases the effects of introducing a physiotherapist co-ordinator, visiting prosthetist and medical officer from the local Artificial Limb and Appliance Centre (ALAC), and finally trained surgeons were studied. During the final phases of the study, the effects of changing team staff were monitored. The results have shown that only when the full Team Approach is adopted are the best results achieved, but that, once this approach is established, staff changes can be made without serious reductions in effectiveness. The study has shown that the team can reduce in-patient stay by 20 days; reduce the need for post-discharge physiotherapy by 94%; increase the proportion of patients discharged with a prosthesis more than fivefold and increase the effectiveness of long term rehabilitation threefold. PMID:3588260

  4. Performance improvement through best practice team management: human factors in complex trauma.

    PubMed

    Mercer, Simon; Arul, G S; Pugh, H E J

    2014-06-01

    Human factors or non-technical skills are now commonplace in the medical literature, having taken the lead from the airline and nuclear industries and more recently Formula One motor racing. They have been suggested as playing a vital role in the success of the trauma teams in recent conflicts. This article outlines the background to human factors, referring to early papers and reports and also outlines high profile cases that highlight their importance. We then describe the importance of human factors in the deployed setting and some of the lessons that have been learnt from current conflicts. PMID:24389744

  5. Introducing the notion of social context of collective trauma to ESTSS

    PubMed Central

    Ajduković, Dean

    2013-01-01

    Living amidst war and mass suffering while grasping the opportunity for professional growth, intertwined into my life perspective. Along the years, ESTSS provided a backdrop for my contacts with mental health colleagues from whom I learned, and among whom many became my friends. These rich experiences guided me towards promoting awareness within ESTSS of the importance of social context in which healing of traumatized populations is expected to progress. Each incident of organized violence leaves behind new scores of traumatized individuals and family members, among whom many will need support that may stretch their resources beyond reasonable limits. We need to acknowledge the hindering effects of living in such a social context and that many people that we meet as professionals may carry the burden of unresolved trauma, which should not go by unattended. PMID:23755326

  6. The use of the reverse shock index to identify high-risk trauma patients in addition to the criteria for trauma team activation: a cross-sectional study based on a trauma registry system

    PubMed Central

    Kuo, Spencer C H; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Rau, Cheng-Shyuan; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

    2016-01-01

    Objectives The presentation of decrease blood pressure with tachycardia is usually an indicator of significant blood loss. In this study, we used the reverse shock index (RSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), to evaluate the haemodynamic status of trauma patients. As an SBP lower than the HR (RSI<1) may indicate haemodynamic instability, the objective of this study was to assess whether RSI<1 can help to identify high-risk patients with potential shock and poor outcome, even though these patients do not yet meet the criteria for multidisciplinary trauma team activation (TTA). Design Cross-sectional study. Setting Taiwan. Participants We retrospectively reviewed the data of 20 106 patients obtained from the trauma registry system of a level I trauma centre for trauma admissions from January 2009 through December 2014. Patients for whom a trauma team was not activated (regular patients) and who had RSI<1 were compared with regular patients with RSI≥1. The ORs of the associated conditions and injuries were calculated with 95% CIs. Main outcome measures In-hospital mortality. Results Among regular patients with RSI<1, significantly more patients had an Injury Severity Score (ISS) ≥25 (OR 2.4, 95% CI 1.58 to 3.62; p<0.001) and the mortality rate was also higher (2.1% vs 0.5%; OR 3.9, 95% CI 2.10 to 7.08; p<0.001) than in regular patients with RSI≥1. The intensive care unit length of stay was longer in regular patients with RSI<1 than in regular patients with RSI≥1. Conclusions Among patients who did not reach the criteria for TTA, RSI<1 indicates a potentially worse outcome and a requirement for more attention and aggressive care in the emergency department. PMID:27329440

  7. Team Problem-Solving Strategies: Introducing Students to Industry Practices. A Peer-Reviewed Article.

    ERIC Educational Resources Information Center

    Marcus, Michael

    2003-01-01

    Describes a teaching method involving problem-solving techniques used by project teams in industry that have been tailored for use in an introductory engineering technology course. Provides step-by-step guidelines for each component. (JOW)

  8. Trauma.

    PubMed

    Huisman, Thierry A G M; Poretti, Andrea

    2016-01-01

    Traumatic brain and spine injury (TBI/TSI) is a leading cause of death and lifelong disability in children. The biomechanical properties of the child's brain, skull, and spine, the size of the child, the age-specific activity pattern, and variance in trauma mechanisms result in a wide range of age-specific traumas and patterns of brain and spine injuries. A detailed knowledge about the various types of primary and secondary pediatric head and spine injuries is essential to better identify and understand pediatric TBI/TSI, which enhances sensitivity and specificity of diagnosis, will guide therapy, and may give important information about the prognosis. The purposes of this chapter are to: (1) discuss the unique epidemiology, mechanisms, and characteristics of TBI/TSI in children; (2) review the anatomic and functional imaging techniques that can be used to study common and rare pediatric TBI/TSI and their complications; (3) comprehensively review frequent primary and secondary brain injuries; and (4) to give a short overview of two special types of pediatric TBI/TSI: birth-related and nonaccidental injuries. PMID:27430465

  9. Multidisciplinary trauma team care in Kandahar, Afghanistan: current injury patterns and care practices.

    PubMed

    Beckett, Andrew; Pelletier, Pierre; Mamczak, Christiaan; Benfield, Rodd; Elster, Eric

    2012-12-01

    Multidisciplinary trauma care systems have been shown to improve patient outcomes. Medical care in support of the global war on terror has provided opportunities to refine these systems. We report on the multidisciplinary trauma care system at the Role III Hospital at Kandahar Airfield, Afghanistan. We reviewed the Joint Trauma System Registry, Kandahar database from 1 October 2009 to 31 December 2010 and extracted data regarding patient demographics, clinical variables and outcomes. We also queried the operating room records from 1 January 2009 to 31 December 2010. In the study period of 1 October 2009 to 31 December 2010, 2599 patients presented to the trauma bay, with the most common source of injury being from Improvised Explosive Device (IED) blasts (915), followed by gunshot wounds (GSW) (327). Importantly, 19 patients with triple amputations as a result of injuries from IEDs were seen. 127 patients were massively transfused. The in-hospital mortality was 4.45%. From 1 January 2010 to 31 December 2010, 4106.24 operating room hours were logged to complete 1914 patient cases. The mean number of procedures per case in 2009 was 1.27, compared to 3.11 in 2010. Multinational, multidisciplinary care is required for the large number of severely injured patients seen at Kandahar Airfield. Multidisciplinary trauma care in Kandahar is effective and can be readily employed in combat hospitals in Afghanistan and serve as a model for civilian centres. PMID:22305587

  10. Cohesion and Trauma: An Examination of a Collegiate Women's Volleyball Team

    ERIC Educational Resources Information Center

    Fletcher, Teresa B.; Meyer, Barbara B.

    2009-01-01

    This study examined the effects of Adventure Based Counseling (i.e., a low-element challenge program) on the cohesion of a collegiate women's volleyball team. Results suggest postintervention improvements in team cohesion. The support created in the challenge experience also transferred to the players helping one another to grieve the untimely…

  11. S.T.A.R.T.T. plus: addition of prehospital personnel to a national multidisciplinary crisis resource management trauma team training course

    PubMed Central

    Gillman, Lawrence M.; Martin, Doug; Engels, Paul T.; Brindley, Peter; Widder, Sandy; French, Cheryl

    2016-01-01

    Summary The Simulated Trauma and Resuscitation Team Training (S.T.A.R.T.T.) course is a unique multidisciplinary trauma team training course deliberately designed to address the common crisis resource management (CRM) skills of trauma team members. Moreover, the curriculum has been updated to also target the specific learning needs of individual participating professionals: physicians, nurses and respiratory therapists. This commentary outlines further modifications to the course curriculum in order to address the needs of a relatively undertargeted group: prehospital personnel (i.e., emergency medical services). Maintenance of high participant satisfaction, regardless of profession, suggests that the S.T.A.R.T.T. course can be readily modified to incorporate prehospital personnel without losing its utility or popularity. PMID:26574706

  12. Benefit or burden: introducing paraprofessional support staff to health visiting teams: the case of Starting Well.

    PubMed

    Mackenzie, Mhairi

    2006-11-01

    With increased public-sector funding to expand and improve frontline services, pre-existing skill shortages within key professional workforces have become more acute. One response to this has been to encourage the development of skill-mix approaches which allow tasks previously undertaken by professional staff groupings to be assumed by new paraprofessional employees. Within the UK National Health Service, one group of professionals who are being challenged to change their way of working in this way are health visitors. Starting Well, one of Scotland's four health demonstration projects, which was established in 2000 to bring about a step-change in child health within deprived communities in Glasgow, operated as a pilot for such a skill-mix model of health visiting. The project was evaluated using a multimethod approach that encompassed the study of both processes and outcomes. The present paper reports on a process evaluation of the project's implementation that addressed the rationale underlying the development of Starting Well's skill-mix approach and the challenges which this model faced in practice. The perceptions of both managerial staff (n=18) and those working in practice (n=33) were gathered using semistructured interviews which sought to elicit and test Starting Well's theory of change in relation to the use of paraprofessional staff. Two sets of interviews were conducted with each group of staff between 2001 and 2003. Two main types of challenge were identified: deploying potentially vulnerable members of staff; and co-management of paraprofessionals by the health service and a voluntary-sector organisation. A potential challenge identified from the literature, i.e. that of implementing a new role within an existing team, proved to be less problematic within Starting Well. These issues are discussed in relation to current policy and practice debates. PMID:17059494

  13. Computer-Based 3D Simulation: A Study of Communication Practices in a Trauma Team Performing Patient Examination and Diagnostic Work

    ERIC Educational Resources Information Center

    Krange, Ingeborg; Moen, Anne; Ludvigsen, Sten

    2012-01-01

    Diagnostic work in trauma teams is critical for the patient's condition and for the possibility of survival. It is a difficult situation to train due to the inherently unpredictable and time-critical practice when an injured patient presents in the Emergency Room (ER). Different types of simulations have been developed for specialized training of…

  14. Explosive ordinance disposal team equipment and its use in diagnosing extremity trauma.

    PubMed

    Midla, George S; McGranahan, Mark E

    2002-12-01

    A 31-year-old man presented to the Rakkasan battalion aid station, located at the Qandahar Airport, Afghanistan, with complaints and physical findings consistent with those that would either support a grade III ankle sprain or fracture. The battalion aid station is an echelon I level of care. This facility does not have radiographic capabilities. With the closest radiology facility located in Seeb, Oman the 710th Explosive Ordinance Disposal team, which was operating in the area, was contacted. This unit was able to perform radiographs in a timely manner to help aid in correctly diagnosing the injury. PMID:12502182

  15. Abusive head trauma and accidental head injury: a 20-year comparative study of referrals to a hospital child protection team

    PubMed Central

    John, Simon; Vincent, Andrea L; Reed, Peter

    2015-01-01

    Aim To describe children referred for suspected abusive head trauma (AHT) to a hospital child protection team in Auckland, New Zealand. Methods Comparative review of demographics, histories, injuries, investigations and diagnostic outcomes for referrals under 15 years old from 1991 to 2010. Results Records were available for 345 children. Referrals increased markedly (88 in the first decade, 257 in the second), but the diagnostic ratio was stable: AHT 60%, accidental or natural 29% and uncertain cause 11%. The probability of AHT was similar regardless of socio-economic status or ethnicity. In children under 2 years old with accidental head injuries (75/255, 29%) or AHT (180/255, 71%), characteristics of particular interest for AHT included no history of trauma (88/98, 90%), no evidence of impact to the head (84/93, 90%), complex skull fractures with intracranial injury (22/28, 79%), subdural haemorrhage (160/179, 89%) and hypoxic ischaemic injury (38/39, 97%). In children over 2 years old, these characteristics did not differ significantly between children with accidental head injuries (21/47, 45%) and AHT (26/47, 55%). The mortality of AHT was higher in children over 2 years old (10/26, 38%) than under 2 years (19/180, 11%). Conclusions The striking increase in referrals for AHT probably represents increasing incidence. The decision to refer a hospitalised child with a head injury for assessment for possible AHT should not be influenced by socio-economic status or ethnicity. Children over 2 years old hospitalised for AHT are usually injured by mechanisms involving impact and should be considered at high risk of death. PMID:26130384

  16. Geriatric Trauma.

    PubMed

    Reske-Nielsen, Casper; Medzon, Ron

    2016-08-01

    Within the next 15 years, 1 in 5 Americans will be over age 65. $34 billion will be spent yearly on trauma care of this age group. This section covers situations in trauma unique to the geriatric population, who are often under-triaged and have significant injuries underestimated. Topics covered include age-related pathophysiological changes, underlying existing medical conditions and certain daily medications that increase the risk of serious injury in elderly trauma patients. Diagnostic evaluation of this group requires liberal testing, imaging, and a multidisciplinary team approach. Topics germane to geriatric trauma including hypothermia, elder abuse, and depression and suicide are also covered. PMID:27475011

  17. Video recording of emergency department trauma resuscitations.

    PubMed

    Brown, Debra M

    2003-01-01

    Although hospitals are faced with the challenges of appropriately informing the public regarding health care and protecting the privacy of patients, a comprehensive policy concerning videotaping of trauma resuscitations can be developed to comply with regulatory bodies. Video recording of trauma team resuscitations can be utilized as an effective quality improvement tool to evaluate trauma team performance, psychomotor skills and techniques, and to identify educational needs related to specific trauma populations. Video recording of Trauma resuscitations is an effective tool for improving trauma team performance by educating clinical staff regarding roles and responsibilities. PMID:16265920

  18. Trauma system development.

    PubMed

    Lendrum, R A; Lockey, D J

    2013-01-01

    The word 'trauma' describes the disease entity resulting from physical injury. Trauma is one of the leading causes of death worldwide and deaths due to injury look set to increase. As early as the 1970s, it became evident that centralisation of resources and expertise could reduce the mortality rate from serious injury and that organisation of trauma care delivery into formal systems could improve outcome further. Internationally, trauma systems have evolved in various forms, with widespread reports of mortality and functional outcome benefits when major trauma management is delivered in this way. The management of major trauma in England is currently undergoing significant change. The London Trauma System began operating in April 2010 and others throughout England became operational this year. Similar systems exist internationally and continue to be developed. Anaesthetists have been and continue to be involved with all levels of trauma care delivery, from the provision of pre-hospital trauma and retrieval teams, through to chronic pain management and rehabilitation of patients back into society. This review examines the international development of major trauma care delivery and the components of a modern trauma system. PMID:23210554

  19. Trauma in the geriatric population.

    PubMed

    Maxwell, Cathy A

    2015-06-01

    Injury in older adults is a looming public health crisis. This article provides a broad overview of geriatric trauma across the continuum of care. After a review of the epidemiology of geriatric trauma, optimal approaches to patient care are presented for triage and transport, trauma team activation and initial assessment, inpatient management, and injury prevention. Special emphasis is given to assessment of frailty, advanced care planning, and transitions of care. PMID:25981722

  20. Assuring optimal trauma care: the role of trauma centre accreditation

    PubMed Central

    Simons, Richard; Kirkpatrick, Andrew

    2002-01-01

    Optimal care of the injured patient requires the delivery of appropriate, definitive care shortly after injury. Over the last 30 to 40 years, civilian trauma systems and trauma centres have been developed in the United States based on experience gained in military conflicts, particularly in Korea and Vietnam. A similar process is evolving in Canada. National trauma committees in the US and Canada have defined optimal resources to meet the goal of rapid, appropriate care in trauma centres. They have introduced programs (verification or accreditation) to externally audit trauma centre performance based on these guidelines. It is generally accepted that implementing trauma systems results in decreased preventable death and improved survival after trauma. What is less clear is the degree to which each facet of trauma system development contributes to this improvement. The relative importance of national performance guidelines and trauma centre audit as integral steps toward improved outcomes following injury are reviewed. Current Trauma Association of Canada guidelines for trauma centres are presented and the process of trauma centre accreditation is discussed. PMID:12174987

  1. MRI Evaluation of Patella Alignment Before and After Anatomical Reconstruction of ACL Undergoing Unified Rehabilitation Programme Introduced by CMC Physical Therapy Team

    PubMed Central

    Straszewski, Dariusz; Plenzler, Marcin; Szczepaniak, Joanna; Śmigielski, Robert; Ciszkowska-Łysoń, Beata; Popieluch, Marcin; Kopko, Szymon

    2014-01-01

    Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by

  2. Team Learning in Teacher Teams: Team Entitativity as a Bridge between Teams-in-Theory and Teams-in-Practice

    ERIC Educational Resources Information Center

    Vangrieken, Katrien; Dochy, Filip; Raes, Elisabeth

    2016-01-01

    This study aimed to investigate team learning in the context of teacher teams in higher vocational education. As teacher teams often do not meet all criteria included in theoretical team definitions, the construct "team entitativity" was introduced. Defined as the degree to which a group of individuals possesses the quality of being a…

  3. Facial trauma

    MedlinePlus

    Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 23. Mayersak RJ. Facial trauma. In: Marx JA, Hockberger RS, ...

  4. Facial trauma

    MedlinePlus

    Maxillofacial injury; Midface trauma; Facial injury; LeFort injuries ... Kellman RM. Maxillofacial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: ...

  5. Systemic trauma.

    PubMed

    Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

    2014-01-01

    Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering. PMID:24617751

  6. Adopting Team Contracts to Initiate Team Learning

    ERIC Educational Resources Information Center

    Marcellino, Patricia Ann

    2008-01-01

    Creighton, Harris and Coleman (2005) suggest that educational leadership instructors introduce aspiring administrators to a sound knowledge base. Currently, engaging in teams is recommended for high performance and problem-solving. Bolton (1999) recommends that instructors coach teams so teaming skills are improved. But, oftentimes, there are team…

  7. Elite Teams Get the Job Done.

    ERIC Educational Resources Information Center

    Labich, Kenneth

    1996-01-01

    Looks at highly successful, noncorporate teams--U.S. Navy SEALs; the Dallas Cowboys; the Tokyo String Quartet; the University of North Carolina women's soccer team; the Massachusetts General Hospital emergency-trauma team; Boots and Coots, hellfighters; and the Childress NASCAR racing team--and discusses the secrets of their success. (JOW)

  8. Pitfalls in penetrating trauma.

    PubMed

    van Vugt, A B

    2003-08-01

    In Western Europe the most frequent cause of multiple injuries is blunt trauma. Only few of us have experience with penetrating trauma, without exception far less than in the USA or South-Africa. In Rotterdam, the Erasmus Medical Centre is a level I trauma centre, situated directly in the town centre. All penetrating traumas are directly presented to our emergency department by a well organized ambulance service supported by a mobile medical team if necessary. The delay with scoop and run principles is very short for these cases, resulting in severely injured reaching the hospital alive in increasing frequency. Although the basic principles of trauma care according to the guidelines of the Advanced Trauma Life Support (ATLS) (1-2) are the same for blunt and penetrating trauma with regard to priorities, diagnostics and primary therapy, there are some pitfalls in the strategy of management in penetrating trauma one should be aware of. Simple algorithms can be helpful, especially in case of limited experience (3). In case of life-saving procedures, the principles of Damage Control Surgery (DCS) must be followed (4-5). This approach is somewhat different from "traditional" surgical treatment. In the Ist phase prompt interventions by emergency thoracotomy and laparotomy are carried out, with only two goals to achieve: surgical control of haemorrhage and contamination. After temporary life-saving procedures, the 2nd phase is characterized by intensive care treatment, dealing with hypothermia, metabolic acidosis and clotting disturbances. Finally in the 3rd phase, within 6-24 hours, definitive surgical care takes place. In this overview, penetrating injuries of neck, thorax, abdomen and extremities will be outlined. Penetrating cranial injuries, as a neurosurgical emergency with poor prognosis, are not discussed. History and physical examination remain the corner stones of good medical praxis. In a work-up according to ATLS principles airway, breathing and circulation

  9. [Chest trauma].

    PubMed

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. PMID:21640287

  10. Tailbone trauma

    MedlinePlus

    Choi SB, Cwinn AA. Pelvic trauma. In: Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 55. Vora ...

  11. Team coordination dynamics.

    PubMed

    Gorman, Jamie C; Amazeen, Polemnia G; Cooke, Nancy J

    2010-07-01

    Team coordination consists of both the dynamics of team member interaction and the environmental dynamics to which a team is subjected. Focusing on dynamics, an approach is developed that contrasts with traditional aggregate-static concepts of team coordination as characterized by the shared mental model approach. A team coordination order parameter was developed to capture momentary fluctuations in coordination. Team coordination was observed in three-person uninhabited air vehicle teams across two experimental sessions. The dynamics of the order parameter were observed under changes of a team familiarity control parameter. Team members returned for the second session to either the same (Intact) or different (Mixed) team. 'Roadblock' perturbations, or novel changes in the task environment, were introduced in order to probe the stability of team coordination. Nonlinear dynamic methods revealed differences that a traditional approach did not: Intact and Mixed team coordination dynamics looked very different; Mixed teams were more stable than Intact teams and explored the space of solutions without the need for correction. Stability was positively correlated with the number of roadblock perturbations that were overcome successfully. The novel and non-intuitive contribution of a dynamical analysis was that Mixed teams, who did not have a long history working together, were more adaptive. Team coordination dynamics carries new implications for traditional problems such as training adaptive teams. PMID:20587302

  12. Does Size and Location of the Vital Signs Monitor Matter? A Study of Two Trauma Centers

    PubMed Central

    Sarcevic, Aleksandra; Marsic, Ivan; Burd, Randall S.

    2010-01-01

    We report the results of an observational study in which we compared how the size and location of the vital signs monitor impact teamwork at two trauma centers. Our observations focused on three factors: information exchange, situational awareness, and ergonomic issues. We found that the smaller display was difficult to view and required more team communication and workarounds, such as periodic verbal reports. The larger and closer display, although accessible to more team members, did not uniformly improve team’s situational awareness because vital signals were not verbalized and the monitor was often ignored. We suggest introducing multiple larger and closer displays, while keeping the practice of periodic verbal reporting. PMID:21347070

  13. Introducing Vectors.

    ERIC Educational Resources Information Center

    Roche, John

    1997-01-01

    Suggests an approach to teaching vectors that promotes active learning through challenging questions addressed to the class, as opposed to subtle explanations. Promotes introducing vector graphics with concrete examples, beginning with an explanation of the displacement vector. Also discusses artificial vectors, vector algebra, and unit vectors.…

  14. Introducing "Excel"

    ERIC Educational Resources Information Center

    Tyrrell, Sidney

    2006-01-01

    In this brief article, the author instructs teachers on how to produce an interactive spreadsheet from scratch in about 20 minutes and en route equip themselves and their students, with handy "Excel" skills. The aim is to introduce the basics of "Excel," plus some fun bits, speedily and with a purpose; producing something that is useful in its own…

  15. Management of Pediatric Trauma.

    PubMed

    2016-08-01

    Injury is still the number 1 killer of children ages 1 to 18 years in the United States (http://www.cdc.gov/nchs/fastats/children.htm). Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region. Only the comprehensive cooperation of a broadly diverse trauma team will have a significant effect on improving the care of injured children. PMID:27456509

  16. Elderly trauma.

    PubMed

    Holleran, Renee Semonin

    2015-01-01

    Across the world, the population is aging. Adults 65 years and older make up one of the fastest growing segments of the US population. Trauma is a disease process that affects all age groups. The mortality and morbidity that result from an injury can be influenced by many factors including age, physical condition, and comorbidities. The management of the elderly trauma patient can present some unique challenges. This paper addresses the differences that occur in the management of elderly patient who has been injured. This paper also includes a discussion of how to prevent injury in the elderly. PMID:26039652

  17. Redesigning the response to patients with trauma.

    PubMed

    Edwards, Carla; Seggie, Julie; Murphy, Margaret

    2012-06-01

    In 2008, a multidisciplinary team of nurses, doctors, clerical staff, a social worker and paramedic at Westmead Hospital, Sydney, New South Wales, began a project to redesign the composition and practice of the hospital's trauma team. This article describes the process involved and explains why staff collaboration, the involvement of stakeholders and the sponsorship of the hospital executive team were crucial to the success of the project. These principles can be transferred to other hospitals. PMID:22876507

  18. An organized approach to trauma care: legacy of R Adams Cowley.

    PubMed

    Edlich, Richard F; Wish, John R; Britt, L D; Long, William B

    2004-01-01

    The organized approach to caring for trauma patients was introduced into the civilian setting by the innovative pioneer, R Adams Cowley. His system in Maryland has the following 11 components: (1) a State Police Aviation Division that transports patients throughout the State; (2) trained paramedics at the scene of the accident as well as on the helicopter, who will stabilize the patients en route to the Shock Trauma Center; (3) one central dispatch communication center in Baltimore that coordinates information between paramedics and the Trauma Center; (4) a Shock Trauma Center with a helicopter landing zone near the building; (5) trained trauma nurses and trauma technicians to transfer the patient from the helicopter by stretcher to the resuscitation area; if there is a special complication, such as an airway problem, the anesthesiologist and or trauma surgeon may meet the helicopter on the roof as well; (6) trauma surgeons, board-certified in surgery, with a certificate of added qualification in surgical critical care, to treat the critically ill trauma patients in the resuscitation area; (7) a CT scan and portable X-ray units in the admission area that aid in the diagnosis of the injury; (8) operating rooms adjacent to the admission area for repair of trauma injuries; (9) a surgical intensive unit to care for the trauma patient; (10) a team of specialty physicians trained in a wide variety of specialties who work as a multidisciplinary unit caring for the hospitalized patient; and (11) an ambulatory outpatient unit that allows the patient to be followed in the center after discharge. Dr. R Adams Cowley incorporated each of these 11 components for an organized trauma center into Maryland. In recognition of his landmark contributions to trauma, the eight-story Shock Trauma Center was named the R Adams Cowley Shock Trauma Center. There is growing evidence that this organized system in trauma care seen in Maryland must be replicated in every state in our nation. The

  19. Shock trauma.

    PubMed

    Trunkey, D D

    1984-09-01

    Trauma - accidental or intentional injury - is a major health and social problem. It is still the chief cause of death in people between the ages of 1 and 38 years. In the United States, the mortality due to trauma between the ages of 15 and 24 years increased by 13% from 1960 to 1978. During the same period, the mortality for people aged 25 to 64 years declined by 16%. Murders have increased from 8464 in 1960, to 26 000 in 1982. The overall death rate of American teenagers and young adults is 50% higher than that of their counterparts in Britain, Sweden and Japan. Trauma affects young, productive citizens, and the estimated costs for death, disability and loss of productivity exceed $230 million a day. The most tragic statistic is that at least 40% of the deaths are needless and preventable if better treatment and prevention programs were available. Trauma deaths that might be prevented are those due to motor vehicle accidents, homicide, burns, and alcohol and drug abuse. In this paper suggestions for prevention are made. They include improved crash worthiness of motor vehicles, revocation of drunk drivers' licences, use of devices that limit drunk drivers, increased tax on alcohol and random breathalyser tests, and the use of seat belts and motorcycle helmets. Control of hand-guns and burn characteristics of cigarettes could also reduce deaths. The problems and issues in trauma care can be divided into two broad categories: system and professional. System problems include prehospital care, in-hospital care, rehabilitation and prevention. Professional problems include education, research, economics, and quality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6478325

  20. Virtual worlds and team training.

    PubMed

    Dev, Parvati; Youngblood, Patricia; Heinrichs, W Leroy; Kusumoto, Laura

    2007-06-01

    An important component of all emergency medicine residency programs is managing trauma effectively as a member of an emergency medicine team, but practice on live patients is often impractical and mannequin-based simulators are expensive and require all trainees to be physically present at the same location. This article describes a project to develop and evaluate a computer-based simulator (the Virtual Emergency Department) for distance training in teamwork and leadership in trauma management. The virtual environment provides repeated practice opportunities with life-threatening trauma cases in a safe and reproducible setting. PMID:17574193

  1. Team Participation in Environmental Biology

    ERIC Educational Resources Information Center

    Musgrave, A. J.

    1969-01-01

    Describes experiments on the nutrition of weevils suitable for student teams, each team replicating the same experiment or experiments. Gives step by step experimental procedures and useful background information on weevils. Designed to introduce students to teamwork in science. (EB)

  2. Penetrating trauma

    PubMed Central

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Zaric, Bojan; Branislav, Perin; Dervelegas, Konstantinos; Porpodis, Konstantinos

    2014-01-01

    Pneumothorax occurs when air enters the pleural space. Currently there is increasing incidence of road traffic accidents, increasing awareness of healthcare leading to more advanced diagnostic procedures, and increasing number of admissions in intensive care units are responsible for traumatic (non iatrogenic and iatrogenic) pneumothorax. Pneumothorax has a clinical spectrum from asymptomatic patient to life-threatening situations. Diagnosis is usually made by clinical examination and imaging techniques. In our current work we focus on the treatment of penetrating trauma. PMID:25337403

  3. Penetrating trauma.

    PubMed

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Zaric, Bojan; Branislav, Perin; Dervelegas, Konstantinos; Porpodis, Konstantinos; Zarogoulidis, Paul

    2014-10-01

    Pneumothorax occurs when air enters the pleural space. Currently there is increasing incidence of road traffic accidents, increasing awareness of healthcare leading to more advanced diagnostic procedures, and increasing number of admissions in intensive care units are responsible for traumatic (non iatrogenic and iatrogenic) pneumothorax. Pneumothorax has a clinical spectrum from asymptomatic patient to life-threatening situations. Diagnosis is usually made by clinical examination and imaging techniques. In our current work we focus on the treatment of penetrating trauma. PMID:25337403

  4. Trauma-Informed Care in the Massachusetts Child Trauma Project.

    PubMed

    Bartlett, Jessica Dym; Barto, Beth; Griffin, Jessica L; Fraser, Jenifer Goldman; Hodgdon, Hilary; Bodian, Ruth

    2016-05-01

    Child maltreatment is a serious public health concern, and its detrimental effects can be compounded by traumatic experiences associated with the child welfare (CW) system. Trauma-informed care (TIC) is a promising strategy for addressing traumatized children's needs, but research on the impact of TIC in CW is limited. This study examines initial findings of the Massachusetts Child Trauma Project, a statewide TIC initiative in the CW system and mental health network. After 1 year of implementation, Trauma-Informed Leadership Teams in CW offices emerged as key structures for TIC systems integration, and mental health providers' participation in evidence-based treatment (EBT) learning collaboratives was linked to improvements in trauma-informed individual and agency practices. After approximately 6 months of EBT treatment, children had fewer posttraumatic symptoms and behavior problems compared to baseline. Barriers to TIC that emerged included scarce resources for trauma-related work in the CW agency and few mental providers providing EBTs to young children. Future research might explore variations in TIC across service system components as well as the potential for differential effects across EBT models disseminated through TIC. PMID:26564909

  5. Reaching Out: Team AETHER

    NASA Technical Reports Server (NTRS)

    Murphy, Gloria A.

    2010-01-01

    Embry Riddle Aeronautical University's Daytona Beach Campus Lunabotics Team took the opportunity to share the love of space, engineering and technology through the educational outreach portion of the competition. Through visits to elementary schools and high schools, and through support of science fairs and robotics competitions, younger generations were introduced to space, engineering and robotics. This report documents the outreach activities of team Aether.

  6. Vascular Radiology in Trauma: A Review

    SciTech Connect

    Nicholson, Anthony A.

    2004-03-15

    It's been 30 years since an endovascular technique to control traumatic hemorrhage was first described. Despite major technical advances in both diagnostic and therapeutic technology, and a great deal of experience since then, endovascular techniques are rarely considered as part of frontline management for vascular trauma. This review considers the literature and calls for better planning and implementation of diagnostic and image=guided therapeutic facilities. Endovascular techniques should be an essential part of vascular trauma management along with endovascular specialists, partners in trauma teams.

  7. Lightweight Trauma Module - LTM

    NASA Technical Reports Server (NTRS)

    Hatfield, Thomas

    2008-01-01

    Current patient movement items (PMI) supporting the military's Critical Care Air Transport Team (CCATT) mission as well as the Crew Health Care System for space (CHeCS) have significant limitations: size, weight, battery duration, and dated clinical technology. The LTM is a small, 20 lb., system integrating diagnostic and therapeutic clinical capabilities along with onboard data management, communication services and automated care algorithms to meet new Aeromedical Evacuation requirements. The Lightweight Trauma Module is an Impact Instrumentation, Inc. project with strong Industry, DoD, NASA, and Academia partnerships aimed at developing the next generation of smart and rugged critical care tools for hazardous environments ranging from the battlefield to space exploration. The LTM is a combination ventilator/critical care monitor/therapeutic system with integrated automatic control systems. Additional capabilities are provided with small external modules.

  8. Toxic trauma.

    PubMed

    Moles, T M; Baker, D J

    2001-01-01

    Hazardous materials (HAZMAT) carry many inherent dangers. Such materials are distributed widely in industrial and military sites. Toxic trauma (TT) denotes the complex of systemic and organ injury caused by toxic agents. Often, TT is associated with other injuries that also require the application of life-support techniques. Rapid onset of acute respiratory failure and consequent cardiovascular failure are of primary concern. Management of TT casualties is dependent upon the characteristics of the toxic agents involved and on the demographics surrounding the HAZMAT incident. Agents that can produce TT possess two pairs of salient characteristics: (1) causality (toxicity and latency), and (2) EMS system (persistency and transmissibility). Two characteristics of presentations are important: (1) incident presentation, and (2) casualty presentation. In addition, many of these agents complicate the processes associated with anaesthesia and must be dealt with. Failure of recognition of these factors may result in the development of respiratory distress syndromes and multiorgan system failure, or even death. PMID:11513285

  9. Enabling Team Learning in Healthcare

    ERIC Educational Resources Information Center

    Boak, George

    2016-01-01

    This paper is based on a study of learning processes within 35 healthcare therapy teams that took action to improve their services. The published research on team learning is introduced, and the paper suggests it is an activity that has similarities with action research and with those forms of action learning where teams address collective…

  10. Trauma care systems in Spain.

    PubMed

    Queipo de Llano, E; Mantero Ruiz, A; Sanchez Vicioso, P; Bosca Crespo, A; Carpintero Avellaneda, J L; de la Torre Prado, M V

    2003-09-01

    Trauma care systems in Spain are provided by the Nacional Health Service in a decentralized way by the seventeen autonomous communities whose process of decentralization was completed in January 2002. Its organisation is similar in all of them. Public sector companies of sanitary emergencies look after the health of citizens in relation to medical and trauma emergencies with a wide range of up to date resources both technical and human. In the following piece there is a description of the emergency response teams divided into ground and air that are responsible for the on site care of the patients in coordination with other public services. They also elaborate the prehospital clinical history that is going to be a valuable piece of information for the teams that receive the patient in the Emergency Hospital Unit (EHU). From 1980 to 1996 the mortality rate per 10.000 vehicles and the deaths per 1.000 accidents dropped significantly: in 1980 6.4 and 96.19% and in 1996, 2.8 and 64.06% respectively. In the intrahospital organisation there are two differentiated areas to receive trauma patients the casualty department and the EHU. In the EHU the severe and multiple injured patients are treated by the emergency hospital doctors; first in the triage or resuscitation areas and after when stabilised they are passed too the observation area or to the Intensive Care Unit (ICU) and from there the EHU or ICU doctors call the appropriate specialists. There is a close collaboration and coordination between the orthopaedic surgeon the EHU doctors and the other specialists surgeons in order to comply with treatment prioritization protocols. Once the patient has been transferred an entire process of assistance continuity is developed based on interdisciplinary teams formed in the hospital from the services areas involved in trauma assistance and usually coordinated by the ICU doctors. There is also mentioned the assistance registry of trauma patients, the ICU professional training

  11. The patient safety culture as perceived by staff at two different emergency departments before and after introducing a flow-oriented working model with team triage and lean principles: a repeated cross-sectional study

    PubMed Central

    2014-01-01

    Background Patient safety is of the utmost importance in health care. The patient safety culture in an institution has great impact on patient safety. To enhance patient safety and to design strategies to reduce medical injuries, there is a current focus on measuring the patient safety culture. The aim of the present study was to describe the patient safety culture in an ED at two different hospitals before and after a Quality improvement (QI) project that was aimed to enhance patient safety. Methods A repeated cross-sectional design, using the Hospital Survey On Patient Safety Culture questionnaire before and after a quality improvement project in two emergency departments at a county hospital and a university hospital. The questionnaire was developed to obtain a better understanding of the patient safety culture of an entire hospital or of specific departments. The Swedish version has 51 questions and 15 dimensions. Results At the county hospital, a difference between baseline and follow-up was observed in three dimensions. For two of these dimensions, Team-work within hospital and Communication openness, a higher score was measured at the follow-up. At the university hospital, a higher score was measured at follow-up for the two dimensions Team-work across hospital units and Team-work within hospital. Conclusion The result showed changes in the self-estimated patient safety culture, mainly regarding team-work and communication openness. Most of the improvements at follow-up were seen by physicians, and mainly at the county hospital. PMID:25005231

  12. Team Teaching.

    ERIC Educational Resources Information Center

    Cunningham, David C.

    1963-01-01

    A study was designed to evaluate the effectiveness of principals in structuring teaching teams; to assess background and personality characteristics appearing essential to successful individual and team performance; and to select personality factor scores which would predict individual and team success. Subjects were 31 teaching teams (99…

  13. Team Management.

    ERIC Educational Resources Information Center

    Lindelow, John; Bentley, Scott

    Chapter 6 of a revised volume on school leadership, this chapter defines and explains management teams and describes several successful examples of team management. Superintendents have come to rely on their management team's expertise to resolve increasingly complex policy, administrative, and instructional issues. Although team management has…

  14. Transforming US Army trauma care: an evidence-based review of the trauma literature.

    PubMed

    Remick, Kyle N; Dickerson, James A; Nessen, Shawn C; Rush, Robert M; Beilman, Greg J

    2010-01-01

    The US Army has been charged to transform to meet the demands of current and anticipated near-future combat needs, covering a full spectrum of military operations. The US Army combat trauma care system was created to deliver combat casualty care in a variety of situations and has been adapted to meet the needs of such care in both Operations Enduring Freedom and Iraqi Freedom. Questions related to our current system include the use and positioning of medical evacuation assets, the type of training for our trauma care providers, the positioning of these providers in proximity to the battlefield, and the type of units most suited to the wide variety of medical operations required of today's military medical team. The review was performed to evaluate available information in light of anticipated future needs to ensure preparedness. We reviewed trauma literature regarding the areas of civilian trauma systems, military trauma systems, presurgical trauma care, medical evacuation times, and the medical evacuation system. Among the conclusions drawn from the reviewed data include the following: regional trauma systems improve outcomes in significantly-injured patients; rural trauma care as part of a trauma system yields improved results compared to nontrauma hospitals and comparable results to those at a higher level center; and delivery of advanced trauma life support care has the potential to extend the period of time of safe medical evacuation to surgical capabilities. These lessons are used to discuss components of an improved system of trauma care, flexible for the varied needs of modern battlefield trauma and adaptable to provide support for anticipated future conflicts. PMID:21181650

  15. Teamwork improvement in emergency trauma departments

    PubMed Central

    Khademian, Zahra; Sharif, Farkhondeh; Tabei, Seyed Ziaadin; Bolandparvaz, Shahram; Abbaszadeh, Abbas; Abbasi, Hamid Reza

    2013-01-01

    Background: Interprofessional teamwork is considered as the key to improve the quality of patient management in critical settings such as trauma emergency departments, but it is not fully conceptualized in these areas to guide practice. The aim of this article is to explore interprofessional teamwork and its improvement strategies in trauma emergency departments. Materials and Methods: Participants of this qualitative study consisted of 11 nurses and 6 supervisors recruited from the emergency departments of a newly established trauma center using purposive sampling. Data were generated using two focus group and six in-depth individual interviews, and analyzed using qualitative content analysis. Results: Interprofessional teamwork attributes and improvement strategies were emerged in three main themes related to team, context, and goal. These were categorized as the effective presence of team members, role definition in team framework, managerial and physical context, effective patient management, and overcoming competing goals Conclusions: Interprofessional teamwork in trauma emergency departments is explained as interdependence of team, context, and goal; so, it may be improved by strengthening these themes. The findings also provide a basis to evaluate, teach, and do research on teamwork. PMID:24403932

  16. [Who is who revisited: spinal trauma].

    PubMed

    Schueller, G

    2010-12-01

    The ideal classification of spinal trauma does not yet exist, primarily because the combination of morphological, biomechanical and clinical parameters in one single nomenclature has proved impossible. For radiologists and surgeons who work closely together, only a few classifications of injury patterns have been shown to be useful enough to provide rapid and stable therapy decisions. Many classifications are too complex to be practical for day-to-day practice, such as the Magerl classification, which has been adopted by the Arbeitsgemeinschaft für Osteosynthesefragen (AO). Not least because of this classification difficulty, eponyms and synonyms are widely used to describe trauma of the spine, comparable to the number of terms used to describe fractures of the upper and lower limbs. The members of trauma teams should be aware of the definitions of these terms as well as the strengths and limitations of the existing classifications of spinal trauma. PMID:20967415

  17. Abusive head trauma: past, present, and future.

    PubMed

    Narang, Sandeep; Clarke, Jennifer

    2014-12-01

    Abusive head trauma has a robust and interesting scientific history. Recently, the American Academy of Pediatrics has endorsed a change in terminology to a term that is more general in describing the vast array of abusive mechanisms that can result in pediatric head injury. Simply defined, abusive head trauma is "child physical abuse that results in injury to the head or brain." Abusive head trauma is a relatively common cause of childhood neurotrauma, with an estimated incidence of 16 to 33 cases per 100,000 children per year in the first 2 years of life. Clinical findings are variable; AHT should be considered in all children with neurologic signs and symptoms, especially if no or only mild trauma is described. Subdural and retinal hemorrhages are the most common findings. The current best evidence-based literature has identified some features--apnea and severe retinal hemorrhages--that reliably discriminate abusive from accidental injury. Longitudinal studies of outcomes in abusive head trauma patients demonstrate that approximately one-third of the children are severely disabled, one third of them are moderately disabled, and one third have no or only mild symptoms. Abusive head trauma cases are complex cases that require a rigorous, multidisciplinary team approach. The clinician can establish this diagnosis with confidence if he/she maintains a high index of suspicion for the diagnosis, has knowledge of the signs, symptoms, and risk factors of abusive head trauma, and reasonably excludes other etiologies on the differential diagnosis. PMID:25316728

  18. Rural trauma management.

    PubMed

    Wayne, R

    1989-05-01

    Rural trauma is a major problem in the United States. Up to 70 percent of trauma fatalities occur in rural areas, even though 70 percent of the population live in urban areas. Over the past 3 decades, numerous studies have defined the concept of preventable trauma death in both rural and urban populations. With the development of a regional trauma care system in Oregon, preventable trauma mortality should decrease. An effort was made to improve the quality of trauma care in Clatsop County, Oregon, a community of 30,000 people with 2 small rural hospitals. To obtain this goal, four steps were taken: (1) physician and nurse education was improved, (2) trauma protocols promoting prompt resuscitation and stabilization of patients were established, (3) regular trauma case reviews were conducted, and (4) emergency medical technician and prehospital management were coordinated. This study reviews the trail from sporadic, uncoordinated rural trauma care to the designation process. PMID:2712202

  19. Relationship between trauma narratives and trauma pathology.

    PubMed

    Amir, N; Stafford, J; Freshman, M S; Foa, E B

    1998-04-01

    In this study we examined the relationship between posttrauma pathology and the level of articulation (complexity) in rape narratives recounted by victims shortly after the assault. Degree of articulation was operationalized as the reading level of the narrative as determined by a computer program. Shortly after the trauma, reading level was correlated with severity of anxiety but not with posttraumatic stress disorder (PTSD) symptoms. Degree of the narrative articulation shortly after the trauma, however, was related to severity of later PTSD. These results are consistent with the hypothesis that the less developed trauma narratives hinder recovery from trauma. PMID:9565923

  20. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  1. Team Management.

    ERIC Educational Resources Information Center

    Lindelow, John

    Chapter 5 of a volume on school leadership, this chapter reviews the literature to define and explain management teams and to describe several successful management team arrangements. The author begins by noting that team management has recently enjoyed a resurgence as a response to collective negotiations, but beyond this function can have value…

  2. The Genesis of a Trauma Performance Improvement Plan.

    PubMed

    Pidgeon, Kristopher

    2015-01-01

    The purpose of this article is to assist the trauma medical and program director with developing a performance improvement and patients safety plan (PIPS), which is a required component of a successful trauma verification process by the American College of Surgeons. This article will review trauma quality standards and will describe in detail the required elements of a successful trauma center's performance improvement plan including a written comprehensive plan that outlines the mission and vision of the PIPS Program, authority of the PIPS Program, PIPS Program Committee reporting structure to the other hospital committees, list of required PIPS multidisciplinary team members, the operational components of the utilized data management system (trauma registry), list of indicators/audit filters, levels of review, peer determinations, corrective action plan with implementation, event resolution, and reevaluation. Strategies to develop a successful trauma performance improvement plan are presented. PMID:26574945

  3. Management of hemorrhage in trauma.

    PubMed

    Schöchl, Herbert; Grassetto, Alberto; Schlimp, Christoph J

    2013-08-01

    Hemorrhage remains one of the leading causes of trauma-related deaths. Uncontrolled diffuse microvascular bleeding in the course of initial care is common, potentially resulting in exsanguination. Early and aggressive hemostatic intervention increases survival and reduces the incidence of massive transfusion. Thus, timely diagnosis of the underlying coagulation disorders is mandatory. It has been shown that standard coagulation tests do not sufficiently characterize trauma-induced coagulopathy (TIC). This has led to increasing interest in alternatives, such as the viscoelastic test, to diagnose TIC and to provide the basis for a goal-directed hemostatic therapy. The concept of damage control resuscitation (DCR) has been introduced widely in trauma patients with severe bleeding. This strategy addresses important confounders of the coagulation process such as hemodilution, hypothermia, and acidosis; DCR is based on a damage control surgical approach, permissive hypotension, and improvement of hemostatic competence. Many studies have shown benefit in mortality when using high ratios of fresh frozen plasma (FFP) to red blood cells (RBC) as early treatment. However, there is increased awareness that coagulation factor concentrate could be beneficial in the treatment of trauma-induced coagulopathy. PMID:23910535

  4. Team Development of Virtual Teams

    ERIC Educational Resources Information Center

    Kim, Sooyoung

    2004-01-01

    Advanced technologies, globalization, the competitiveness of business, flexible working practices, and other rapid changes in the nature of work have all led to the booming of "virtual teams." This paper will provide an overview of virtual teams, including a description of their emergence, a definition and typology of the term "virtual team," an…

  5. Helping Youth Overcome Trauma

    ERIC Educational Resources Information Center

    Chambers, Jamie C.

    2005-01-01

    The effects of trauma can roll on unchecked like a spirit of death. In its path are strewn its once vibrant victims. Human bonds are rent asunder by the disgrace of trauma. These are the youngsters who have been verbally bashed, physically battered, sexually assaulted, and spiritually exploited. Other traumas of childhood neglect include: (1)…

  6. [The challenges faced in the field of trauma care in China].

    PubMed

    Jiang, Baoguo

    2015-06-01

    With the continuous development of China's urbanization and socio-economic, death and disability caused by trauma has increased prominently, and trauma has become the first cause of death in the people younger than 45 years old. Compared with the treatment of other diseases, China are facing many problems and challenges in terms of trauma treatment, specifically focused in three areas: First, the medical profession and society had not attach enough attention to trauma; Second, trauma centers in our country is insufficient; The level of trauma care vary greatly between different regions, the doctors and nurses commitment to trauma care lack of standardized training; Third, scientific treatment process and treatment system that compliance with international standards and meet the geographical features of China is insufficient. In view of the above situation and existing problems, learn from the successful experience of foreign countries, we think we should proceed from the following three aspects to change the status of China's treatment of trauma gradually: First of all, we should establish Traumatology that deals with the treatment of serious wounds and injuries. Secondly we should establish the right trauma care system that suitable for China's conditions; The third point is the establishment of trauma specialist training system composed by "basic training" and "targeted training"; Final we should establish severe trauma multidisciplinary treatment team model in the process of trauma care. Thereby improving our overall level of trauma treatment through above means, reduce the disability and mortality caused by trauma, thus promoting the development of trauma forward. PMID:26359050

  7. Computed tomography in trauma

    SciTech Connect

    Toombs, B.D.; Sandler, C.M.

    1987-01-01

    This book begins with a chapter dealing with the epidemiology and mechanisms of trauma. Trauma accounts for more lives lost in the United States than cancer and heart disease. The fact that 30%-40% of trauma-related deaths are caused by improper or delayed diagnoses or treatment emphasizes the importance of rapid and accurate methods to establish a diagnosis. Acute thoracic, abdominal, and pelvic trauma and their complications are discussed. A chapter on high-resolution CT of spinal and facial trauma and the role of three-dimensional reconstruction images is presented.

  8. Conservative treatment of liver trauma.

    PubMed

    Andersson, R; Bengmark, S

    1990-01-01

    A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted, especially during the last decade. This change in regimen was first seen in the handling of splenic trauma, initiated by pediatric surgeons. Later, the concept of conservative management was also introduced among adults and it is now widely accepted. Here, an almost mandatory splenectomy has been replaced by attempts at various forms of splenic salvage. The development followed an initial report by King and Shumacker in 1952 on an increased susceptibility to overwhelming sepsis in splenectomized children, findings which later also were demonstrated among adults. It has also been shown that the bleeding from intraparenchymal lesions with an intact splenic capsule or minor capsular tears frequently ceases spontaneously, hereby making nonoperative management possible in selective cases. PMID:2200210

  9. Early management of ballistic hand trauma.

    PubMed

    Eardley, W G P; Stewart, M P M

    2010-02-01

    Complex hand wounds are an unfortunate consequence of conflict. Increased battlefield survival rates have resulted in an evolving range of ballistic hand trauma encountered by deployed surgical teams, requiring increased knowledge and understanding of these injuries. In the civilian setting, the combined threats of gun crime and acts of terrorism warrant appreciation for such injury among all surgeons. Surgeons often have to relearn the management of ballistic hand trauma and other aspects of war surgery under difficult circumstances because the experiences of their predecessors may be forgotten. Current evidence regarding these injuries is scarce. Ballistic hand trauma is rarely isolated. The demand on surgical resources from combat injury is significant, and it is imperative that a phased strategy be followed in this setting. Minimal, accurate débridement and decompression with early stability are crucial. Delayed primary closure and an awareness of future reconstructive options are fundamental. PMID:20118328

  10. Developing and organizing a trauma system and mass casualty management: some useful observations from the israeli trauma model.

    PubMed

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care. PMID:23634336

  11. Developing and Organizing a Trauma System and Mass Casualty Management: Some Useful Observations from the Israeli Trauma Model

    PubMed Central

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care. PMID:23634336

  12. Yea, Team.

    ERIC Educational Resources Information Center

    Rinn, Fauneil J.; Weir, Sybil B.

    1984-01-01

    Four problems in higher education are identified: hardening curriculum, graying faculty, shrinking budget, and disappearing students. Team teaching is suggested as one solution. A conceptual framework for types of team teaching is presented and practical suggestions to those who want to work within that framework are provided. (Author/MLW)

  13. Developing psychological services following facial trauma.

    PubMed

    Choudhury-Peters, Deba; Dain, Vicky

    2016-01-01

    Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress. PMID:27493750

  14. Developing psychological services following facial trauma

    PubMed Central

    Choudhury-Peters, Deba; Dain, Vicky

    2016-01-01

    Adults presenting to oral and maxillofacial surgery services are at high risk of psychological morbidity. Research by the Institute of Psychotrauma and the centre for oral and maxillofacial surgery trauma clinic at the Royal London hospital (2015) demonstrated nearly 40% of patients met diagnostic criteria for either depression, post traumatic stress disorder (PTSD), anxiety, alcohol misuse, or substance misuse, or were presenting with facial appearance distress. Most facial injury patients were not receiving mental health assessment or treatment, and the maxillofacial team did not have direct access to psychological services. Based on these research findings, an innovative one-year pilot psychology service was designed and implemented within the facial trauma clinic. The project addressed this need by offering collaborative medical and psychological care for all facial injury patients. The project provided brief screening, assessment, and early psychological intervention. The medical team were trained to better recognise and respond to psychological distress. PMID:27493750

  15. Training nurses and technologists for trauma surgery.

    PubMed

    Ross, Cynthia

    2006-01-01

    Getting assigned to a trauma for the first time is still stressful for perioperative staff members. However, viewing the video/DVD does seem to help overcome some of the inherent anxiety. In addition, encouraging new or inexperienced staff nurses and technologists to participate on trauma cases with more seasoned staff also seems to alleviate some of those fears. Saying "let's make believe it's an emergency" and setting up quickly for a scheduled case will keep those skills current. Having staff members utilize "what if" scenarios tends to keep them thinking and anticipating. Prioritizing and reviewing all the case actions will allow nurses and technologists to perform these actions/skills in an emergency without even thinking. Although specific internal injuries a trauma patient will have cannot always be predicted, the perioperative staff members must still use their basic training to be ready for anything that comes through the doors to surgery. Making a video seemed like an overwhelming task at first, but the team sought out guidance and support from appropriate resources (videographer, surgeons, etc) in order to collaborate effectively, and the result was a great educational product. The Staff Development team continues to present inservices that are specialty or case specific. The "trauma" aspect of these presentations is also always included to reinforce the topics that were brought out in the video. PMID:17263102

  16. [Abusive head trauma: report of a case].

    PubMed

    Grana, M; Nazar, M; de Luca, S; Casalini, E; Eyheremendy, E

    2015-01-01

    The abusive head trauma is a form of child abuse. The most frequent injuries are intracranial lesions, such as subdural hematoma, as well as retinal hemorrhages, usually without other external injuries. Due to its complexity, this problem requires a multidisciplinary medical team, where the role of the radiologist is important, since there are multiple diagnostic methods that are complementary in order to arrive at the correct diagnosis. PMID:24853831

  17. Radiation dose from initial trauma assessment and resuscitation: review of the literature

    PubMed Central

    Hui, Catherine M.; MacGregor, John H.; Tien, Homer C.; Kortbeek, John B.

    2009-01-01

    Background Trauma care benefits from the use of imaging technologies. Trauma patients and trauma team members are exposed to radiation during the continuum of care. Knowledge of exposure amounts and effects are important for trauma team members. Methods We performed a review of the published literature; keywords included “trauma,” “patients,” “trauma team members,” “wounds,” “injuries,” “radiation,” “exposure,” “dose” and “computed tomography” (CT). We also reviewed the Board on Radiation Effects Research (BEIR VII) report, published in 2005 and 2006. Results We found no randomized controlled trials or studies. Relevant studies demonstrated that CT accounts for the single largest radiation exposure in trauma patients. Exposure to 100 mSv could result in a solid organ cancer or leukemia in 1 of 100 people. Trauma team members do not exceed the acceptable occupation radiation exposure determined by the National Council of Radiation Protection and Management. Modern imaging technologies such as 16- and 64-slice CT scanners may decrease radiation exposure. Conclusion Multiple injured trauma patients receive a substantial dose of radiation. Radiation exposure is cumulative. The low individual risk of cancer becomes a greater public health issue when multiplied by a large number of examinations. Though CT scans are an invaluable resource and are becoming more easily accessible, they should not replace careful clinical examination and should be used only in appropriate patients. PMID:19399211

  18. Interprofessional teamwork in the trauma setting: a scoping review.

    PubMed

    Courtenay, Molly; Nancarrow, Susan; Dawson, David

    2013-01-01

    Approximately 70 to 80% of healthcare errors are due to poor team communication and understanding. High-risk environments such as the trauma setting (which covers a broad spectrum of departments in acute services) are where the majority of these errors occur. Despite the emphasis on interprofessional collaborative practice and patient safety, interprofessional teamworking in the trauma setting has received little attention. This paper presents the findings of a scoping review designed to identify the extent and nature of this literature in this setting. The MEDLINE (via OVID, using keywords and MeSH in OVID), and PubMed (via NCBI using MeSH), and CINAHL databases were searched from January 2000 to April 2013 for results of interprofessional teamworking in the trauma setting. A hand search was conducted by reviewing the reference lists of relevant articles. In total, 24 published articles were identified for inclusion in the review. Studies could be categorized into three main areas, and within each area were a number of themes: 1) descriptions of the organization of trauma teams (themes included interaction between team members, and leadership); 2) descriptions of team composition and structure (themes included maintaining team stability and core team members); and 3) evaluation of team work interventions (themes included activities in practice and activities in the classroom setting).Descriptive studies highlighted the fluid nature of team processes, the shared mental models, and the need for teamwork and communication. Evaluative studies placed a greater emphasis on specialized roles and individual tasks and activities. This reflects a multiprofessional as opposed to an interprofessional model of teamwork. Some of the characteristics of high-performing interprofessional teams described in this review are also evident in effective teams in the community rehabilitation and intermediate care setting. These characteristics may well be pertinent to other settings, and

  19. Virtuoso teams.

    PubMed

    Fischer, Bill; Boynton, Andy

    2005-01-01

    Managing a traditional team seems pretty straightforward: Gather up whoever's available, give them time and space to do their jobs, and make sure they all play nicely together. But these teams produce results that are often as unremarkable as the teams themselves. When big change and high performance are required, a virtuoso team is far more likely to deliver outstanding and innovative results. Virtuoso teams are fundamentally different from the garden-variety work groups that most organizations form to pursue more modest goals. They comprise the top experts in their particular fields, are specially convened for ambitious projects, work with frenetic rhythm, and emanate a discernible energy. Not surprisingly, however, the superstars who make up these teams are renowned for being elitist, temperamental, egocentric, and difficult to work with. As a result, many managers fear that if they force such people to interact on a high-stakes project, the group just might implode. In this article, Bill Fischer and Andy Boynton put the inner workings of highly successful virtuoso teams on full display through three examples: the creative group behind West Side Story, the team of writers for Sid Caesar's 1950s-era television hit Your Show of Shows, and the high-powered technologists who averted an investor-relations crisis for Norsk Hydro, the Norwegian energy giant. Each of these teams accomplished enormous goals and changed their businesses, their customers, even their industries. And they did so by breaking all the conventional rules of collaboration--from the way they recruited the best members to the way they enforced their unusual processes, and from the high expectations they held to the exceptional results they produced. PMID:16028822

  20. Caring for Trauma Survivors.

    PubMed

    Antai-Otong, Deborah

    2016-06-01

    Although trauma exposure is common, few people develop acute and chronic psychiatric disorders. Those who develop posttraumatic stress disorder likely have coexisting psychiatric and physical disorders. Psychiatric nurses must be knowledgeable about trauma responses, implement evidence-based approaches to conduct assessments, and create safe environments for patients. Most researchers assert that trauma-focused cognitive-behavioral approaches demonstrate the most efficacious treatment outcomes. Integrated approaches, offer promising treatment options. This article provides an overview of clinical factors necessary to help the trauma survivor begin the process of healing and recovery and attain an optimal level of functioning. PMID:27229285

  1. Blunt thoracic trauma.

    PubMed

    Weyant, Michael J; Fullerton, David A

    2008-01-01

    Blunt thoracic trauma represents a significant portion of trauma admissions to hospitals in the United States. These injuries are encountered by physicians in many specialities such as emergency medicine, pediatrics, general surgery and thoracic surgery. Accurate diagnosis and treatment improves the chances of favorable outcomes and it is desirable for all treating physicians to have current knowledge of all aspects of blunt thoracic trauma. Cardiothoracic surgeons often treat the most severe forms of blunt thoracic injuries and we review the aspects of blunt thoracic trauma that are pertinent to the practicing cardiothoracic surgeon. PMID:18420123

  2. Autonomous mobile robot teams

    NASA Technical Reports Server (NTRS)

    Agah, Arvin; Bekey, George A.

    1994-01-01

    This paper describes autonomous mobile robot teams performing tasks in unstructured environments. The behavior and the intelligence of the group is distributed, and the system does not include a central command base or leader. The novel concept of the Tropism-Based Cognitive Architecture is introduced, which is used by the robots in order to produce behavior transforming their sensory information to proper action. The results of a number of simulation experiments are presented. These experiments include worlds where the robot teams must locate, decompose, and gather objects, and defend themselves against hostile predators, while navigating around stationary and mobile obstacles.

  3. Improving outcome in severe trauma: trauma systems and initial management: intubation, ventilation and resuscitation.

    PubMed

    Harris, Tim; Davenport, Ross; Hurst, Tom; Jones, Jonathan

    2012-10-01

    Severe trauma is an increasing global problem mainly affecting fit and healthy younger adults. Improvements in the entire pathway of trauma care have led to improvements in outcome. Development of a regional trauma system based around a trauma centre is associated with a 15-50% reduction in mortality. Trauma teams led by senior doctors provide better care. Although intuitively advantageous, the involvement of doctors in the pre-hospital care of trauma patients currently lacks clear evidence of benefit. Poor airway management is consistently identified as a cause of avoidable morbidity and mortality. Rapid sequence induction/intubation is frequently indicated but the ideal drugs have yet to be identified. The benefits of cricoid pressure are not clear cut. Dogmas in the management of pneumothoraces have been challenged: chest x-ray has a role in the diagnosis of tension pneumothoraces, needle aspiration may be ineffective, and small pneumothoraces can be managed conservatively. Identification of significant haemorrhage can be difficult and specific early resuscitation goals are not easily definable. A hypotensive approach may limit further bleeding but could worsen significant brain injury. The ideal initial resuscitation fluid remains controversial. In appropriately selected patients early aggressive blood product resuscitation is beneficial. Hypothermia can exacerbate bleeding and the benefit in traumatic brain injury is not adequately studied for firm recommendations. PMID:23014941

  4. Creativity and Creative Teams

    NASA Technical Reports Server (NTRS)

    Wood, Richard M.; Bauer, Steven X. S.; Hunter, Craig A.

    2001-01-01

    A review of the linkage between knowledge, creativity, and design is presented and related to the best practices of multidisciplinary design teams. The discussion related to design and design teams is presented in the context of both the complete aerodynamic design community and specifically the work environment at the NASA Langley Research Center. To explore ways to introduce knowledge and creativity into the research and design environment at NASA Langley Research Center a creative design activity was executed within the context of a national product development activity. The success of the creative design team activity gave rise to a need to communicate the experience in a straightforward and managed approach. As a result the concept of creative potential its formulated and assessed with a survey of a small portion of the aeronautics research staff at NASA Langley Research Center. The final section of the paper provides recommendations for future creative organizations and work environments.

  5. Team Learning and Team Composition in Nursing

    ERIC Educational Resources Information Center

    Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Elseviers, Monique; Denekens, Joke

    2011-01-01

    Purpose: This study aims to explore team learning activities in nursing teams and to test the effect of team composition on team learning to extend conceptually an initial model of team learning and to examine empirically a new model of ambidextrous team learning in nursing. Design/methodology/approach: Quantitative research utilising exploratory…

  6. The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma*

    PubMed Central

    2010-01-01

    available at: http://www.sequential-trauma-score.com Conclusions This score is the first sequential, dynamic score to provide a prognosis for patients with blunt major trauma at several points in time. With every additional piece of information the precision increases. The medical team has a simple, useful tool to identify patients at high risk and to predict the prognosis of an individual patient with major trauma very early, quickly and precisely. PMID:20562057

  7. Imaging of head trauma.

    PubMed

    Rincon, Sandra; Gupta, Rajiv; Ptak, Thomas

    2016-01-01

    Imaging is an indispensable part of the initial assessment and subsequent management of patients with head trauma. Initially, it is important for diagnosing the extent of injury and the prompt recognition of treatable injuries to reduce mortality. Subsequently, imaging is useful in following the sequelae of trauma. In this chapter, we review indications for neuroimaging and typical computed tomography (CT) and magnetic resonance imaging (MRI) protocols used in the evaluation of a patient with head trauma. We review the role of CT), the imaging modality of choice in the acute setting, and the role of MRI in the evaluation of patients with head trauma. We describe an organized and consistent approach to the interpretation of imaging of these patients. Important topics in head trauma, including fundamental concepts related to skull fractures, intracranial hemorrhage, parenchymal injury, penetrating trauma, cerebrovascular injuries, and secondary effects of trauma, are reviewed. The chapter concludes with advanced neuroimaging techniques for the evaluation of traumatic brain injury, including use of diffusion tensor imaging (DTI), functional MRI (fMRI), and MR spectroscopy (MRS), techniques which are still under development. PMID:27432678

  8. The use of trauma interprofessional simulated education (TIPSE) to enhance role awareness in the emergency department setting.

    PubMed

    Brown, Craig William; Howard, Morag; Morse, Jerry

    2016-05-01

    Interprofessional simulation-based education (IPSE) is common in medicine and nursing curricula, however, less evident in diagnostic radiography. Previous work suggests graduate radiographers are unprepared in terms of trauma knowledge and experience. A trauma IPSE programme as a joint venture between two universities was developed. Our aim was to explore the views of radiography, nursing, and medical students regarding preparedness for trauma practice. Second-year radiography (n = 39), nursing (n = 10), and medical (n = 5) students were invited to participate in trauma simulations. Pre- and post-scenario questionnaires were completed and quantitative analysis undertaken. Prior to IPSE, the majority of students were unprepared to manage trauma. Post-scenario felt significantly more prepared to undertake their role in the team and had better understanding of their and other professions' roles in trauma (P < 0.01). IPSE is an effective means of preparing undergraduate students in understanding both their and other professional's roles within the trauma team. PMID:27029800

  9. The coagulopathy of trauma.

    PubMed

    Maegele, M

    2014-04-01

    Trauma is a leading cause of death, with uncontrolled hemorrhage and exsanguination being the primary causes of preventable deaths during the first 24 h following trauma. Death usually occurs quickly, typically within the first 6 h after injury. One out of four patients arriving at the Emergency Department after trauma is already in hemodynamic and hemostatic depletion. This early manifestation of hemostatic depletion is referred to as the coagulopathy of trauma, which may distinguished as: (i) acute traumatic coagulopathy (ATC) and (ii) iatrogenic coagulopathy (IC). The principle drivers of ATC have been characterized by tissue trauma, inflammation, hypoperfusion/shock, and the acute activation of the neurohumoral system. Hypoperfusion leads to an activation of protein C with cleavage of activated factors V and VIII and the inhibition of plasminogen activator inhibitor-1 (PAI-1), with subsequent fibrinolysis. Endothelial damage and activation results in Weibel-Palade body degradation and glycocalyx shedding associated with autoheparinization. In contrast, there is an IC which occurs secondary to uncritical volume therapy, leading to acidosis, hypothermia, and hemodilution. This coagulopathy may, then, be an integral part of the "vicious cycle" when combined with acidosis and hypothermia. The awareness of the specific pathophysiology and of the principle drivers underlying the coagulopathy of trauma by the treating physician is paramount. It has been shown that early recognition prompted by appropriate and aggressive management can correct coagulopathy, control bleeding, reduce blood product use, and improve outcome in severely injured patients. This paper summarizes: (i) the current concepts of the pathogenesis of the coagulopathy of trauma, including ATC and IC, (ii) the current strategies available for the early identification of patients at risk for coagulopathy and ongoing life-threatening hemorrhage after trauma, and (iii) the current and updated European

  10. Trauma and Mobile Radiography

    SciTech Connect

    Drafke, M.W.

    1989-01-01

    Trauma and Mobile Radiography focuses on the radiography of trauma patients and of patients confined to bed. This book offers students a foundation in the skills they need to produce quality radiograms without causing additional injury or pain to the patient. Features of this new book include: coverage of the basics of radiography and patient care, including monitoring of heavily sedated, immobile, and accident patients. Information on the injuries associated with certain types of accidents, and methods for dealing with these problems. Detailed explanation of the positioning of each anatomical area. A Quick Reference Card with information on evaluating, monitoring and radiographing trauma patients.

  11. Team building

    SciTech Connect

    Kane, C.

    1993-04-01

    Power plants are particularly complicated projects with abundant opportunities for disputes. Efforts are beginning in the power industry to change the way the industry does business. Key elements of a comprehensive team-building approach include partnering, constructability, use of incentives, and the disputes review board.

  12. Team Building

    ERIC Educational Resources Information Center

    Begg, Roddy

    2005-01-01

    A personal reminiscence of the events surrounding the establishment of Tertiary Education and Management (TEAM), the journal of the European Association for Institutional Research EAIR, the European Higher Education Society--and its development over its first decade, by the founding Editor, at the time of his retirement from the post.

  13. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338

  14. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2011-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:21808173

  15. TEAM Act

    THOMAS, 112th Congress

    Sen. Landrieu, Mary L. [D-LA

    2012-05-22

    05/22/2012 Read twice and referred to the Committee on Small Business and Entrepreneurship. (text of measure as introduced: CR S3425-3426) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Imaging in orbital trauma

    PubMed Central

    Lin, Ken Y.; Ngai, Philip; Echegoyen, Julio C.; Tao, Jeremiah P.

    2012-01-01

    Orbital trauma is one of the most common reasons for ophthalmology specialty consultation in the emergency department setting. We survey the literature from 1990 to present to describe the role of computed tomography (CT), magnetic resonance imaging (MRI) and their associated angiography in some of the most commonly encountered orbital trauma conditions. CT orbit can often detect certain types of foreign bodies, lens dislocation, ruptured globe, choroidal or retinal detachments, or cavernous sinus thrombosis and thus complement a bedside ophthalmic exam that can sometimes be limited in the setting of trauma. CT remains the workhorse for acute orbital trauma owing to its rapidity and ability to delineate bony abnormalities; however MRI remains an important modality in special circumstances such as soft tissue assessment or with organic foreign bodies. PMID:23961028

  17. Imaging of Abusive Trauma.

    PubMed

    Shekdar, Karuna

    2016-06-01

    "Shaken baby syndrome" is a term often used by the physicians and public to describe abusive trauma inflicted on infants and young children. Advances in the understanding of the mechanisms and the associated clinical spectrum of injury has lead us to modify our terminology and address it as "abusive trauma" (AT). Pediatric abusive head trauma is defined as an injury to the skull or intracranial contents of an infant or a young child (< 5 y age) due to inflicted blunt impact and/or violent shaking. This chapter focuses on the imaging aspects of childhood abusive trauma along with a brief description of the mechanism and pathophysiology of abusive injury. The diagnosis of AT is not always obvious, and abusive injuries in many infants may remain unrecognized. Pediatricians should be cognizant of AT since pediatricians play a crucial role in the diagnosis, management and prevention of AT. PMID:26882906

  18. Trauma program development.

    PubMed

    Althausen, Peter L

    2014-07-01

    The development of a strong trauma program is clearly one of the most important facets of successful business development. Several recent publications have demonstrated that well run trauma services can generate significant profits for both the hospital and the surgeons involved. There are many aspects to this task that require constant attention and insight. Top notch patient care, efficiency, and cost-effective resource utilization are all important components that must be addressed while providing adequate physician compensation within the bounds of hospital financial constraints and the encompassing legal issues. Each situation is different but many of the components are universal. This chapter addresses all aspects of trauma program development to provide the graduating fellow with the tools to create a new trauma program or improve an existing program in order to provide the best patient care while optimizing financial reward and improving care efficiency. PMID:24918830

  19. Basic trauma life support.

    PubMed

    Werman, H A; Nelson, R N; Campbell, J E; Fowler, R L; Gandy, P

    1987-11-01

    The impact of traumatic injuries on modern society in terms of morbidity, mortality, and economic cost is enormous. Studies have shown that both advanced life support skills and rapid stabilization and transport of the trauma victim have a beneficial effect on the patient's ultimate outcome. The Basic Trauma Life Support (BTLS) course was designed to provide pre-hospital care providers with the skills necessary to provide a thorough assessment, initial resuscitation, and rapid transportation of the trauma victim. Early studies suggest that the material is easily learned by prehospital care providers and that the on-scene time for trauma cases is reduced following training in BTLS. More widespread training in BTLS may have a significant effect on the mortality and morbidity associated with traumatic injuries. PMID:3662184

  20. Narrative methods in a study of trauma recovery.

    PubMed

    Hall, Joanne M

    2011-01-01

    Multiple narrative perspectives can guide narrative research. The complexity of health narratives presents a significant challenge. Trauma recovery accounts are health narratives demonstrating successes as well as struggles. In this article, I describe a large-scale narrative study in which specific qualitative methods were combined to fit research aims, stories elicited, and emergent questions in the analysis process. Under my direction, an interdisciplinary team conducted this constructivist, feminist, narrative study describing the trauma recovery process. The study was focused on success or thriving in women surviving childhood maltreatment. I took an advocacy stance in favor of participants' interests, as is commensurate with a critical feminist standpoint. Through initial analyses the research team constructed a trauma recovery process termed "becoming resolute." Subanalyses were focused on key relationships, life trajectories, self-strategies, and perceptual changes. My purpose is to explain the various kinds and levels of analysis used here to provide options for others studying recovery narratives. PMID:20663939

  1. Penetrating extremity trauma.

    PubMed

    Ivatury, Rao R; Anand, Rahul; Ordonez, Carlos

    2015-06-01

    Penetrating extremity trauma (PET) usually becomes less important when present along with multiple truncal injuries. The middle eastern wars documented the terrible mortality and morbidity resulting from PET. Even in civilian trauma, PET can lead to significant morbidity and mortality. There are now well-established principles in the evaluation and management of vascular, bony, soft tissue, and neurologic lesions that will lead to a reduction of the poor outcomes. This review will summarize some of these recent concepts. PMID:25413177

  2. Trauma registry reengineered.

    PubMed

    Wargo, Christina; Bolig, Nicole; Hixson, Heather; McWilliams, Nate; Rummerfield, Heather; Stratton, Elaine; Woodruff, Tracy

    2014-01-01

    A successful trauma registry balances accuracy of abstraction and timeliness of case submissions to achieve quality performance. Staffing to achieve quality performance is a challenge at times based on competitive institutional need. The aim of this performance improvement timing study was to identify trauma registry job responsibilities and redesign the responsibilities to create increased abstraction time and maintain accuracy of data abstraction. The outcome is measured by case submission rates with existing staffing and interrater reliability outcomes. PMID:25397337

  3. Airway management in trauma.

    PubMed

    Langeron, O; Birenbaum, A; Amour, J

    2009-05-01

    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration. PMID:19412149

  4. Noninvasive ventilation in trauma.

    PubMed

    Karcz, Marcin K; Papadakos, Peter J

    2015-02-01

    Trauma patients are a diverse population with heterogeneous needs for ventilatory support. This requirement depends mainly on the severity of their ventilatory dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop hypoxemic respiratory failure which may or may not be associated with hypercapnia. Hypoxemia in these patients is due to ventilation perfusion mismatching and right to left shunt because of lung contusion, atelectasis, an inability to clear secretions as well as pneumothorax and/or hemothorax, all of which are common in trauma patients. Noninvasive ventilation has been tried in these patients in order to avoid the complications related to endotracheal intubation, mainly ventilator-associated pneumonia. The potential usefulness of noninvasive ventilation in the ventilatory management of trauma patients, though reported in various studies, has not been sufficiently investigated on a large scale. According to the British Thoracic Society guidelines, the indications and efficacy of noninvasive ventilation treatment in respiratory distress induced by trauma have thus far been inconsistent and merely received a low grade recommendation. In this review paper, we analyse and compare the results of various studies in which noninvasive ventilation was applied and discuss the role and efficacy of this ventilator modality in trauma. PMID:25685722

  5. Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma.

    PubMed

    Greene, Nathaniel; Bhananker, Sanjay; Ramaiah, Ramesh

    2012-09-01

    Trauma care in the general population has largely become protocol-driven, with an emphasis on fast and efficient treatment, good team communication at all levels of care including prehospital care, initial resuscitation, intensive care, and rehabilitation. Most available literature on trauma care has focused on adults, allowing the potential to apply concepts from adult care to pediatric care. But there remain issues that will always be specific to pediatric patients that may not translate from adults. Several new devices such as intraosseous (IO) needle systems and techniques such as ultrasonography to cannulate central and peripheral veins have become available for integration into our pre-existing trauma care system for children. This review will focus specifically on the latest techniques and evidence available for establishing intravenous access, rational approaches to fluid resuscitation, and blood product transfusion in the pediatric trauma patient. PMID:23181207

  6. The Effect of Availability of Manpower on Trauma Resuscitation Times in a Tertiary Academic Hospital

    PubMed Central

    Quek, Nathaniel Xin Ern; Koh, Zhi Xiong; Nadkarni, Nivedita; Singaram, Kanageswari; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock

    2016-01-01

    Background For trauma patients, delays to assessment, resuscitation, and definitive care affect outcomes. We studied the effects of resuscitation area occupancy and trauma team size on trauma team resuscitation speed in an observational study at a tertiary academic institution in Singapore. Methods From January 2014 to January 2015, resuscitation videos of trauma team activated patients with an Injury Severity Score of 9 or more were extracted for review within 14 days by independent reviewers. Exclusion criteria were patients dead on arrival, inter-hospital transfers, and up-triaged patients. Data captured included manpower availability (trauma team size and resuscitation area occupancy), assessment (airway, breathing, circulation, logroll), interventions (vascular access, imaging), and process-of-care time intervals (time to assessment/intervention/adjuncts, time to imaging, and total time in the emergency department). Clinical data were obtained by chart review and from the trauma registry. Results Videos of 70 patients were reviewed over a 13-month period. The median time spent in the emergency department was 154.9 minutes (IQR 130.7–207.5) and the median resuscitation team size was 7, with larger team sizes correlating with faster process-of-care time intervals: time to airway assessment (p = 0.08) and time to disposition (p = 0.04). The mean resuscitation area occupancy rate (RAOR) was 1.89±2.49, and the RAOR was positively correlated with time spent in the emergency department (p = 0.009). Conclusion Our results suggest that adequate staffing for trauma teams and resuscitation room occupancy are correlated with faster trauma resuscitation and reduced time spent in the emergency department. PMID:27136299

  7. Oesophageal trauma: incidence, diagnosis, and management.

    PubMed Central

    Triggiani, E; Belsey, R

    1977-01-01

    The clinical manifestations, diagnosis, and surgical treatment of 110 cases of oesophageal trauma, admitted under the care of one surgical team between 1949 and 1973, are reviewed. The importance of early diagnosis and an aggressive surgical approach in the management of a potentially lethal situation are stressed. In our opinion, spontaneous rupture of the oesophagus, instrumental perforation, open and closed traumatic lesions, and postoperative anastomotic leaks are, as far as diagnosis and management are concerned, different aspects of the same desperate surgical problem. Oesophageal trauma is accompanied by a high morbidity and mortality rate if diagnosis and treatment are delayed. Perforations of the cervical oesophagus may be treated conservatively. Intrathoracic perforations demand an aggressive surgical appraoch; only exteriorisation followed by reconstruction at a later date offers a reasonable chance to save the life of the patient and ultimately restore continuity. PMID:882938

  8. Introducing Current Technologies

    NASA Technical Reports Server (NTRS)

    Mitchell, Tiffany

    1995-01-01

    The objective of the study was a continuation of the 'technology push' activities that the Technology Transfer Team conducts at this time. It was my responsibility to research current technologies at Langley Research Center and find a commercial market for these technologies in the private industry. After locating a market for the technologies, a mailing package was put together which informed the companies of the benefits of NASA Langley's technologies. The mailing package included articles written about the technology, patent material, abstracts from technical papers, and one-pagers which were used at the Technology Opportunities Showcase (TOPS) exhibitions. The companies were encouraged to consult key team members for further information on the technologies.

  9. Team-Building Strategies for Multimedia Teams.

    ERIC Educational Resources Information Center

    Mugg, Joan Canby

    1996-01-01

    Discusses characteristics of strong teams, lists problems that can destroy them, and presents basic steps in creating strong ones. Describes roles for an effective multimedia team, raises specific multimedia issues, and makes recommendations for team organization. (PEN)

  10. Evaluation of leadership skills during the simulation education course for the initial management of blunt trauma.

    PubMed

    Schott, Eric; Brautigam, Robert T; Smola, Jacqueline; Burns, Karyl J

    2012-04-01

    Leadership skills of senior residents, trauma fellows, and a nurse practitioner were assessed during simulation training for the initial management of blunt trauma. This was a pilot, observational study, that in addition to skill development and assessment also sought to determine the need for a dedicated leadership training course for surgical residents. The study evaluated the leadership skills and adherence to Advance Trauma Life Support (ATLS) guidelines of the team leaders during simulation training. The team leaders' performances on criteria regarding prearrival planning, critical actions based on ATLS, injury identification, patient management, and communication were evaluated for each of five blunt-trauma scenarios. Although there was a statistically significant increase in leadership skills for performing ATLS critical actions, P < 0.05, there were 10 adverse events. A structured simulation program dedicated to developing skills for team leadership willbe a worthwhile endeavor at our institution. PMID:22611722

  11. Implementation of team training in medical education in Denmark.

    PubMed

    Østergaard, H T; Østergaard, D; Lippert, A

    2008-10-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed. PMID:19017834

  12. Implementation of team training in medical education in Denmark.

    PubMed

    Østergaard, H T; Østergaard, D; Lippert, A

    2004-10-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed. PMID:15465962

  13. Asteroid team

    NASA Technical Reports Server (NTRS)

    Matson, D. L.

    1988-01-01

    The purpose of this task is to support asteroid research and the operation of an Asteroid Team within the Earth and Space Sciences Division at the Jet Propulsion Laboratory (JPL). The Asteroid Team carries out original research on asteroids in order to discover, better characterize and define asteroid properties. This information is needed for the planning and design of NASA asteroid flyby and rendezvous missions. The asteroid Team also provides scientific and technical advice to NASA and JPL on asteroid related programs. Work on asteroid classification continued and the discovery of two Earth-approaching M asteroids was published. In the asteroid photometry program researchers obtained N or Q photometry for more than 50 asteroids, including the two M-earth-crossers. Compositional analysis of infrared spectra (0.8 to 2.6 micrometer) of asteroids is continuing. Over the next year the work on asteroid classification and composition will continue with the analysis of the 60 reduced infrared spectra which we now have at hand. The radiometry program will continue with the reduction of the N and Q bandpass data for the 57 asteroids in order to obtain albedos and diameters. This year the emphasis will shift to IRAS follow-up observations; which includes objects not observed by IRAS and objects with poor or peculiar IRAS data. As in previous year, we plan to give top priority to any opportunities for observing near-Earth asteroids and the support (through radiometric lightcurve observations from the IRTF) of any stellar occultations by asteroids for which occultation observation expeditions are fielded. Support of preparing of IRAS data for publication and of D. Matson for his participation in the NASA Planetary Astronomy Management and Operations Working Group will continue.

  14. Classification of Liver Trauma

    PubMed Central

    Rizoli, Sandro B.; Brenneman, Frederick D.; Hanna, Sherif S.; Kahnamoui, Kamyar

    1996-01-01

    The classification of liver injuries is important for clinical practice, clinical research and quality assurance activities. The Organ Injury Scaling (OIS) Committee of the American Association for the Surgery of Trauma proposed the OIS for liver trauma in 1989. The purpose ofthe present study was to apply this scale to a cohort ofliver trauma patients managed at a single Canadian trauma centre from January 1987 to June 1992.170 study patients were identified and reviewed. The mean age was 30, with 69% male and a mean ISS of 33.90% had a blunt mechanism ofinjury. The 170 patients were categorized into the 60IS grades ofliver injury. The number of units of blood transfused, the magnitude of the operative treatment required, the liver-related complications and the liver-related mortality correlated well with the OIS grade. The OIS grade was unable to predict the need for laparotomy or the length of stay in hospital. We conclude that the OIS is a useful, practical and important tool for the categorization of liver injuries, and it may prove to be the universally accepted classification scheme in liver trauma. PMID:8809585

  15. Epidemiology of severe trauma.

    PubMed

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. PMID:25241267

  16. Male genital trauma

    SciTech Connect

    Jordan, G.H.; Gilbert, D.A.

    1988-07-01

    We have attempted to discuss genital trauma in relatively broad terms. In most cases, patients present with relatively minimal trauma. However, because of the complexity of the structures involved, minimal trauma can lead to significant disability later on. The process of erection requires correct functioning of the arterial, neurologic, and venous systems coupled with intact erectile bodies. The penis is composed of structures that are compliant and distensible to the limits of their compliance. These structures therefore tumesce in equal proportion to each other, allowing for straight erection. Relatively minimal trauma can upset this balance of elasticity, leading to disabling chordee. Likewise, relatively minimal injuries to the vascular erectile structures can lead to significantly disabling spongiofibrosis. The urethra is a conduit of paramount importance. Whereas the development of stricture is generally related to the nature of the trauma, the extent of stricture and of attendant complications is clearly a function of the immediate management. Overzealous debridement can greatly complicate subsequent reconstruction. A delicate balance between aggressive initial management and maximal preservation of viable structures must be achieved. 38 references.

  17. Leadership and Teamwork in Trauma and Resuscitation

    PubMed Central

    Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand

    2016-01-01

    Introduction Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching

  18. Orofacial trauma in Brazilian basketball players and level of information concerning trauma and mouthguards.

    PubMed

    Frontera, Renata Reis; Zanin, Luciane; Ambrosano, Glaucia Maria Bovi; Flório, Flávia Martão

    2011-06-01

    Orofacial injuries are increasingly considered a public health problem in high impact sports. The purposes of this study were: to assess orofacial trauma (OT) history in basketball players, in relation to wearing mouthguards (MG), facial types, presence of mouth breathing and player's position in the game, also to check athletes' level of knowledge about trauma and MGs. Questionnaires were given to category A-1 adult athletes registered in 2006/07 in the State of São Paulo and Brazilian Basketball Confederation Championships, and National Team members. Of the total sample (n=388), 50% of athletes sustained orofacial injuries; dental trauma accounted for 69.7%, with emphasis on maxillary central incisors, followed by soft tissue (60.8%), in which lip injuries were the most prevalent. No relationship was found between trauma history and player's position (P=0.19), facial type (P=0.97), presence of mouth breathing (P=0.98), but there was statistically significant association between the prevalence of OT and lack of MG use (P≤0.0001). Of all the athletes affected, only 1% wore a MG at the time of the trauma, 26.5% did not know about the MGs and 10.6% did not know their functions. When trauma occurred, 79.6% replied one must look for the tooth at the accident site, 50% knew it must be stored in liquid, as replantation was possible (62.3%) and 75.8% believed elapsed time could influence prognosis. Basketball is a high impact sport with high prevalence of OT, particularly maxillary central incisor and lip injuries, but athletes did not use MGs. There should be more educational campaigns to inform players about orofacial injuries and their prevention in Brazilian basketball. PMID:21496201

  19. Paediatric Blunt Torso Trauma

    PubMed Central

    Bhatti, Khalid M.; Taqi, Kadhim M.; Al-Harthy, Ahmed Z. S.; Hamid, Rana S.; Al-Balushi, Zainab N.; Sankhla, Dilip K.; Al-Qadhi, Hani A.

    2016-01-01

    Objectives: Trauma is the greatest cause of morbidity and mortality in paediatric/adolescent populations worldwide. This study aimed to describe trauma mechanisms, patterns and outcomes among children with blunt torso trauma admitted to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective single-centre study involved all children ≤12 years old with blunt torso trauma admitted for paediatric surgical care at SQUH between January 2009 and December 2013. Medical records were analysed to collect demographic and clinical data. Results: A total of 70 children were admitted with blunt torso trauma during the study period, including 39 (55.7%) male patients. The mean age was 5.19 ± 2.66 years. Of the cohort, 35 children (50.0%) received their injuries after having been hit by cars as pedestrians, while 19 (27.1%) were injured by falls, 12 (17.1%) during car accidents as passengers and four (5.7%) by falling heavy objects. According to computed tomography scans, thoracic injuries were most common (65.7%), followed by abdominal injuries (42.9%). The most commonly involved solid organs were the liver (15.7%) and spleen (11.4%). The majority of the patients were managed conservatively (92.9%) with a good outcome (74.3%). The mortality rate was 7.1%. Most deaths were due to multisystem involvement. Conclusion: Among children with blunt torso trauma admitted to SQUH, the main mechanism of injury was motor vehicle accidents. As a result, parental education and enforcement of infant car seat/child seat belt laws are recommended. Conservative management was the most successful approach. PMID:27226913

  20. Trauma-Focused CBT for Youth who Experience Ongoing Traumas

    PubMed Central

    Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura A.

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will this in some way impair their responding to current or ongoing trauma? The paper addresses practical strategies for implementing one evidence-based treatment, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with ongoing traumas. Collaboration with local therapists and families participating in TF-CBT community and international programs elucidated effective strategies for applying TF-CBT with these youth. These strategies included: 1) enhancing safety early in treatment; 2) effectively engaging parents who experience personal ongoing trauma; and 3) during the trauma narrative and processing component focusing on a) increasing parental awareness and acceptance of the extent of the youths’ ongoing trauma experiences; b) addressing youths’ maladaptive cognitions about ongoing traumas; and c) helping youth differentiate between real danger and generalized trauma reminders. Case examples illustrate how to use these strategies in diverse clinical situations. Through these strategies TF-CBT clinicians can effectively improve outcomes for youth experiencing ongoing traumas. PMID:21855140

  1. Trauma-Focused CBT for Youth Who Experience Ongoing Traumas

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Murray, Laura K.

    2011-01-01

    Many youth experience ongoing trauma exposure, such as domestic or community violence. Clinicians often ask whether evidence-based treatments containing exposure components to reduce learned fear responses to historical trauma are appropriate for these youth. Essentially the question is, if youth are desensitized to their trauma experiences, will…

  2. Critical Care Team

    MedlinePlus

    ... Please enable scripts and reload this page. About Critical Care Currently selected Team Questions During the ICU Chronic ... Team Currently selected Questions Patients and Families > About Critical Care > Team Tweet Team Page Content ​The critical care ...

  3. Advances in prehospital trauma care

    PubMed Central

    Williamson, Kelvin; Ramesh, Ramaiah; Grabinsky, Andreas

    2011-01-01

    Prehospital trauma care developed over the last decades parallel in many countries. Most of the prehospital emergency medical systems relied on input or experiences from military medicine and were often modeled after the existing military procedures. Some systems were initially developed with the trauma patient in mind, while other systems were tailored for medical, especially cardiovascular, emergencies. The key components to successful prehospital trauma care are the well-known ABCs of trauma care: Airway, Breathing, Circulation. Establishing and securing the airway, ventilation, fluid resuscitation, and in addition, the quick transport to the best-suited trauma center represent the pillars of trauma care in the field. While ABC in trauma care has neither been challenged nor changed, new techniques, tools and procedures have been developed to make it easier for the prehospital provider to achieve these goals in the prehospital setting and thus improve the outcome of trauma patients. PMID:22096773

  4. Introducing the Blues.

    ERIC Educational Resources Information Center

    Sinclair, Bryan

    2000-01-01

    Discusses the history of the blues and presents a list of resources that are designed to introduce the blues, both as a feeling and as an influential part of American music and culture. Includes picture books and nonfiction for young readers, nonfiction for older readers, Web sites, and compact disks. (LRW)

  5. INTRODUCED TERRESTRIAL SPECIES RICHNESS

    EPA Science Inventory

    These data represent predicted current distributions of all introduced mammals, birds, reptiles, amphibians and butterflies in the Middle-Atlantic region. These data are available for both 8-digit HUCs and EMAP hexagons. The data are species counts for each spatial unit.

  6. Introducing Electromagnetic Field Momentum

    ERIC Educational Resources Information Center

    Hu, Ben Yu-Kuang

    2012-01-01

    I describe an elementary way of introducing electromagnetic field momentum. By considering a system of a long solenoid and line charge, the dependence of the field momentum on the electric and magnetic fields can be deduced. I obtain the electromagnetic angular momentum for a point charge and magnetic monopole pair partially through dimensional…

  7. Cammp Team

    NASA Technical Reports Server (NTRS)

    Evertt, Shonn F.; Collins, Michael; Hahn, William

    2008-01-01

    The International Space Station (ISS) Configuration Analysis Modeling and Mass Properties (CAMMP) Team is presenting a demo of certain CAMMP capabilities at a Booz Allen Hamilton conference in San Antonio. The team will be showing pictures of low fidelity, simplified ISS models, but no dimensions or technical data. The presentation will include a brief description of the contract and task, description and picture of the Topology, description of Generic Ground Rules and Constraints (GGR&C), description of Stage Analysis with constraints applied, and wrap up with description of other tasks such as Special Studies, Cable Routing, etc. The models include conceptual Crew Exploration Vehicle (CEV) and Lunar Lander images and animations created for promotional purposes, which are based entirely on public domain conceptual images from public NASA web sites and publicly available magazine articles and are not based on any actual designs, measurements, or 3D models. Conceptual Mars rover and lander are completely conceptual and are not based on any NASA designs or data. The demonstration includes High Fidelity Computer Aided Design (CAD) models of ISS provided by the ISS 3D CAD Team which will be used in a visual display to demonstrate the capabilities of the Teamcenter Visualization software. The demonstration will include 3D views of the CAD models including random measurements that will be taken to demonstrate the measurement tool. A 3D PDF file will be demonstrated of the Blue Book fidelity assembly complete model with no vehicles attached. The 3D zoom and rotation will be displayed as well as random measurements from the measurement tool. The External Configuration Analysis and Tracking Tool (ExCATT) Microsoft Access Database will be demonstrated to show its capabilities to organize and track hardware on ISS. The data included will be part numbers, serial numbers, historical, current, and future locations, of external hardware components on station. It includes dates of

  8. The effective team member: avoiding team burnout.

    PubMed

    Routhieaux, R L; Higgins, S E

    1999-09-01

    This article outlines specific suggestions for team members designed to help ensure that team membership is a satisfying experience. The suggestions offered provide clear guidelines for the responsibilities individual health care providers must assume when working on teams. Your proactive engagement in addressing the suggestions provided is part of an integrated, holistic approach to teams. PMID:10747466

  9. Team Tune-Up: Examining Team Transcripts

    ERIC Educational Resources Information Center

    Journal of Staff Development, 2010

    2010-01-01

    This article presents a worksheet that can be used to examine documentation of team meetings in light of goals the team has established. Materials for this worksheet include copies of team transcripts, yellow and pink highlighters, and pencils. Directions for examining team transcripts are presented.

  10. Understanding Teamwork in Trauma Resuscitation through Analysis of Team Errors

    ERIC Educational Resources Information Center

    Sarcevic, Aleksandra

    2009-01-01

    An analysis of human errors in complex work settings can lead to important insights into the workspace design. This type of analysis is particularly relevant to safety-critical, socio-technical systems that are highly dynamic, stressful and time-constrained, and where failures can result in catastrophic societal, economic or environmental…

  11. Trauma Induced Myocardial Infarction

    PubMed Central

    Lolay, Georges A.; Abdel-Latef, Ahmed K.

    2016-01-01

    Chest Trauma in athletes is a common health problem. However, myocardial infarction secondary to coronary dissection in the setting of blunt chest trauma is extremely rare. We report a case of acute inferior wall myocardial infarction following blunt chest trauma. A 32-year-old male with no relevant medical problems was transferred to our medical center for retrosternal chest pain after being elbowed in the chest during a soccer game. Few seconds later, he started experiencing sharp retrosternal chest pain that was severe to that point where he called the emergency medical service. Upon arrival to the Trauma department patient was still complaining of chest pain. ECG demonstrated ST segment elevation in the inferior leads with reciprocal changes in the lateral leads all consistent with active ischemia. After rolling out Aortic dissection, patient was loaded with ASA, ticagerlor, heparin and was emergently taken to the cardiac catheterization lab. Coronary angiography demonstrated 100% thrombotic occlusion in the distal right coronary artery with TIMI 0 flow distally. After thrombus aspiration, a focal dissection was noted on the angiogram that was successfully stented. Two days after admission patient was discharged home. Echocardiography prior to discharge showed inferior wall akinesis, normal right ventricular systolic function and normal overall ejection fraction. PMID:26490501

  12. Structured Sensory Trauma Interventions

    ERIC Educational Resources Information Center

    Steele, William; Kuban, Caelan

    2010-01-01

    This article features the National Institute of Trauma and Loss in Children (TLC), a program that has demonstrated via field testing, exploratory research, time series studies, and evidence-based research studies that its Structured Sensory Intervention for Traumatized Children, Adolescents, and Parents (SITCAP[R]) produces statistically…

  13. Early Childhood Trauma

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  14. Pediatric head trauma

    PubMed Central

    Alexiou, George A; Sfakianos, George; Prodromou, Neofytos

    2011-01-01

    Head injury in children accounts for a large number of emergency department visits and hospital admissions. Falls are the most common type of injury, followed by motor-vehicle-related accidents. In the present study, we discuss the evaluation, neuroimaging and management of children with head trauma. Furthermore, we present the specific characteristics of each type of pediatric head injury. PMID:21887034

  15. How to Preempt Team Conflict.

    PubMed

    Toegel, Ginka; Barsoux, Jean-Louis

    2016-06-01

    Team conflict can add value or destroy it. Good conflict fosters respectful debate and yields mutually agreed-upon solutions that are often far superior to those first offered. Bad conflict occurs when team members simply can't get past their differences, killing productivity and stifling innovation. Destructive conflict typically stems not from differences of opinion but from a perceived incompatibility between the way certain team members think and act. The conventional approach to working through such conflict is to respond to clashes as they arise. But this approach routinely fails because it allows frustrations to build for too long, making it difficult to reset negative impressions and restore trust. In their research on team dynamics and experience working with executive teams, Toegel and Barsoux have found a proactive approach to be much more effective. In this article, they introduce a methodology that focuses on how people look, act, speak, think, and feel. Team leaders facilitate five conversations--one focused on each category--before the team gets under way, to build a shared understanding of the process, rather than the content, of work and lay the foundation for effective collaboration. PMID:27491198

  16. Teaching Engineering Students Team Work

    NASA Technical Reports Server (NTRS)

    Levi, Daniel

    1998-01-01

    The purpose of this manual is to provide professor's in engineering classes which the background necessary to use student team projects effectively. This manual describes some of the characteristics of student teams and how to use them in class. It provides a set of class activities and films which can be used to introduce and support student teams. Finally, a set of teaching modules used in freshmen, sophomore, and senior aeronautical engineering classes are presented. This manual was developed as part of a NASA sponsored project to improve the undergraduate education of aeronautical engineers. The project has helped to purchase a set of team work films which can be checked out from Cal Poly's Learning Resources Center in the Kennedy Library. Research for this project has included literature reviews on team work and cooperative learning; interviews, observations, and surveys of Cal Poly students from Industrial and Manufacturing Engineering, Aeronautical Engineering and Psychology; participation in the Aeronautical Engineering senior design lab; and interviews with engineering faculty. In addition to this faculty manual, there is a student team work manual which has been designed to help engineering students work better in teams.

  17. Introducing CAML II

    SciTech Connect

    Pelaia II, Tom; Boyes, Matthew

    2009-01-01

    Channel Access Markup Language (CAML) is a XML based markup language and implementation for displaying EPICS channel access controls within a web browser. The CAML II project expanded upon the work of CAML I adding more features and greater integration with other web technologies. The most dramatic new feature introduced in CAML II is the introduction of a namespace so CAML controls can be embedded within XHTML documents. A repetition template with macro substitution allows for rapid coding of arbitrary XHTML repetitions. Enhancements have been made to several controls including more powerful plotting options. Advanced formatting options were introduced for text controls. Virtual process variables allow for custom calculations. An EDL to CAML translator eases the transition from EDM screens to CAML pages.

  18. Imaging in spinal trauma.

    PubMed

    Van Goethem, Johan W M; Maes, Menno; Ozsarlak, Ozkan; van den Hauwe, Luc; Parizel, Paul M

    2005-03-01

    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  19. Concepts for Developing Expert Surgical Teams Using Simulation.

    PubMed

    Gardner, Aimee K; Scott, Daniel J

    2015-08-01

    This article investigates how simulation-based training can enhance the effectiveness of surgical teams. First, a description of team training within surgical settings is provided. Then, empirical work from a variety of fields is introduced to describe common characteristics of expert teams, with a specific focus on training surgical teams in simulated settings. Finally, methods and suggestions for evaluation of simulation-based team training are discussed. PMID:26210965

  20. Introducing electromagnetic field momentum

    NASA Astrophysics Data System (ADS)

    Yu-Kuang Hu, Ben

    2012-07-01

    I describe an elementary way of introducing electromagnetic field momentum. By considering a system of a long solenoid and line charge, the dependence of the field momentum on the electric and magnetic fields can be deduced. I obtain the electromagnetic angular momentum for a point charge and magnetic monopole pair partially through dimensional analysis and without using vector calculus identities or the need to evaluate integrals. I use this result to show that linear and angular momenta are conserved for a charge in the presence of a magnetic dipole when the dipole strength is changed.

  1. Trauma Tactics: Rethinking Trauma Education for Professional Nurses.

    PubMed

    Garvey, Paula; Liddil, Jessica; Eley, Scott; Winfield, Scott

    2016-01-01

    According to the National Trauma Institute (2015), trauma accounts for more than 180,000 deaths each year in the United States. Nurses play a significant role in the care of trauma patients and therefore need appropriate education and training (L. ). Although several courses exist for trauma education, many nurses have not received adequate education in trauma management (B. ; L. ). Trauma Tactics, a 2-day course that focuses on high-fidelity human patient simulation, was created to meet this educational need. This descriptive study was conducted retrospectively to assess the effectiveness of the Trauma Tactics course. Pre- and postsurveys, tests, and simulation performance were used to evaluate professional nurses who participated in Trauma Tactics over a 10-month period. Fifty-five nurses were included in the study. Pre- and postsurveys revealed an increase in overall confidence, test scores increased by an average of 2.5 points, and simulation performance scores increased by an average of 16 points. Trauma Tactics is a high-quality course that provides a valuable and impactful educational experience for nurses. Further research is needed to evaluate the long-term effects of Trauma Tactics and its impacts on quality of care and patient outcomes. PMID:27414143

  2. Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

    PubMed Central

    Rehim, S. A.; Dagash, H.; Godbole, P. P.; Raghavan, A.; Murthi, G. V.

    2010-01-01

    Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM). Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT) scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children. PMID:21209813

  3. Maxillofacial trauma scoring systems.

    PubMed

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. PMID:26971084

  4. Needle Thoracotomy in Trauma.

    PubMed

    Rottenstreich, Misgav; Fay, Shmuel; Gendler, Sami; Klein, Yoram; Arkovitz, Marc; Rottenstreich, Amihai

    2015-12-01

    Tension pneumothorax is one of the leading causes of preventable death in trauma patients. Needle thoracotomy (NT) is the currently accepted first-line intervention but has not been well validated. In this review, we have critically discussed the evidence for NT procedure, re-examined the recommendations by the Advanced Trauma Life Support organization and investigated the safest and most effective way of NT. The current evidence to support the use of NT is limited. However, when used, it should be applied in the 2nd intercostal space at midclavicular line using a catheter length of at least 4.5 cm. Alternative measures should be studied for better prehospital management of tension pneumothorax. PMID:26633663

  5. Introducing the CTA concept

    NASA Astrophysics Data System (ADS)

    Acharya, B. S.; Actis, M.; Aghajani, T.; Agnetta, G.; Aguilar, J.; Aharonian, F.; Ajello, M.; Akhperjanian, A.; Alcubierre, M.; Aleksić, J.; Alfaro, R.; Aliu, E.; Allafort, A. J.; Allan, D.; Allekotte, I.; Amato, E.; Anderson, J.; Angüner, E. O.; Antonelli, L. A.; Antoranz, P.; Aravantinos, A.; Arlen, T.; Armstrong, T.; Arnaldi, H.; Arrabito, L.; Asano, K.; Ashton, T.; Asorey, H. G.; Awane, Y.; Baba, H.; Babic, A.; Baby, N.; Bähr, J.; Bais, A.; Baixeras, C.; Bajtlik, S.; Balbo, M.; Balis, D.; Balkowski, C.; Bamba, A.; Bandiera, R.; Barber, A.; Barbier, C.; Barceló, M.; Barnacka, A.; Barnstedt, J.; Barres de Almeida, U.; Barrio, J. A.; Basili, A.; Basso, S.; Bastieri, D.; Bauer, C.; Baushev, A.; Becerra, J.; Becherini, Y.; Bechtol, K. C.; Becker Tjus, J.; Beckmann, V.; Bednarek, W.; Behera, B.; Belluso, M.; Benbow, W.; Berdugo, J.; Berger, K.; Bernard, F.; Bernardino, T.; Bernlöhr, K.; Bhat, N.; Bhattacharyya, S.; Bigongiari, C.; Biland, A.; Billotta, S.; Bird, T.; Birsin, E.; Bissaldi, E.; Biteau, J.; Bitossi, M.; Blake, S.; Blanch Bigas, O.; Blasi, P.; Bobkov, A.; Boccone, V.; Boettcher, M.; Bogacz, L.; Bogart, J.; Bogdan, M.; Boisson, C.; Boix Gargallo, J.; Bolmont, J.; Bonanno, G.; Bonardi, A.; Bonev, T.; Bonifacio, P.; Bonnoli, G.; Bordas, P.; Borgland, A.; Borkowski, J.; Bose, R.; Botner, O.; Bottani, A.; Bouchet, L.; Bourgeat, M.; Boutonnet, C.; Bouvier, A.; Brau-Nogué, S.; Braun, I.; Bretz, T.; Briggs, M.; Bringmann, T.; Brook, P.; Brun, P.; Brunetti, L.; Buanes, T.; Buckley, J.; Buehler, R.; Bugaev, V.; Bulgarelli, A.; Bulik, T.; Busetto, G.; Buson, S.; Byrum, K.; Cailles, M.; Cameron, R.; Camprecios, J.; Canestrari, R.; Cantu, S.; Capalbi, M.; Caraveo, P.; Carmona, E.; Carosi, A.; Carr, J.; Carton, P.-H.; Casanova, S.; Casiraghi, M.; Catalano, O.; Cavazzani, S.; Cazaux, S.; Cerruti, M.; Chabanne, E.; Chadwick, P.; Champion, C.; Chen, A.; Chiang, J.; Chiappetti, L.; Chikawa, M.; Chitnis, V. R.; Chollet, F.; Chudoba, J.; Cieślar, M.; Cillis, A.; Cohen-Tanugi, J.; Colafrancesco, S.; Colin, P.; Colome, J.; Colonges, S.; Compin, M.; Conconi, P.; Conforti, V.; Connaughton, V.; Conrad, J.; Contreras, J. L.; Coppi, P.; Corona, P.; Corti, D.; Cortina, J.; Cossio, L.; Costantini, H.; Cotter, G.; Courty, B.; Couturier, S.; Covino, S.; Crimi, G.; Criswell, S. J.; Croston, J.; Cusumano, G.; Dafonseca, M.; Dale, O.; Daniel, M.; Darling, J.; Davids, I.; Dazzi, F.; De Angelis, A.; De Caprio, V.; De Frondat, F.; de Gouveia Dal Pino, E. M.; de la Calle, I.; De La Vega, G. A.; de los Reyes Lopez, R.; De Lotto, B.; De Luca, A.; de Mello Neto, J. R. T.; de Naurois, M.; de Oliveira, Y.; de Oña Wilhelmi, E.; de Souza, V.; Decerprit, G.; Decock, G.; Deil, C.; Delagnes, E.; Deleglise, G.; Delgado, C.; Della Volpe, D.; Demange, P.; Depaola, G.; Dettlaff, A.; Di Paola, A.; Di Pierro, F.; Díaz, C.; Dick, J.; Dickherber, R.; Dickinson, H.; Diez-Blanco, V.; Digel, S.; Dimitrov, D.; Disset, G.; Djannati-Ataï, A.; Doert, M.; Dohmke, M.; Domainko, W.; Dominis Prester, D.; Donat, A.; Dorner, D.; Doro, M.; Dournaux, J.-L.; Drake, G.; Dravins, D.; Drury, L.; Dubois, F.; Dubois, R.; Dubus, G.; Dufour, C.; Dumas, D.; Dumm, J.; Durand, D.; Dyks, J.; Dyrda, M.; Ebr, J.; Edy, E.; Egberts, K.; Eger, P.; Einecke, S.; Eleftheriadis, C.; Elles, S.; Emmanoulopoulos, D.; Engelhaupt, D.; Enomoto, R.; Ernenwein, J.-P.; Errando, M.; Etchegoyen, A.; Evans, P.; Falcone, A.; Fantinel, D.; Farakos, K.; Farnier, C.; Fasola, G.; Favill, B.; Fede, E.; Federici, S.; Fegan, S.; Feinstein, F.; Ferenc, D.; Ferrando, P.; Fesquet, M.; Fiasson, A.; Fillin-Martino, E.; Fink, D.; Finley, C.; Finley, J. P.; Fiorini, M.; Firpo Curcoll, R.; Flores, H.; Florin, D.; Focke, W.; Föhr, C.; Fokitis, E.; Font, L.; Fontaine, G.; Fornasa, M.; Förster, A.; Fortson, L.; Fouque, N.; Franckowiak, A.; Fransson, C.; Fraser, G.; Frei, R.; Albuquerque, I. F. M.; Fresnillo, L.; Fruck, C.; Fujita, Y.; Fukazawa, Y.; Fukui, Y.; Funk, S.; Gäbele, W.; Gabici, S.; Gabriele, R.; Gadola, A.; Galante, N.; Gall, D.; Gallant, Y.; Gámez-García, J.; García, B.; Garcia López, R.; Gardiol, D.; Garrido, D.; Garrido, L.; Gascon, D.; Gaug, M.; Gaweda, J.; Gebremedhin, L.; Geffroy, N.; Gerard, L.; Ghedina, A.; Ghigo, M.; Giannakaki, E.; Gianotti, F.; Giarrusso, S.; Giavitto, G.; Giebels, B.; Gika, V.; Giommi, P.; Girard, N.; Giro, E.; Giuliani, A.; Glanzman, T.; Glicenstein, J.-F.; Godinovic, N.; Golev, V.; Gomez Berisso, M.; Gómez-Ortega, J.; Gonzalez, M. M.; González, A.; González, F.; González Muñoz, A.; Gothe, K. S.; Gougerot, M.; Graciani, R.; Grandi, P.; Grañena, F.; Granot, J.; Grasseau, G.; Gredig, R.; Green, A.; Greenshaw, T.; Grégoire, T.; Grimm, O.; Grube, J.; Grudzinska, M.; Gruev, V.; Grünewald, S.; Grygorczuk, J.; Guarino, V.; Gunji, S.; Gyuk, G.; Hadasch, D.; Hagiwara, R.; Hahn, J.; Hakansson, N.; Hallgren, A.; Hamer Heras, N.; Hara, S.; Hardcastle, M. J.; Harris, J.; Hassan, T.; Hatanaka, K.; Haubold, T.; Haupt, A.; Hayakawa, T.; Hayashida, M.; Heller, R.; Henault, F.; Henri, G.; Hermann, G.; Hermel, R.; Herrero, A.; Hidaka, N.; Hinton, J.; Hoffmann, D.; Hofmann, W.; Hofverberg, P.; Holder, J.; Horns, D.; Horville, D.; Houles, J.; Hrabovsky, M.; Hrupec, D.; Huan, H.; Huber, B.; Huet, J.-M.; Hughes, G.; Humensky, T. B.; Huovelin, J.; Ibarra, A.; Illa, J. M.; Impiombato, D.; Incorvaia, S.; Inoue, S.; Inoue, Y.; Ioka, K.; Ismailova, E.; Jablonski, C.; Jacholkowska, A.; Jamrozy, M.; Janiak, M.; Jean, P.; Jeanney, C.; Jimenez, J. J.; Jogler, T.; Johnson, T.; Journet, L.; Juffroy, C.; Jung, I.; Kaaret, P.; Kabuki, S.; Kagaya, M.; Kakuwa, J.; Kalkuhl, C.; Kankanyan, R.; Karastergiou, A.; Kärcher, K.; Karczewski, M.; Karkar, S.; Kasperek, J.; Kastana, D.; Katagiri, H.; Kataoka, J.; Katarzyński, K.; Katz, U.; Kawanaka, N.; Kellner-Leidel, B.; Kelly, H.; Kendziorra, E.; Khélifi, B.; Kieda, D. B.; Kifune, T.; Kihm, T.; Kishimoto, T.; Kitamoto, K.; Kluźniak, W.; Knapic, C.; Knapp, J.; Knödlseder, J.; Köck, F.; Kocot, J.; Kodani, K.; Köhne, J.-H.; Kohri, K.; Kokkotas, K.; Kolitzus, D.; Komin, N.; Kominis, I.; Konno, Y.; Köppel, H.; Korohoda, P.; Kosack, K.; Koss, G.; Kossakowski, R.; Kostka, P.; Koul, R.; Kowal, G.; Koyama, S.; Kozioł, J.; Krähenbühl, T.; Krause, J.; Krawzcynski, H.; Krennrich, F.; Krepps, A.; Kretzschmann, A.; Krobot, R.; Krueger, P.; Kubo, H.; Kudryavtsev, V. A.; Kushida, J.; Kuznetsov, A.; La Barbera, A.; La Palombara, N.; La Parola, V.; La Rosa, G.; Lacombe, K.; Lamanna, G.; Lande, J.; Languignon, D.; Lapington, J.; Laporte, P.; Lavalley, C.; Le Flour, T.; Le Padellec, A.; Lee, S.-H.; Lee, W. H.; Leigui de Oliveira, M. A.; Lelas, D.; Lenain, J.-P.; Leopold, D. J.; Lerch, T.; Lessio, L.; Lieunard, B.; Lindfors, E.; Liolios, A.; Lipniacka, A.; Lockart, H.; Lohse, T.; Lombardi, S.; Lopatin, A.; Lopez, M.; López-Coto, R.; López-Oramas, A.; Lorca, A.; Lorenz, E.; Lubinski, P.; Lucarelli, F.; Lüdecke, H.; Ludwin, J.; Luque-Escamilla, P. L.; Lustermann, W.; Luz, O.; Lyard, E.; Maccarone, M. C.; Maccarone, T. J.; Madejski, G. M.; Madhavan, A.; Mahabir, M.; Maier, G.; Majumdar, P.; Malaguti, G.; Maltezos, S.; Manalaysay, A.; Mancilla, A.; Mandat, D.; Maneva, G.; Mangano, A.; Manigot, P.; Mannheim, K.; Manthos, I.; Maragos, N.; Marcowith, A.; Mariotti, M.; Marisaldi, M.; Markoff, S.; Marszałek, A.; Martens, C.; Martí, J.; Martin, J.-M.; Martin, P.; Martínez, G.; Martínez, F.; Martínez, M.; Masserot, A.; Mastichiadis, A.; Mathieu, A.; Matsumoto, H.; Mattana, F.; Mattiazzo, S.; Maurin, G.; Maxfield, S.; Maya, J.; Mazin, D.; Mc Comb, L.; McCubbin, N.; McHardy, I.; McKay, R.; Medina, C.; Melioli, C.; Melkumyan, D.; Mereghetti, S.; Mertsch, P.; Meucci, M.; Michałowski, J.; Micolon, P.; Mihailidis, A.; Mineo, T.; Minuti, M.; Mirabal, N.; Mirabel, F.; Miranda, J. M.; Mirzoyan, R.; Mizuno, T.; Moal, B.; Moderski, R.; Mognet, I.; Molinari, E.; Molinaro, M.; Montaruli, T.; Monteiro, I.; Moore, P.; Moralejo Olaizola, A.; Mordalska, M.; Morello, C.; Mori, K.; Mottez, F.; Moudden, Y.; Moulin, E.; Mrusek, I.; Mukherjee, R.; Munar-Adrover, P.; Muraishi, H.; Murase, K.; Murphy, A.; Nagataki, S.; Naito, T.; Nakajima, D.; Nakamori, T.; Nakayama, K.; Naumann, C.; Naumann, D.; Naumann-Godo, M.; Nayman, P.; Nedbal, D.; Neise, D.; Nellen, L.; Neustroev, V.; Neyroud, N.; Nicastro, L.; Nicolau-Kukliński, J.; Niedźwiecki, A.; Niemiec, J.; Nieto, D.; Nikolaidis, A.; Nishijima, K.; Nolan, S.; Northrop, R.; Nosek, D.; Nowak, N.; Nozato, A.; O'Brien, P.; Ohira, Y.; Ohishi, M.; Ohm, S.; Ohoka, H.; Okuda, T.; Okumura, A.; Olive, J.-F.; Ong, R. A.; Orito, R.; Orr, M.; Osborne, J.; Ostrowski, M.; Otero, L. A.; Otte, N.; Ovcharov, E.; Oya, I.; Ozieblo, A.; Padilla, L.; Paiano, S.; Paillot, D.; Paizis, A.; Palanque, S.; Palatka, M.; Pallota, J.; Panagiotidis, K.; Panazol, J.-L.; Paneque, D.; Panter, M.; Paoletti, R.; Papayannis, A.; Papyan, G.; Paredes, J. M.; Pareschi, G.; Parks, G.; Parraud, J.-M.; Parsons, D.; Paz Arribas, M.; Pech, M.; Pedaletti, G.; Pelassa, V.; Pelat, D.; Perez, M. d. C.; Persic, M.; Petrucci, P.-O.; Peyaud, B.; Pichel, A.; Pita, S.; Pizzolato, F.; Platos, Ł.; Platzer, R.; Pogosyan, L.; Pohl, M.; Pojmanski, G.; Ponz, J. D.; Potter, W.; Poutanen, J.; Prandini, E.; Prast, J.; Preece, R.; Profeti, F.; Prokoph, H.; Prouza, M.; Proyetti, M.; Puerto-Gimenez, I.; Pühlhofer, G.; Puljak, I.; Punch, M.; Pyzioł, R.; Quel, E. J.; Quinn, J.; Quirrenbach, A.; Racero, E.; Rajda, P. J.; Ramon, P.; Rando, R.; Rannot, R. C.; Rataj, M.; Raue, M.; Reardon, P.; Reimann, O.; Reimer, A.; Reimer, O.; Reitberger, K.; Renaud, M.; Renner, S.; Reville, B.; Rhode, W.; Ribó, M.; Ribordy, M.; Richer, M. G.; Rico, J.; Ridky, J.; Rieger, F.; Ringegni, P.; Ripken, J.; Ristori, P. R.; Riviére, A.; Rivoire, S.; Rob, L.; Roeser, U.; Rohlfs, R.; Rojas, G.; Romano, P.; Romaszkan, W.; Romero, G. E.; Rosen, S.; Rosier Lees, S.; Ross, D.; Rouaix, G.; Rousselle, J.; Rousselle, S.; Rovero, A. C.; Roy, F.; Royer, S.; Rudak, B.; Rulten, C.; Rupiński, M.; Russo, F.; Ryde, F.; Sacco, B.; Saemann, E. O.; Saggion, A.; Sahakian, V.; Saito, K.; Saito, T.; Saito, Y.; Sakaki, N.; Sakonaka, R.; Salini, A.; Sanchez, F.; Sanchez-Conde, M.; Sandoval, A.; Sandaker, H.; Sant'Ambrogio, E.; Santangelo, A.; Santos, E. M.; Sanuy, A.; Sapozhnikov, L.; Sarkar, S.; Sartore, N.; Sasaki, H.; Satalecka, K.; Sawada, M.; Scalzotto, V.; Scapin, V.; Scarcioffolo, M.; Schafer, J.; Schanz, T.; Schlenstedt, S.; Schlickeiser, R.; Schmidt, T.; Schmoll, J.; Schovanek, P.; Schroedter, M.; Schultz, C.; Schultze, J.; Schulz, A.; Schure, K.; Schwab, T.; Schwanke, U.; Schwarz, J.; Schwarzburg, S.; Schweizer, T.; Schwemmer, S.; Segreto, A.; Seiradakis, J.-H.; Sembroski, G. H.; Seweryn, K.; Sharma, M.; Shayduk, M.; Shellard, R. C.; Shi, J.; Shibata, T.; Shibuya, A.; Shum, E.; Sidoli, L.; Sidz, M.; Sieiro, J.; Sikora, M.; Silk, J.; Sillanpää, A.; Singh, B. B.; Sitarek, J.; Skole, C.; Smareglia, R.; Smith, A.; Smith, D.; Smith, J.; Smith, N.; Sobczyńska, D.; Sol, H.; Sottile, G.; Sowiński, M.; Spanier, F.; Spiga, D.; Spyrou, S.; Stamatescu, V.; Stamerra, A.; Starling, R.; Stawarz, Ł.; Steenkamp, R.; Stegmann, C.; Steiner, S.; Stergioulas, N.; Sternberger, R.; Sterzel, M.; Stinzing, F.; Stodulski, M.; Straumann, U.; Strazzeri, E.; Stringhetti, L.; Suarez, A.; Suchenek, M.; Sugawara, R.; Sulanke, K.-H.; Sun, S.; Supanitsky, A. D.; Suric, T.; Sutcliffe, P.; Sykes, J.; Szanecki, M.; Szepieniec, T.; Szostek, A.; Tagliaferri, G.; Tajima, H.; Takahashi, H.; Takahashi, K.; Takalo, L.; Takami, H.; Talbot, G.; Tammi, J.; Tanaka, M.; Tanaka, S.; Tasan, J.; Tavani, M.; Tavernet, J.-P.; Tejedor, L. A.; Telezhinsky, I.; Temnikov, P.; Tenzer, C.; Terada, Y.; Terrier, R.; Teshima, M.; Testa, V.; Tezier, D.; Thuermann, D.; Tibaldo, L.; Tibolla, O.; Tiengo, A.; Tluczykont, M.; Todero Peixoto, C. J.; Tokanai, F.; Tokarz, M.; Toma, K.; Torii, K.; Tornikoski, M.; Torres, D. F.; Torres, M.; Tosti, G.; Totani, T.; Toussenel, F.; Tovmassian, G.; Travnicek, P.; Trifoglio, M.; Troyano, I.; Tsinganos, K.; Ueno, H.; Umehara, K.; Upadhya, S. S.; Usher, T.; Uslenghi, M.; Valdes-Galicia, J. F.; Vallania, P.; Vallejo, G.; van Driel, W.; van Eldik, C.; Vandenbrouke, J.; Vanderwalt, J.; Vankov, H.; Vasileiadis, G.; Vassiliev, V.; Veberic, D.; Vegas, I.; Vercellone, S.; Vergani, S.; Veyssiére, C.; Vialle, J. P.; Viana, A.; Videla, M.; Vincent, P.; Vincent, S.; Vink, J.; Vlahakis, N.; Vlahos, L.; Vogler, P.; Vollhardt, A.; von Gunten, H.-P.; Vorobiov, S.; Vuerli, C.; Waegebaert, V.; Wagner, R.; Wagner, R. G.; Wagner, S.; Wakely, S. P.; Walter, R.; Walther, T.; Warda, K.; Warwick, R.; Wawer, P.; Wawrzaszek, R.; Webb, N.; Wegner, P.; Weinstein, A.; Weitzel, Q.; Welsing, R.; Werner, M.; Wetteskind, H.; White, R.; Wierzcholska, A.; Wiesand, S.; Wilkinson, M.; Williams, D. A.; Willingale, R.; Winiarski, K.; Wischnewski, R.; Wiśniewski, Ł.; Wood, M.; Wörnlein, A.; Xiong, Q.; Yadav, K. K.; Yamamoto, H.; Yamamoto, T.; Yamazaki, R.; Yanagita, S.; Yebras, J. M.; Yelos, D.; Yoshida, A.; Yoshida, T.; Yoshikoshi, T.; Zabalza, V.; Zacharias, M.; Zajczyk, A.; Zanin, R.; Zdziarski, A.; Zech, A.; Zhao, A.; Zhou, X.; Ziętara, K.; Ziolkowski, J.; Ziółkowski, P.; Zitelli, V.; Zurbach, C.; Żychowski, P.; CTA Consortium

    2013-03-01

    The Cherenkov Telescope Array (CTA) is a new observatory for very high-energy (VHE) gamma rays. CTA has ambitions science goals, for which it is necessary to achieve full-sky coverage, to improve the sensitivity by about an order of magnitude, to span about four decades of energy, from a few tens of GeV to above 100 TeV with enhanced angular and energy resolutions over existing VHE gamma-ray observatories. An international collaboration has formed with more than 1000 members from 27 countries in Europe, Asia, Africa and North and South America. In 2010 the CTA Consortium completed a Design Study and started a three-year Preparatory Phase which leads to production readiness of CTA in 2014. In this paper we introduce the science goals and the concept of CTA, and provide an overview of the project.

  6. Substance Abuse and Trauma.

    PubMed

    Simmons, Shannon; Suárez, Liza

    2016-10-01

    There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD. PMID:27613348

  7. Rethinking historical trauma.

    PubMed

    Kirmayer, Laurence J; Gone, Joseph P; Moses, Joshua

    2014-06-01

    Recent years have seen the rise of historical trauma as a construct to describe the impact of colonization, cultural suppression, and historical oppression of Indigenous peoples in North America (e.g., Native Americans in the United States, Aboriginal peoples in Canada). The discourses of psychiatry and psychology contribute to the conflation of disparate forms of violence by emphasizing presumptively universal aspects of trauma response. Many proponents of this construct have made explicit analogies to the Holocaust as a way to understand the transgenerational effects of genocide. However, the social, cultural, and psychological contexts of the Holocaust and of post-colonial Indigenous "survivance" differ in many striking ways. Indeed, the comparison suggests that the persistent suffering of Indigenous peoples in the Americas reflects not so much past trauma as ongoing structural violence. The comparative study of genocide and other forms of massive, organized violence can do much to illuminate both common mechanisms and distinctive features, and trace the looping effects from political processes to individual experience and back again. The ethics and pragmatics of individual and collective healing, restitution, resilience, and recovery can be understood in terms of the self-vindicating loops between politics, structural violence, public discourse, and embodied experience. PMID:24855142

  8. Using a Checklist to Improve Family Communication in Trauma Care.

    PubMed

    Dennis, Bradley M; Nolan, Tracy L; Brown, Cecil E; Vogel, Robert L; Flowers, Kristin A; Ashley, Dennis W; Nakayama, Don K

    2016-01-01

    Modern concepts of patient-centered care emphasize effective communication with patients and families, an essential requirement in acute trauma settings. We hypothesized that using a checklist to guide the initial family conversation would improve the family's perception of the interaction. Institutional Review Board-approved, prospective pre/post study involving families of trauma patients admitted to our Level I trauma center for >24 hours. In the control group, families received information according to existing practices. In the study group, residents gave patient information to a first-degree family member using a checklist that guided the interaction. The checklist included a physician introduction, patient condition, list of known injuries, admission unit or intensive care unit, any consultants involved, plans for additional studies or operations, and opportunity for family to ask questions. An 11-item survey was administered 24 to 48 hours after admission to each group that evaluated the trauma team's communication in the areas of physician introduction, patient condition, ongoing treatment, and family perception of the interaction. Responses were on a Likert scale and analyzed using the Wilcoxon-Mann-Whitney test. There were 130 patients in each group. The study group had significantly (P < 0.05) better responses in 8 of 11 items surveyed: physician spoke to family, physician introduction, understanding of their relative's injuries, admitting unit, consultants involved, urgent surgical procedures required, ongoing diagnostic studies, and understanding of the treatment plan. In conclusion, using a checklist improves the perception of the initial communication between the trauma team and family members of trauma patients, especially their understanding of the treatment plan. PMID:26802859

  9. [The Trauma Network of the German Society for Trauma 2009].

    PubMed

    Kühne, C A; Mand, C; Sturm, J; Lackner, C K; Künzel, A; Siebert, H; Ruchholtz, S

    2009-10-01

    In 2009, 3 years after the foundation of the Trauma Network of the German Society for Trauma (TraumaNetzwerkD DGU), the majority of German hospitals participating in the treatment of seriously injured patients is registered in regional trauma networks (TNW). Currently there are 41 trauma networks with more than 660 hospitals in existence, 18 more are registered but are still in the planning phase. Each Federal State has an average of 39 trauma centres of different levels taking part in the treatment of seriously injured patients and every trauma network has an average catchment area of 8708 km(2). The most favourable geographical infrastructure conditions exist in Nordrhein-Westfalen, the least favourable in Sachsen-Anhalt and Mecklenburg-Vorpommern. A total of 95 hospitals have already fulfilled the first audit of the structural, personnel and qualitative requirements by the certification bodies. Examination of the check lists of 26 hospitals showed shortcomings in the clinical structure so that these hospitals must be rechecked after correction of the shortcomings. A total of 59 hospitals throughout Germany were successfully audited and only one failed to fulfil the requirements. Because of the varying sizes of the trauma networks there are differences in the areas covered by each trauma network and trauma centre. Concerning the process of certification and auditing (together with the company DIOcert) it could be seen that by careful examination of the check lists of each hospital unforeseen problems during the audit could be avoided. The following article will present the current state of development of the Trauma Network of the German Society for Trauma and describe the certification and auditing process. PMID:19756455

  10. Semi- and Fully Self-Organised Teams

    NASA Astrophysics Data System (ADS)

    Kumlander, Deniss

    Most modern companies realise that the best way to improve stability and earning in the global, rapidly changing world is to be innovating and produce software that will be fully used and appreciated by customers. The key aspect on this road is personnel and processes. In the paper we review self-organised teams proposing several new approaches and constraints ensuring such teams' stability and efficiency. The paper also introduce a semi-self organised teams, which are in the shortterm time perspective as the same reliable as fully self-organised teams and much simpler to organise and support.

  11. Current theories on the pathophysiology of multiple organ failure after trauma.

    PubMed

    Tsukamoto, Takeshi; Chanthaphavong, R Savanh; Pape, Hans-Christoph

    2010-01-01

    Despite the enormous efforts to elucidate the mechanisms of the development of multiple organ failure (MOF) following trauma, MOF following trauma is still a leading cause of late post-injury death and morbidity. Now, it has been proven that excessive systemic inflammation following trauma participates in the development of MOF. Fundamentally, the inflammatory response is a host-defence response; however, on occasion, this response turns around to cause deterioration to host depending on exo- and endogenic factors. Through this review we aim to describe the pathophysiological approach for MOF after trauma studied so far and also introduce the prospects of this issue for the future. PMID:19729158

  12. Outcome of major trauma patients in a Hong Kong general hospital.

    PubMed

    Kam, C W; Kitchell, A K; Yau, H H; Kan, C H

    1998-09-01

    This is a retrospective study on the outcome using the TRISS methodology of 94 significantly injured patients over a 24-month period, managed by the Hospital Trauma Team in a general hospital since the formation of the Team in August 1994. There were 37 deaths and nine (24.3%) of these were 'potentially preventable' according to TRISS methodology. Seven of these nine 'potentially preventable or unexpected deaths' were transferred from a nearby district hospital where there was no acute operative facilities. There was no significant difference between the sex, age, mode of injury or Injury Severity Score between the direct admission and transfer-in cases and the M-statistic values of the two groups were similar. Five of the nine deaths happened in the first 4 months after the formation of the Trauma Team and the other four were scattered in the subsequent 20 months. The rate of preventable deaths was 50% (five out of 10 deaths) in the first 4 months, and was 15% (four out of 26) in the subsequent period. The probable causes for the 'potentially preventable trauma deaths' were delay owing to interhospital transfer, delay in activation of the trauma team, unidentified intra-peritoneal haemorrhage, failure to control haemorrhage and delayed or inadequate definitive operation. The evident improvement in the reduction of unexpected trauma deaths were likely associated with the success factors of the improvement of the multi-disciplinary cooperation including mutual understanding, simultaneous patient assessment, higher readiness to use diagnostic peritoneal lavage or ultrasonography to evaluate blunt abdominal trauma, earlier senior participation in patient care, shortening in response time of supportive facilities and a gradual cultural change towards dedicated trauma patient care. Further reduction in unexpected deaths can be expected if better prehospital triage by ambulance staff is attained to transfer trauma patients to the most appropriate instead of the nearest

  13. Burn Teams and Burn Centers: The Importance of a Comprehensive Team Approach to Burn Care

    PubMed Central

    Al-Mousawi, Ahmed M.; Mecott-Rivera, Gabriel A.; Jeschke, Marc G.; Herndon, David N.

    2009-01-01

    Synopsis Advances in burn care have been colossal, but while extra work is needed, it is clear that the organized effort of burn teams can continue making improvements in survival rates and quality of life possible for patients. Burn patients are unique, representing the most severe model of trauma,33 and hence this necessitates treatment in the best facilities available for that endeavor. Burn centers have developed to meet these intricate needs but can only function productively and most efficiently through well organized, multifaceted, patient-centered teams in areas of clinical care and research. PMID:19793550

  14. Introducing ADS Labs

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Henneken, E.; Grant, C. S.; Kurtz, M. J.; Di Milia, G.; Luker, J.; Thompson, D. M.; Bohlen, E.; Murray, S. S.

    2011-05-01

    ADS Labs is a platform that ADS is introducing in order to test and receive feedback from the community on new technologies and prototype services. Currently, ADS Labs features a new interface for abstract searches, faceted filtering of results, visualization of co-authorship networks, article-level recommendations, and a full-text search service. The streamlined abstract search interface provides a simple, one-box search with options for ranking results based on a paper relevancy, freshness, number of citations, and downloads. In addition, it provides advanced rankings based on collaborative filtering techniques. The faceted filtering interface allows users to narrow search results based on a particular property or set of properties ("facets"), allowing users to manage large lists and explore the relationship between them. For any set or sub-set of records, the co-authorship network can be visualized in an interactive way, offering a view of the distribution of contributors and their inter-relationships. This provides an immediate way to detect groups and collaborations involved in a particular research field. For a majority of papers in Astronomy, our new interface will provide a list of related articles of potential interest. The recommendations are based on a number of factors, including text similarity, citations, and co-readership information. The new full-text search interface allows users to find all instances of particular words or phrases in the body of the articles in our full-text archive. This includes all of the scanned literature in ADS as well as a select portion of the current astronomical literature, including ApJ, ApJS, AJ, MNRAS, PASP, A&A, and soon additional content from Springer journals. Fulltext search results include a list of the matching papers as well as a list of "snippets" of text highlighting the context in which the search terms were found. ADS Labs is available at http://adslabs.org

  15. Global trauma: the great divide

    PubMed Central

    Paniker, Jayanth; Graham, Simon Matthew; Harrison, James William

    2015-01-01

    Road trauma is an emergent global issue. There is huge disparity between the population affected by road trauma and the resource allocation. If the current trend continues, a predicted extra 5 million lives will be lost in this decade. This article aims to create an awareness of the scale of the problem of road trauma and the inequality in the resources available to address this problem. It also describes the responses from the international organisations and the orthopaedic community in dealing with this issue. The International Orthopaedic community has a unique opportunity and moral obligation to play a part in changing this trend of global trauma. PMID:27163075

  16. Trauma care documentation: a comprehensive guide.

    PubMed

    Southard, P; Frankel, P

    1989-01-01

    The medical record serves numerous functions. It provides chronologic evidence of patient evaluation, treatment, and response to therapy, and a means to review the quality of the care. Communication among members of the health care team regarding the patient's status and plan of care also occurs by means of the medical record. The medical and legal importance of a comprehensive, accurate trauma resuscitation record cannot be overemphasized. The success of this type of documentation will depend on the design of the record and the understanding of the personnel involved. In addition, nursing managers responsible for the fiscal accountability of their departments understand the value of accurate documentation. The trauma resuscitation record can be used to demonstrate to insurance companies the reason for charging trauma patients additional fees. Inadequate documentation can cause charges to be disallowed by the third-party payors. Perhaps one of the most important functions of the medical record is to assist in protecting the legal interest of the patient and the health care provider. Minimum documentation for care provided in the emergency department must include patient identification, how the patient arrived, care that was rendered before arrival, pertinent history, chronologic notation of results of physical examination including vital signs, and the results of diagnostic and therapeutic procedures and tests. The physician's orders and diagnostic impression should be recorded. It is important that the patient's response to the interventions, not just the intervention itself, be described. The patient's disposition and condition on discharge from the emergency department must be documented. For the trauma patient, mechanisms of injury, GCS, trauma score (or essential components), spinal immobilization, and the status of airway, breathing, and circulatory systems also must be recorded. The importance of accurate and comprehensive documentation on every medical

  17. Exploring the "Lone Wolf" Phenomenon in Student Teams

    ERIC Educational Resources Information Center

    Barr, Terri Feldman; Dixon, Andrea L.; Gassenheimer, Jule B.

    2005-01-01

    The proliferation of projects using student teams has motivated researchers to examine factors that affect both team process and outcomes. This research introduces an individual difference variable found in the business environment that has not been examined in a classroom context. The lone wolf appears to play a role in how teams function and…

  18. Biomechanics of penetrating trauma.

    PubMed

    Yoganandan, N; Pintar, F A

    1997-01-01

    It is well known that injuries and deaths due to penetrating projectiles have become a national and an international epidemic in Western society. The application of biomedical engineering to solve day-to-day problems has produced considerable advances in safety and mitigation/prevention of trauma. The study of penetrating trauma has been largely in the military domain where war-time specific applications were advanced with the use of high-velocity weapons. With the velocity and weapon caliber in the civilian population at half or less compared with the military counterpart, wound ballistics is a largely different problem in today's trauma centers. The principal goal of the study of penetrating injuries in the civilian population is secondary prevention and optimized emergency care after occurrence. A thorough understanding of the dynamic biomechanics of penetrating injuries quantifies missile type, caliber, and velocity to hard and soft tissue damage. Such information leads to a comprehensive assessment of the acute and long-term treatment of patients with penetrating injuries. A review of the relevant military research applied to the civilian domain and presentation of new technology in the biomechanical study of these injuries offer foundation to this field. Relevant issues addressed in this review article include introduction of the military literature, the need for secondary prevention, environmental factors including projectile velocity and design, experimental studies with biological tissues and physical models, and mathematical simulations and analyses. Areas of advancement are identified that enables the pursuit of biomechanics research in order to arrive at better secondary prevention strategies. PMID:9719858

  19. Rural Trauma: Is Trauma Designation Associated with Better Hospital Outcomes?

    ERIC Educational Resources Information Center

    Bowman, Stephen M.; Zimmerman, Frederick J.; Sharar, Sam R.; Baker, Margaret W.; Martin, Diane P.

    2008-01-01

    Context: While trauma designation has been associated with lower risk of death in large urban settings, relatively little attention has been given to this issue in small rural hospitals. Purpose: To examine factors related to in-hospital mortality and delayed transfer in small rural hospitals with and without trauma designation. Methods: Analysis…

  20. Trauma-Focused CBT for Youth with Complex Trauma

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2012-01-01

    Objectives: Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive…

  1. Trauma-focused CBT for youth with complex trauma

    PubMed Central

    Mannarino, Anthony P.; Kliethermes, Matthew; Murray, Laura A.

    2013-01-01

    Objectives Many youth develop complex trauma, which includes regulation problems in the domains of affect, attachment, behavior, biology, cognition, and perception. Therapists often request strategies for using evidence-based treatments (EBTs) for this population. This article describes practical strategies for applying Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth with complex trauma. Methods TF-CBT treatment phases are described and modifications of timing, proportionality and application are described for youth with complex trauma. Practical applications include a) dedicating proportionally more of the model to the TF-CBT coping skills phase; b) implementing the TF-CBT Safety component early and often as needed throughout treatment; c) titrating gradual exposure more slowly as needed by individual youth; d) incorporating unifying trauma themes throughout treatment; and e) when indicated, extending the TF-CBT treatment consolidation and closure phase to include traumatic grief components and to generalize ongoing safety and trust. Results Recent data from youth with complex trauma support the use of the above TF-CBT strategies to successfully treat these youth. Conclusions The above practical strategies can be incorporated into TF-CBT to effectively treat youth with complex trauma. Practice implications Practical strategies include providing a longer coping skills phase which incorporates safety and appropriate gradual exposure; including relevant unifying themes; and allowing for an adequate treatment closure phase to enhance ongoing trust and safety. Through these strategies therapists can successfully apply TF-CBT for youth with complex trauma. PMID:22749612

  2. Radiology of skeletal trauma

    SciTech Connect

    Rogers, L.F.

    1982-01-01

    This 1000-page book contains over 1700 illustrations, is presented in two volumes and subdivided into 23 chapters. After brief chapters of Introduction and General Anatomy, a section on Skeletal Biomechanics is presented. The Epidemiology of Fractures chapter examines, among other things, the effects of age on the frequency and distribution of fractures. In the chapter on Classifications of Fractures, the author describes the character of traumatic forces such as angulating, torsional, avulsive, and compressive, and then relates these to the resultant fracture configurations. The Fracture Treatment chapter presents an overview of treatment principles. Other chapters deal with specific problems in pediatric trauma, fracture healing and nonhealing, and fracture complications.

  3. Regional Anesthesia in Trauma Medicine

    PubMed Central

    Wu, Janice J.; Lollo, Loreto; Grabinsky, Andreas

    2011-01-01

    Regional anesthesia is an established method to provide analgesia for patients in the operating room and during the postoperative phase. While regional anesthesia offers unique advantages, as shown by the recent military experience, it is not commonly utilized in the prehospital or emergency department setting. Most often, regional anesthesia techniques for traumatized patients are first utilized in the operating room for procedural anesthesia or for postoperative pain control. While infiltration or single nerve block procedures are often used by surgeons or emergency medicine physicians in the preoperative phase, more advanced techniques such as plexus block procedures or regional catheter placements are more commonly performed by anesthesiologists for surgery or postoperative pain control. These regional techniques offer advantages over intravenous anesthesia, not just in the perioperative phase but also in the acute phase of traumatized patients and during the initial transport of injured patients. Anesthesiologists have extensive experience with regional techniques and are able to introduce regional anesthesia into settings outside the operating room and in the early treatment phases of trauma patients. PMID:22162684

  4. Speeding Up Team Learning.

    ERIC Educational Resources Information Center

    Edmondson, Amy; Bohmer, Richard; Pisano, Gary

    2001-01-01

    A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)

  5. The Discipline of Teams.

    ERIC Educational Resources Information Center

    Katzenbach, Jon R.; Smith, Douglas K.

    1993-01-01

    Teams share commitment, translate purpose into performance goals, and have members be accountable with and to their teammates. Types of teams are those that recommend, make or do things, and run things. The distinction between teams and other working groups is performance: an effective team is worth more than the sum of its parts. (SK)

  6. Sports Teams Extend Reach

    ERIC Educational Resources Information Center

    Shah, Nirvi

    2012-01-01

    Unlike traditional high school athletic teams, Unified Sports teams are designed to immerse students with intellectual disabilities in a facet of school culture that has largely eluded them. Nationwide, more than 2,000 schools in 42 states have the teams, where the ideal is for about half the athletes on each team to be students with intellectual…

  7. Assessing Team Performance.

    ERIC Educational Resources Information Center

    Trimble, Susan; Rottier, Jerry

    Interdisciplinary middle school level teams capitalize on the idea that the whole is greater than the sum of its parts. Administrators and team members can maximize the advantages of teamwork using team assessments to increase the benefits for students, teachers, and the school environment. Assessing team performance can lead to high performing…

  8. TeamXchange: A Team Project Experience Involving Virtual Teams and Fluid Team Membership

    ERIC Educational Resources Information Center

    Dineen, Brian R.

    2005-01-01

    TeamXchange, an online team-based exercise, is described. TeamXchange is consistent with the collaborative model of learning and provides a means of fostering enhanced student learning and engagement through collaboration in virtual teams experiencing periodic membership changes. It was administered in an undergraduate Organizational Behavior…

  9. Student Team Learning.

    ERIC Educational Resources Information Center

    Slavin, Robert E.

    Three Student Team Learning techniques have been extensively researched and found to significantly increase student learning. In Student Teams Achievement Divisions (STAD), teams are made up of high, average, and low performing students of both genders and different racial and ethnic backgrounds. Team members study worksheets, work problems in…

  10. Management of Colorectal Trauma

    PubMed Central

    2011-01-01

    Although the treatment strategy for colorectal trauma has advanced during the last part of the twentieth century and the result has improved, compared to other injuries, problems, such as high septic complication rates and mortality rates, still exist, so standard management for colorectal trauma is still a controversial issue. For that reason, we designed this article to address current recommendations for management of colorectal injuries based on a review of literature. According to the reviewed data, although sufficient evidence exists for primary repair being the treatment of choice in most cases of nondestructive colon injuries, many surgeons are still concerned about anastomotic leakage or failure, and prefer to perform a diverting colostomy. Recently, some reports have shown that primary repair or resection and anastomosis, is better than a diverting colostomy even in cases of destructive colon injuries, but it has not fully established as the standard treatment. The same guideline as that for colonic injury is applied in cases of intraperitoneal rectal injuries, and, diversion, primary repair, and presacral drainage are regarded as the standards for the management of extraperitoneal rectal injuries. However, some reports state that primary repair without a diverting colostomy has benefit in the treatment of extraperitoneal rectal injury, and presacral drainage is still controversial. In conclusion, ideally an individual management strategy would be developed for each patient suffering from colorectal injury. To do this, an evidence-based treatment plan should be carefully developed. PMID:21980586

  11. Coagulopathy after severe pediatric trauma.

    PubMed

    Christiaans, Sarah C; Duhachek-Stapelman, Amy L; Russell, Robert T; Lisco, Steven J; Kerby, Jeffrey D; Pittet, Jean-François

    2014-06-01

    Trauma remains the leading cause of morbidity and mortality in the United States among children aged 1 to 21 years. The most common cause of lethality in pediatric trauma is traumatic brain injury. Early coagulopathy has been commonly observed after severe trauma and is usually associated with severe hemorrhage and/or traumatic brain injury. In contrast to adult patients, massive bleeding is less common after pediatric trauma. The classical drivers of trauma-induced coagulopathy include hypothermia, acidosis, hemodilution, and consumption of coagulation factors secondary to local activation of the coagulation system after severe traumatic injury. Furthermore, there is also recent evidence for a distinct mechanism of trauma-induced coagulopathy that involves the activation of the anticoagulant protein C pathway. Whether this new mechanism of posttraumatic coagulopathy plays a role in children is still unknown. The goal of this review is to summarize the current knowledge on the incidence and potential mechanisms of coagulopathy after pediatric trauma and the role of rapid diagnostic tests for early identification of coagulopathy. Finally, we discuss different options for treating coagulopathy after severe pediatric trauma. PMID:24569507

  12. Sexual Trauma, Spirituality, and Psychopathology

    ERIC Educational Resources Information Center

    Krejci, Mark J.; Thompson, Kevin M.; Simonich, Heather; Crosby, Ross D.; Donaldson, Mary Ann; Wonderlich, Stephen A.; Mitchell, James E.

    2004-01-01

    This study assessed the association between spirituality and psychopathology in a group of sexual abuse victims and controls with a focus on whether spirituality moderated the association between sexual trauma and psychopathology. Seventy-one sexual trauma victims were compared to 25 control subjects on spiritual well-being, the Eating Disorder…

  13. Developing Your Dream Team

    ERIC Educational Resources Information Center

    Gatlin, Kenda

    2005-01-01

    Almost anyone has held various roles on a team, be it a family unit, sports team, or a project-oriented team. As an educator, one must make a conscious decision to build and invest in a team. Gathering the best team possible will help one achieve one's goals. This article explores some of the key reasons why it is important to focus on the team…

  14. Trauma Ultrasound in Civilian Tactical Medicine

    PubMed Central

    Whelan, Lori; Justice, William; Goodloe, Jeffrey M.; Dixon, Jeff D.; Thomas, Stephen H.

    2012-01-01

    The term “tactical medicine” can be defined in more than one way, but in the nonmilitary setting the term tactical emergency medical services (TEMS) is often used to denote medical support operations for law enforcement. In supporting operations involving groups such as special weapons and tactics (SWAT) teams, TEMS entail executing triage, diagnosis, stabilization, and evacuation decision-making in challenging settings. Ultrasound, now well entrenched as a part of trauma evaluation in the hospital setting, has been investigated in the prehospital arena and may have utility in TEMS. This paper addresses potential use of US in the tactical environment, with emphasis on the lessons of recent years' literature. Possible uses of US are discussed, in terms of both specific clinical applications and also with respect to informing triage and related decision making. PMID:23243509

  15. Prehospital Trauma Care in Singapore.

    PubMed

    Ho, Andrew Fu Wah; Chew, David; Wong, Ting Hway; Ng, Yih Yng; Pek, Pin Pin; Lim, Swee Han; Anantharaman, Venkataraman; Hock Ong, Marcus Eng

    2015-01-01

    Prehospital emergency care in Singapore has taken shape over almost a century. What began as a hospital-based ambulance service intended to ferry medical cases was later complemented by an ambulance service under the Singapore Fire Brigade to transport trauma cases. The two ambulance services would later combine and come under the Singapore Civil Defence Force. The development of prehospital care systems in island city-state Singapore faces unique challenges as a result of its land area and population density. This article defines aspects of prehospital trauma care in Singapore. It outlines key historical milestones and current initiatives in service, training, and research. It makes propositions for the future direction of trauma care in Singapore. The progress Singapore has made given her circumstances may serve as lessons for the future development of prehospital trauma systems in similar environments. Key words: Singapore; trauma; prehospital emergency care; emergency medical services. PMID:25494913

  16. “It takes a village” to raise research productivity: Impact of a Trauma Interdisciplinary Group for Research (TIGR) at an urban, Level 1 trauma center

    PubMed Central

    Medeiros, Regina S.; Ferdinand, Colville H.B.; Hawkins, Michael L.; Holsten, Steven B.; Dong, Yanbin; Zhu, Haidong

    2013-01-01

    BACKGROUND Few interdisciplinary research groups include basic scientists, pharmacists, therapists, nutritionists, lab technicians, as well as trauma patients and families, in addition to clinicians. Increasing interprofessional diversity within scientific teams working to improve trauma care is a goal of national organizations and federal funding agencies like the National Institutes of Health (NIH). This paper describes the design, implementation, and outcomes of a Trauma Interdisciplinary Group for Research (TIGR) at a Level 1 trauma center as it relates to increasing research productivity, with specific examples excerpted from an on-going NIH-funded study. METHODS We utilized a pre-test/post-test design with objectives aimed at measuring increases in research productivity following a targeted intervention. A SWOT (strengths, weaknesses, opportunities, threats) analysis was used to develop the intervention which included research skill-building activities, accomplished by adding multidisciplinary investigators to an existing NIH-funded project. The NIH project aimed to test the hypothesis that accelerated biologic aging from chronic stress increases baseline inflammation and reduces inflammatory response to trauma (projected N=150). Pre/Post-TIGR data related to participant screening, recruitment, consent, and research processes were compared. Research productivity was measured through abstracts, publications, and investigator-initiated projects. RESULTS Research products increased from N =12 to N=42; (~ 400%). Research proposals for federal funding increased from N=0 to N=3, with success rate of 66%. Participant screenings for the NIH-funded study increased from N=40 to N=313. Consents increased from N=14 to N=70. Lab service fees were reduced from $300/participant to $5/participant. CONCLUSIONS Adding diversity to our scientific team via TIGR was exponentially successful in 1) improving research productivity, 2) reducing research costs, and 3) increasing

  17. Supporting Information Use and Retention of Pre-Hospital Information during Trauma Resuscitation: A Qualitative Study of Pre-Hospital Communications and Information Needs

    PubMed Central

    Zhang, Zhan; Sarcevic, Aleksandra; Burd, Randall S.

    2013-01-01

    Pre-hospital communication is a critical first step towards ensuring efficient management of critically injured patients during trauma resuscitation. Information about incoming patients received from the field and en route serves a critical role in helping emergency medical teams prepare for patient care. Despite many efforts, inefficiencies persist. In this paper, we examine the pre-hospital communications between pre-hospital and hospital providers, including the types of information transferred during en-route calls, as well as the information needs of trauma teams. Our findings show that Emergency Medical Services (EMS) teams report a great deal of information from the field, most of which match the needs of trauma teams. We discuss design implications for a computerized system to support the use and retention of pre-hospital information during trauma resuscitation. PMID:24551428

  18. [MUSCULOSKELETAL MARKERS, ARTHROPATY, TRAUMAS].

    PubMed

    Caldarini, Carla; Zavaroni, Federica; Benassi, Valentina

    2015-01-01

    The bone tissue remodeling due to strong physical/working activity is defined as ergonomic markers or MSM (Muscoloskeletal Stress Markers) (Capasso et al. 1999) and MOS (Markers of Occupational Stress). Among them we can find: enthesopaties, arthropaties, non metrical stress and traumas markers. In the present study, the analysis of these traits has been used to clarify habitual activity patterns of four imperial populations from Suburbium: Castel Malnome, Casal Bertone area Q, Via Padre Semeria e Quarto Cappello del Prete. The very high prevalence of activity-induced stress lesions occurred among the individuals of Castel Malnome and Casal Bertone area Q suggests that these groups were involved in strenuous occupations such as, respectively: the processing and storage of salt and the dyeing of textiles and hides discernible from the archaeological context. For the individuals of Via Padre Semeria and Quarto Cappello del Prete the alterations, instead, could be compatibles with agricultural work. PMID:27348990

  19. Vascular trauma historical notes.

    PubMed

    Rich, Norman M

    2011-03-01

    This article provides a brief historical review of treatment of vascular trauma. Although methods for ligation came into use in the second century, this knowledge was lost during the Dark Ages and did not come back until the Renaissance. Many advances in vascular surgery occurred during the Balkan Wars, World War I, and World War II, although without antibiotics and blood banking, the philosophy of life over limb still ruled. Documenting and repairing both arteries and veins became more common during the Korean and Vietnam conflicts. Increased documentation has revealed that the current conflicts have resulted in more arterial injuries than in previous wars, likely because of improved body armor, improvised explosive device attacks, tourniquet use, and improved medical evacuation time. This brief review emphasizes the great value of mentorship and the legacy of the management of arterial and venous injuries to be passed on. PMID:21502112

  20. Trauma and religiousness.

    PubMed

    Gostečnik, Christian; Repič Slavič, Tanja; Lukek, Saša Poljak; Cvetek, Robert

    2014-06-01

    Victims of traumatic events who experience re-traumatization often develop a highly ambivalent relationship to God and all religiosity as extremely conflictual. On the one hand, they may choose to blame God for not having protected them, for having left them to feel so alone, for having been indifferent to them or they may even turn their wrath upon God, as the source of cruelty. Often though, the traumas experienced by individuals prompt them to turn to God and religion in search of help. This gives reason for the need of new and up-to-date research that can help elucidate why some people choose to seek help in religion and others turn away from it. PMID:23187617

  1. Team Effectiveness and Team Development in CSCL

    ERIC Educational Resources Information Center

    Fransen, Jos; Weinberger, Armin; Kirschner, Paul A.

    2013-01-01

    There is a wealth of research on computer-supported cooperative work (CSCW) that is neglected in computer-supported collaborative learning (CSCL) research. CSCW research is concerned with contextual factors, however, that may strongly influence collaborative learning processes as well, such as task characteristics, team formation, team members'…

  2. Cohesion, team mental models, and collective efficacy: towards an integrated framework of team dynamics in sport.

    PubMed

    Filho, Edson; Tenenbaum, Gershon; Yang, Yanyun

    2015-01-01

    A nomological network on team dynamics in sports consisting of a multiframework perspective is introduced and tested. The aim was to explore the interrelationship among cohesion, team mental models (TMMs), collective efficacy (CE) and perceived performance potential (PPP). Three hundred and forty college-aged soccer players representing 17 different teams (8 female and 9 male) participated in the study. They responded to surveys on team cohesion, TMMs, CE and PPP. Results are congruent with the theoretical conceptualisation of a parsimonious view of team dynamics in sports. Specifically, cohesion was found to be an exogenous variable predicting both TMMs and CE beliefs. TMMs and CE were correlated and predicted PPP, which in turn accounted for 59% of the variance of objective performance scores as measured by teams' season record. From a theoretical standpoint, findings resulted in a parsimonious view of team dynamics, which may represent an initial step towards clarifying the epistemological roots and nomological network of various team-level properties. From an applied standpoint, results suggest that team expertise starts with the establishment of team cohesion. Following the establishment of cohesiveness, teammates are able to advance team-related schemas and a collective sense of confidence. Limitations and key directions for future research are outlined. PMID:25385557

  3. An ecological view of psychological trauma and trauma recovery.

    PubMed

    Harvey, M R

    1996-01-01

    This paper presents an ecological view of psychological trauma and trauma recovery. Individual differences in posttraumatic response and recovery are the result of complex interactions among person, event, and environmental factors. These interactions define the interrelationship of individual and community and together may foster or impede individual recovery. The ecological model proposes a multidimensional definition of trauma recovery and suggests that the efficacy of trauma-focused interventions depends on the degree to which they enhance the person-community relationship and achieve "ecological fit" within individually varied recovery contexts. In attending to the social, cultural and political context of victimization and acknowledging that survivors of traumatic experiences may recover without benefit of clinical intervention, the model highlights the phenomenon of resiliency, and the relevance of community intervention efforts. PMID:8750448

  4. Immunohistochemical alterations after muscle trauma.

    PubMed

    Fechner, G; Bajanowski, T; Brinkmann, B

    1993-01-01

    The proteins fibrin, fibrinogen, fibronectin and complement C5b-9 were investigated in mechanically damaged skeletal muscle. An accumulation of fibrin, fibrinogen and fibronectin could be observed immediately after intra-vital trauma in damaged fibre zones, later an accumulation at the torn edges of the fibres. The accumulation of complement C5b-9 began one hour after trauma. After post mortem trauma no positive reactions could be observed for any of the proteins. The degree of expression of these proteins can therefore be used to differentiate between vital and postmortem muscle damage as well as the estimation of wound age in the early antemortem time period. PMID:8431399

  5. Initial assessment and management of pediatric trauma patients

    PubMed Central

    McFadyen, J Grant; Ramaiah, Ramesh; Bhananker, Sanjay M

    2012-01-01

    Injury is the leading cause of death and disability in children. Each year, almost one in six children in the United States require emergency department (ED) care for the treatment of injuries, and more than 10,000 children die from injuries. Severely injured children need to be transported to a facility that is staffed 24/7 by personnel experienced in the management of children, and that has all the appropriate equipment to diagnose and manage injuries in children. Anatomical, physiological, and emotional differences between adults and children mean that children are not just scaled-down adults. Facilities receiving injured children need to be child and family friendly, in order to minimize the psychological impact of injury on the child and their family/carers. Early recognition and treatment of life-threatening airway obstruction, inadequate breathing, and intra-abdominal and intra-cranial hemorrhage significantly increases survival rate after major trauma. The initial assessment and management of the injured child follows the same ATLS® sequence as adults: primary survey and resuscitation, followed by secondary survey. A well-organized trauma team has a leader who designates roles to team members and facilitates clear, unambiguous communication between team members. The team leader stands where he/she can observe the entire team and monitor the “bigger picture.” Working together as a cohesive team, the members perform the primary survey in just a few minutes. Life-threatening conditions are dealt with as soon as they are identified. Necessary imaging studies are obtained early. Constant reassessment ensures that any deterioration in the child's condition is picked up immediately. The secondary survey identifies other injuries, such as intra-abdominal injuries and long-bone fractures, which can result in significant hemorrhage. The relief of pain is an important part of the treatment of an injured child. PMID:23181205

  6. Computed tomography in trauma: An atlas approach

    SciTech Connect

    Toombs, B.D.; Sandler, C.

    1986-01-01

    This book discussed computed tomography in trauma. The text is organized according to mechanism of injury and site of injury. In addition to CT, some correlation with other imaging modalities is included. Blunt trauma, penetrating trauma, complications and sequelae of trauma, and use of other modalities are covered.

  7. Secondary Trauma in Children and School Personnel

    ERIC Educational Resources Information Center

    Motta, Robert W.

    2012-01-01

    A review of childhood secondary trauma is presented. Secondary trauma involves the transfer and acquisition of negative affective and dysfunctional cognitive states due to prolonged and extended contact with others, such as family members, who have been traumatized. As such, secondary trauma refers to a spread of trauma reactions from the victim…

  8. Tiger Team audits

    SciTech Connect

    Cheney, G.T.

    1992-01-01

    This paper will address the purpose, scope, and approach of the Department of Energy Tiger Team Assessments. It will use the Tiger Team Assessment experience of Sandia National Laboratories at Albuquerque, New Mexico, as illustration.

  9. Tiger Team audits

    SciTech Connect

    Cheney, G.T.

    1992-03-01

    This paper will address the purpose, scope, and approach of the Department of Energy Tiger Team Assessments. It will use the Tiger Team Assessment experience of Sandia National Laboratories at Albuquerque, New Mexico, as illustration.

  10. Massive rectal bleeding distant from a blunt car trauma.

    PubMed

    Gruden, E; Ragot, E; Arienzo, R; Revaux, A; Magri, M; Grossin, M; Leroy, C; Msika, S; Kianmanesh, R

    2010-09-01

    Mesenteric trauma is one of the possible injuries caused by the use of seat belts in case of motor vehicle crash. We report here a rare case of rectal bleeding by rupture of a mesosigmoid haematoma. An emergent laparotomy revealed a mesosigmoid haematoma with a centimetric rectal perforation. The wearing of safety belts added some specific blunt abdominal trauma, which directly depends on lap-and-sash belts. Mesenteric injuries are found out up to 5% of blunt abdominal traumas. "Seat belt mark" leads the surgical team to strongly suspect an intra-abdominal trauma. When "seat belt mark" sign is found, in patients with mild to severe blunt car injuries, CT-scan has to be realised to eliminate intra-abdominal complications, including mesenteric and mesosigmoid ones. In case of proved mesenteric haematoma associated to intestinal bleeding, a surgical treatment must be considered as first choice. Conservative approach remains possible in stable patients but surgical exploration remains necessary in unstable patients with active bleeding. PMID:20638207

  11. A Genuine TEAM Player

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Qualtech Systems, Inc. developed a complete software system with capabilities of multisignal modeling, diagnostic analysis, run-time diagnostic operations, and intelligent interactive reasoners. Commercially available as the TEAMS (Testability Engineering and Maintenance System) tool set, the software can be used to reveal unanticipated system failures. The TEAMS software package is broken down into four companion tools: TEAMS-RT, TEAMATE, TEAMS-KB, and TEAMS-RDS. TEAMS-RT identifies good, bad, and suspect components in the system in real-time. It reports system health results from onboard tests, and detects and isolates failures within the system, allowing for rapid fault isolation. TEAMATE takes over from where TEAMS-RT left off by intelligently guiding the maintenance technician through the troubleshooting procedure, repair actions, and operational checkout. TEAMS-KB serves as a model management and collection tool. TEAMS-RDS (TEAMS-Remote Diagnostic Server) has the ability to continuously assess a system and isolate any failure in that system or its components, in real time. RDS incorporates TEAMS-RT, TEAMATE, and TEAMS-KB in a large-scale server architecture capable of providing advanced diagnostic and maintenance functions over a network, such as the Internet, with a web browser user interface.

  12. To Become a Team.

    ERIC Educational Resources Information Center

    Standley, Jeff

    1993-01-01

    A discussion of team-building in organizations looks at the essential components of trust, common purpose, supportive internal and external environments, and cohesion. Barriers to team development, such as internal competition or communication problems, and the role of the team leader are also discussed. A student campus organization is used for…

  13. Tracking dynamic team activity

    SciTech Connect

    Tambe, M.

    1996-12-31

    AI researchers are striving to build complex multi-agent worlds with intended applications ranging from the RoboCup robotic soccer tournaments, to interactive virtual theatre, to large-scale real-world battlefield simulations. Agent tracking - monitoring other agent`s actions and inferring their higher-level goals and intentions - is a central requirement in such worlds. While previous work has mostly focused on tracking individual agents, this paper goes beyond by focusing on agent teams. Team tracking poses the challenge of tracking a team`s joint goals and plans. Dynamic, real-time environments add to the challenge, as ambiguities have to be resolved in real-time. The central hypothesis underlying the present work is that an explicit team-oriented perspective enables effective team tracking. This hypothesis is instantiated using the model tracing technology employed in tracking individual agents. Thus, to track team activities, team models are put to service. Team models are a concrete application of the joint intentions framework and enable an agent to track team activities, regardless of the agent`s being a collaborative participant or a non-participant in the team. To facilitate real-time ambiguity resolution with team models: (i) aspects of tracking are cast as constraint satisfaction problems to exploit constraint propagation techniques; and (ii) a cost minimality criterion is applied to constrain tracking search. Empirical results from two separate tasks in real-world, dynamic environments one collaborative and one competitive - are provided.

  14. Development of TOUCH Teams.

    ERIC Educational Resources Information Center

    Skinner, Eva

    This paper describes the multidisciplinary group therapy teams that provide services to older persons in board and care residences in the catchment area of Thalians (California) Community Mental Health Center. It reports on the manner in which the decision to form teams was arrived at, the process by which the teams were established, and the…

  15. Team Building [in HRD].

    ERIC Educational Resources Information Center

    1995

    These five papers are from a symposium that was facilitated by Susan Dougherty at the 1995 conference of the Academy of Human Resource Development (HRD). "The Relationship between Productivity and Work Team Autonomy and Team Process Effectiveness" (Candice L. Phelan) reports that correlation analysis of results of a study of 21 work teams revealed…

  16. Trauma and the wise baby.

    PubMed

    Kilborne, Benjamin

    2011-09-01

    This paper expands upon Ferenczi's concept of the wise baby and explores the dynamics of ignorance and compensatory ideals of wisdom as reactions to trauma and as manifestations of "double conscience," shame dynamics and Oedipal shame. Focusing on feelings of ignorance, of knowing and not knowing and their relation to trauma, the author elaborates on the dynamics of fantasies of wisdom, adumbrating implications for psychoanalytic technique. PMID:21818096

  17. Vascular trauma in civilian practice.

    PubMed Central

    Golledge, J.; Scriven, M. W.; Fligelstone, L. J.; Lane, I. F.

    1995-01-01

    Vascular trauma is associated with major morbidity and mortality, but little is known about its incidence or nature in Britain. A retrospective study of 36 patients requiring operative intervention for vascular trauma under one vascular surgeon over a 6-year period was undertaken. Twenty-four patients suffered iatrogenic trauma (median age 61 years); including cardiological intervention (19), radiological intervention (2), varicose vein surgery (1), umbilical vein catherisation (1) and isolated hyperthermic limb perfusion (1). There were 23 arterial and three venous injuries. Twelve patients had accidental trauma (median age 23 years). Three of the ten patients with blunt trauma were referred for vascular assessment before orthopaedic intervention, two after an on-table angiogram and five only after an initial orthopaedic procedure (range of delay 6 h to 10 days). Injuries were arterial in nine, venous in two and combined in one. Angiography was obtained in six patients, and in two patients with multiple upper limb fractures identified the site of injury when clinical localisation was difficult. A variety of vascular techniques were used to treat the injuries. Two patients died postoperatively and one underwent major limb amputation. Thirty-two (89%) remain free of vascular sequelae after a median follow-up of 48 months (range 3-72 months). Vascular trauma is uncommon in the United Kingdom. To repair the injuries a limited repertoire of vascular surgery techniques is needed. Therefore, vascular surgical assessment should be sought at an early stage to prevent major limb loss. PMID:8540659

  18. Indications for embolization in a French level 1 trauma center.

    PubMed

    Frandon, J; Arvieux, C; Thony, F

    2016-08-01

    Abdominal trauma accounts for nearly 20% of all traumatic injuries. It often involves young patients sustaining multiple injuries, with a high associated mortality rate. Management should begin at the scene of injury and relies on a structured chain of care in order to transport the trauma patient to the appropriate hospital center. Management is multi-disciplinary, involving intensive care specialists, surgeons and radiologists. Imaging to precisely define injury is best performed with whole body dual phase computed tomography, which can also identify the source of bleeding. Non-operative management has developed considerably over the years: this includes selective embolization in case of active bleeding or vascular anomalies in stable or stabilized patients after resuscitation. Embolization has become one of the corner stones of abdominal trauma management and interventional radiologists must play an active role on the trauma team. This overview details the different embolization procedures according to the involved organ and embolic agent used. PMID:27374109

  19. [Trauma of the midface].

    PubMed

    Kühnel, T S; Reichert, T E

    2015-03-01

    Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygoma fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialisation seem to decrease in numbers.Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate.Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair. PMID:25860490

  20. [Major respiratory tract traumas].

    PubMed

    Petrov, D; Obretenov, E; Kalaĭdzhiev, G; Plochev, M; Kostadinov, D

    2002-01-01

    Between 1988 and 2000 a total of 33 patients with traumatic tracheobronchial lesions were diagnosed and treated. The trauma was penetrating in 7 (stab and gun-shot), blunt in 10 (car accidents, compression and falling from heights) and iatrogenic in 16 of them (postintubational--15, after foreign body extraction--1). The main clinical and radiological features were subcutaneous emphysema, hemoptysis, respiratory insufficiency, pneumomediastinum and pneumothorax. The diagnosis was confirmed in all patients by early fiberoptic bronchoscopy. "Watch and see" tactics with massive antibiotics therapy was followed in 4 (12%) patients. A surgical treatment was carried out in 29 (88%) patients as follows: simple repair--19 (58%), left pneumonectomy--2 (6%), tracheal resection and anastomosis "end to end"--2 (6%), tracheostomy--1 (3%), thoracocenthesis and drainage--3 (9%) and cervical mediastinotomy--2 (6%). The operative mortality was 9%. The cause of death in these 3 patients were associated brain and spinal cord injuries. In the rest of patients the early and long-term postoperative results were considered very good. PMID:12515032

  1. Complications of pediatric trauma.

    PubMed

    Czerwinski, S J

    1991-09-01

    MSOF is a life-threatening complication of trauma. The body is a dynamic interrelated group of systems that work together efficiently. Changes in one system generally have a widespread impact, and soon the entire system is changed. In children with MSOF, the normal equilibrium that is maintained between organ systems does not exist. Generalized disruption of organ functions occur, and the body attempts to compensate and regain its homeostasis. This activity will often benefit certain organs and harm others. If the disruption continues and compensation fails, organ dysfunction occurs and general chaos reigns. Medical and nursing interventions are directed toward supporting individual organ systems before failure occurs. Attempts to provide this support for one system can cause adverse effects to occur in other systems. Although this is a potential result of medical and nursing interventions, often there is no other choice. It is essential that nurses be aware of the systemic consequences of these interventions and carefully evaluate them. Although overall mortality rates are high, children have a better chance for survival than adults. Expert nursing assessments, interventions, and evaluations are essential to maximize this outcome. More research in the area of MSOF in children is necessary, with specific attention to nursing management and the effect on patient outcome. PMID:1883588

  2. Trauma of the midface

    PubMed Central

    Kühnel, Thomas S.; Reichert, Torsten E.

    2015-01-01

    Fractures of the midface pose a serious medical problem as for their complexity, frequency and their socio-economic impact. Interdisciplinary approaches and up-to-date diagnostic and surgical techniques provide favorable results in the majority of cases though. Traffic accidents are the leading cause and male adults in their thirties are affected most often. Treatment algorithms for nasal bone fractures, maxillary and zygomatic fractures are widely agreed upon whereas trauma to the frontal sinus and the orbital apex are matter of current debate. Advances in endoscopic surgery and limitations of evidence based gain of knowledge are matters that are focused on in the corresponding chapter. As for the fractures of the frontal sinus a strong tendency towards minimized approaches can be seen. Obliteration and cranialization seem to decrease in numbers. Some critical remarks in terms of high dose methylprednisolone therapy for traumatic optic nerve injury seem to be appropriate. Intraoperative cone beam radiographs and preshaped titanium mesh implants for orbital reconstruction are new techniques and essential aspects in midface traumatology. Fractures of the anterior skull base with cerebrospinal fluid leaks show very promising results in endonasal endoscopic repair. PMID:26770280

  3. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  4. Introducing the World of Work

    ERIC Educational Resources Information Center

    Katz, Andrew J.

    2008-01-01

    The author relates how his realization that students react to lessons positively if they are made to feel like part of a team. The teacher decided to a start a company within his classroom, "hiring" managers, camera operators, and designers to help him start the venture. Students were challenged to apply for a job by submitting an application, a…

  5. Vital Signs Strongly Predict Massive Transfusion Need in Geriatric Trauma Patients.

    PubMed

    Fligor, Scott C; Hamill, Mark E; Love, Katie M; Collier, Bryan R; Lollar, Dan; Bradburn, Eric H

    2016-07-01

    Early recognition of massive transfusion (MT) requirement in geriatric trauma patients presents a challenge, as older patients present with vital signs outside of traditional thresholds for hypotension and tachycardia. Although many systems exist to predict MT need in trauma patients, none have specifically evaluated the geriatric population. We sought to evaluate the predictive value of presenting vital signs in geriatric trauma patients for prediction of MT. We retrospectively reviewed geriatric trauma patients presenting to our Level I trauma center from 2010 to 2013 requiring full trauma team activation. The area under the receiver operating characteristic curve was calculated to assess discrimination of arrival vital signs for MT prediction. Ideal cutoffs with high sensitivity and specificity were identified. A total of 194 patients with complete data were analyzed. Of these, 16 patients received MT. There was no difference between the MT and non-MT groups in sex, age, or mechanism. Systolic blood pressure, pulse pressure, diastolic blood pressure, and shock index all were strongly predictive of MT need. Interestingly, we found that heart rate does not predict MT. MT in geriatric trauma patients can be reliably and simply predicted by arrival vital signs. Heart rate may not reflect serious hemorrhage in this population. PMID:27457863

  6. Oxidative stress in severe pulmonary trauma in critical ill patients. Antioxidant therapy in patients with multiple trauma--a review.

    PubMed

    Bedreag, Ovidiu Horea; Rogobete, Alexandru Florin; Sarandan, Mirela; Cradigati, Alina Carmen; Papurica, Marius; Dumbuleu, Maria Corina; Chira, Alexandru Mihai; Rosu, Oana Maria; Sandesc, Dorel

    2015-01-01

    Multiple trauma patients require extremely good management and thus, the trauma team needs to be prepared and to be up to date with the new standards of intensive therapy. Oxidative stress and free radicals represent an extremely aggressive factor to cells, having a direct consequence upon the severity of lung inflammation. Pulmonary tissue is damaged by oxidative stress, leading to biosynthesis of mediators that exacerbate inflammation modulators. The subsequent inflammation spreads throughout the body, leading most of the time to multiple organ dysfunction and death. In this paper, we briefly present an update of biochemical effects of oxidative stress and free radical damage to the pulmonary tissue in patients in critical condition in the intensive care unit. Also, we would like to present a series of active substances that substantially reduce the aggressiveness of free radicals, increasing the chances of survival. PMID:26037258

  7. Challenges When Introducing Electronic Exam

    ERIC Educational Resources Information Center

    Kuikka, Matti; Kitola, Markus; Laakso, Mikko-Jussi

    2014-01-01

    Time pressures often necessitate the use of more efficient exam tools, such as electronic exams (e-exams), instead of traditional paper exams. However, teachers may face challenges when introducing e-exams in a higher education context. This paper describes what kinds of challenges teachers may face when introducing e-exams, based on experiences…

  8. Liver trauma grading and biochemistry tests.

    PubMed

    Arslan, Gozde; Gemici, Aysegul Akdogan; Yirgin, Inci Kizildag; Gulsen, Esma; Inci, Ercan

    2013-10-01

    Among solid organ blunt traumas, the liver and spleen are mostly subject to injury. In addition, the liver is also commonly injured in penetrating traumas because of its size, location, and the ease of injury to the "Glisson Capsule". Several enzymes are known to be elevated following trauma. In our study, we evaluated the correlation between the levels of serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and gamma-glutamyl transpeptidase in 57 patients with blunt trauma to the liver and compared these values to the American Association for the Surgery of Trauma trauma grading system. Additionally, we compared the enzyme level elevations in these patients to the enzyme levels of 29 healthy subjects. As expected, we found significant elevations in enzyme levels of trauma patients compared to the control group. The calculated point estimates were not significantly different between grades 1 and 2 trauma. However, grade 3 trauma group showed a significant increase in enzyme levels. PMID:23793528

  9. Team Cognition in Experienced Command-and-Control Teams

    ERIC Educational Resources Information Center

    Cooke, Nancy J.; Gorman, Jamie C.; Duran, Jasmine L.; Taylor, Amanda R.

    2007-01-01

    Team cognition in experienced command-and-control teams is examined in an UAV (Uninhabited Aerial Vehicle) simulation. Five 3-person teams with experience working together in a command-and-control setting were compared to 10 inexperienced teams. Each team participated in five 40-min missions of a simulation in which interdependent team members…

  10. Introducing students to clinical audit.

    PubMed

    Parkes, Jacqueline; O'Dell, Cindy

    2015-11-01

    It is more than a decade since the UK Central Council for Nursing Midwifery and Health Visiting said that engaging with clinical audit is 'the business of every registered practitioner', yet there appears to be little evidence that nursing has embraced the process. To address this issue, Northampton General Hospital and the University of Northampton implemented a pilot project in which two third-year adult nursing students worked on a 'real life' audit. Supported by the hospital's audit department, and supervised by academic tutors with the relevant experience, the students worked on a pressure-ulcer care audit for their final year dissertation. This article describes the process undertaken by the hospital audit team and the university academic team to develop the pilot project and support the students. Based on the positive evaluations, the university has extended the project to a second phase, incorporating two new partner organisations. PMID:26508069

  11. Delta Alerts: Changing Outcomes in Geriatric Trauma.

    PubMed

    Wiles, Lynn L; Day, Mark D; Harris, LeAnna

    2016-01-01

    Geriatric trauma patients (GTPs) suffering minor injuries have suboptimal outcomes compared with younger populations. Patients 65 years or older account for 10% of all traumas but 28% of all trauma deaths. This trauma center established a third tier trauma alert specifically targeting GTPs at risk for poor outcomes. A Delta Alert is activated when GTPs suffer injuries that fall outside traditional trauma alert guidelines. Early identification and treatment of injuries and expedited referral to specialty groups have improved our GTPs' outcomes including decreased mortality and length of stay and increased percentage of GTPs who are discharged home. PMID:27414140

  12. The right scan, for the right patient, at the right time: the reorganization of major trauma service provision in England and its implications for radiologists.

    PubMed

    Harvey, J J; West, A T H

    2013-09-01

    Major trauma services in England are currently undergoing a radical overhaul with the formation of regional trauma networks and designated major trauma centres (MTCs). Radiology is scheduled to play a key role within major trauma care both in terms of 24/7 access to whole body computed tomography (WBCT) and interventional radiology (IR) services, as well as providing immediate expert imaging guidance to the trauma team. This review examines the rationale behind trauma networks, as well as drawing attention to the new Royal College of Radiologists' standards for major trauma imaging. It attempts to address radiologists' understandable concerns about the inappropriate use of WBCT, radiation dose, and intravenous contrast medium risks. Reporting whole-body CT for trauma patients is difficult, covering multiple body regions, with great pressure to provide a rapid and accurate report to the trauma team. The benefits of standardized reports, dual-radiologist reporting, and the use of organ injury severity grading are explored to aid succinct communication of findings and further guide patient management. PMID:23453710

  13. Geriatric assessment teams.

    PubMed

    Campbell, L J; Cole, K D

    1987-02-01

    In geriatric care, a form of teamwork is the recommended modality because of the complex biopsychosocial needs of the patient. The goal of geriatric assessment programs is to establish an intensive assessment of older adults which requires the competencies of several coordinated disciplines. Not only do teams have the capacity to assess patients in much greater depth but also patients share different information with different providers. The composition of the team is dictated by the needs of the patient population in accordance with resources available. Next, one must identify a method of team practice in order for interactions to take place. The method of functioning determines what kind of team it is, ranging from independent functioning with minimal formal interfacing to interdependent activity interspersed with formal and informal interactions. In initiating a geriatric assessment program, one needs to determine which tasks demand interdisciplinary collaboration, which require interdisciplinary consultation, and which can be performed using a matrix or extended team model. In this model, the core team is supplemented by other disciplines as determined by the team, predicated on patient problems. Teams can profit from training, which can help with choosing an appropriate model, establishing a manual of procedure, and managing interactive issues and problems. This can occur early in the team's formation, or when a team takes on new members. The minimal level of team development would include establishing program goals, delineating professional responsibilities and roles, and implementing a system for exchanging and documenting information about patient plans. Saving input to share only in team meeting is inefficient, so health care teams need to recognize the importance of informal interchanges. It is still a matter of conjecture about what team works best with which patients under what circumstances or conditions. Multiple randomized clinical trials with teams

  14. The study of psychic trauma.

    PubMed

    Bacciagaluppi, Marco

    2011-01-01

    This article starts from the DSM definition of psychic trauma. A central source in this field is the 1992 book by Judith Herman. One line of investigation is the sexual abuse of women and children. In an early phase, both Janet and Freud described dissociation as a reaction to trauma. In 1897, Freud disputed the reality of sexual trauma, a position countered later by Ferenczi. In a later phase, this subject was investigated by the American feminist movement. Studies of physical abuse are then described, followed by mental abuse and neglect. Another line of investigation is combat neurosis. The two lines converged in the definition of PTSD and its incorporation into the DSM in 1980. The views on trauma of John Bowlby and Alice Miller are also discussed. The integration of the relational model in psychoanalysis with the trauma literature is presented. The most recent advances are located in neurobiology. The discussion makes a preliminary investigation of the remote causes of war and sexual violence. PMID:21902510

  15. Top 10 reasons to become a trauma nurse practitioner.

    PubMed

    Galicyznski, Susan F

    2006-01-01

    Nurse practitioners have played a pivotal role in both advances in patient care and healthcare policy over the last 40 years. As the healthcare environment continues to change, so too does the role of the nurse practitioner. Nurse practitioners are becoming the norm instead of the exception in the critical care setting and, more recently, have been welcomed as valuable members to trauma teams around the country. As the role continues to evolve and grow, the growing pains will multiply. This article will discuss one nurse's experience of being the new nurse practitioner in a new role and the challenges, both positive and negative, that have grown out of that experience. PMID:17052090

  16. A novel trauma leadership model reflective of changing times.

    PubMed

    DʼHuyvetter, Cecile; Cogbill, Thomas H

    2014-01-01

    As a result of generational changes in the health care workforce, we sought to evaluate our current Trauma Medical Director Leadership model. We assessed the responsibilities, accountability, time requirements, cost, and provider satisfaction with the current leadership model. Three new providers who had recently completed fellowship training were hired, each with unique professional desires, skill sets, and experience. Our goal was to establish a comprehensive, cost-effective, accountable leadership model that enabled provider satisfaction and equalized leadership responsibilities. A 3-pronged team model was established with a Medical Director title and responsibilities rotating per the American College of Surgeons verification cycle to develop leadership skills and lessen hierarchical differences. PMID:24828770

  17. On championship TEAMS.

    PubMed

    Jones, Daniel B

    2016-02-01

    Championship teams tap the strengths of the individuals working toward a common goal. Surgery is a team sport, which seeks to provide the very best patient care. For surgeons we seek to cure disease, alleviate suffering, and train the next generation of surgeons. When at our best, we build teamwork with a winning attitude, trust, respect, and love. Together there are no limits to what championship teams can achieve with passion, dedicated practice, mutual respect, and a little luck. PMID:26687961

  18. Managing multicultural teams.

    PubMed

    Brett, Jeanne; Behfar, Kristin; Kern, Mary C

    2006-11-01

    Multicultural teams offer a number of advantages to international firms, including deep knowledge of different product markets, culturally sensitive customer service, and 24-hour work rotations. But those advantages may be outweighed by problems stemming from cultural differences, which can seriously impair the effectiveness of a team or even bring itto a stalemate. How can managers best cope with culture-based challenges? The authors conducted in-depth interviews with managers and members of multicultural teams from all over the world. Drawing on their extensive research on dispute resolution and teamwork and those interviews, they identify four problem categories that can create barriers to a team's success: direct versus indirect communication, trouble with accents and fluency, differing attitudes toward hierarchy and authority, and conflicting norms for decision making. If a manager--or a team member--can pinpoint the root cause of the problem, he or she is likelier to select an appropriate strategy for solving it. The most successful teams and managers, the authors found, dealt with multicultural challenges in one of four ways: adaptation (acknowledging cultural gaps openly and working around them), structural intervention (changing the shape or makeup of the team), managerial intervention (setting norms early or bringing in a higher-level manager), and exit (removing a team member when other options have failed). Which strategy is best depends on the particular circumstances--and each has potential complications. In general, though, managers who intervene early and set norms; teams and managers who try to engage everyone on the team; and teams that can see challenges as stemming from culture, not personality, succeed in solving culture-based problems with good humor and creativity. They are the likeliest to harvest the benefits inherent in multicultural teams. PMID:17131565

  19. Team Teaching at Upper Arlington School.

    ERIC Educational Resources Information Center

    Jackson, Annette R.

    1968-01-01

    Team teaching has been used for 4 years in the 10th-grade English classes at Upper Arlington High School near Columbus, Ohio. Units are prepared, presented, and evaluated by teachers working together voluntarily. A 6-day American literature unit introducing Romanticism has been particularly successful. The contrasts between Neoclassicism and…

  20. Introducing Chemical Formulae and Equations.

    ERIC Educational Resources Information Center

    Dawson, Chris; Rowell, Jack

    1979-01-01

    Discusses when the writing of chemical formula and equations can be introduced in the school science curriculum. Also presents ways in which formulae and equations learning can be aided and some examples for balancing and interpreting equations. (HM)

  1. Management of Carotid Artery Trauma

    PubMed Central

    Lee, Thomas S.; Ducic, Yadranko; Gordin, Eli; Stroman, David

    2014-01-01

    With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone. Despite CTA being used as a common screening modality, it appears to lack sufficient sensitivity. DSA remains to be the gold standard in screening. Endovascular techniques are becoming more widely accepted as the primary surgical modality in the treatment of blunt extracranial carotid injuries and penetrating/blunt intracranial carotid lessions. Nonetheless, open surgical approaches are still needed for the treatment of penetrating extracranial carotid injuries and in patients with unfavorable lesions for endovascular intervention. PMID:25136406

  2. Trauma--the malignant epidemic.

    PubMed

    Muckart, D J

    1991-01-19

    Trauma is the commonest cause of death in children and young adults in the USA and the UK and the incidence of both accidental and non-accidental injury continues to increase. In the Western world more pre-retirement years of life are lost annually from trauma than malignant disease, heart disease, and AIDS combined, and by the beginning of the last decade injury deaths outnumbered deaths from all other causes combined in those under 35 years of age. In South Africa, although infectious diseases continue to exact their toll, a similar pattern is emerging. Alcohol and speed are responsible for the majority of motor vehicle accidents, while the increasing ownership of firearms directly parallels the homicide rates from these weapons. Stricter application of the legislation governing alcohol, driving and firearm control is required and a regionalised trauma care programme is desperately needed to contain this epidemic. PMID:1989097

  3. Transfusion medicine in trauma patients

    PubMed Central

    Murthi, Sarah B; Dutton, Richard P; Edelman, Bennett B; Scalea, Thomas M; Hess, John R

    2011-01-01

    Injured patients stress the transfusion service with frequent demands for uncrossmatched red cells and plasma, occasional requirements for large amounts of blood products and the need for new and better blood products. Transfusion services stress trauma centers with demands for strict accountability for individual blood component units and adherence to indications in a clinical field where research has been difficult, and guidance opinion-based. New data suggest that the most severely injured patients arrive at the trauma center already coagulopathic and that these patients benefit from prompt, specific, corrective treatment. This research is clarifying trauma system requirements for new blood products and blood-product usage patterns, but the inability to obtain informed consent from severely injured patients remains an obstacle to further research. PMID:21083009

  4. Ventilatory strategies in trauma patients.

    PubMed

    Arora, Shubhangi; Singh, Preet Mohinder; Trikha, Anjan

    2014-01-01

    Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS) secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented. PMID:24550626

  5. State of nutrition support teams.

    PubMed

    DeLegge, Mark Henry; Kelly, Andrea True; Kelley, Andrea True

    2013-12-01

    The incidence of malnutrition in hospitalized patients is relatively high (up to 55%) despite breakthroughs in nutrition support therapies. These patients have increased morbidity and mortality, extended hospital stays, and care that is associated with higher costs. These patients are often poorly managed due to inadequate nutrition assessment and poor medical knowledge and practice in the field of nutrition. Nutrition support teams (NSTs) are interdisciplinary support teams with specialty training in nutrition that are often comprised of physicians, dietitians, nurses, and pharmacists. Their role includes nutrition assessment, determination of nutrition needs, recommendations for appropriate nutrition therapy, and management of nutrition support therapy. Studies have demonstrated significant improvements in patient nutrition status and improved clinical outcomes as well as reductions in costs when patients were appropriately managed by a multispecialty NST vs individual caregivers. Despite this, there has been steady decline in the number of formal NST in recent years (65% of hospitals in 1995 to 42% in 2008) as hospitals and other healthcare organizations look for ways to cut costs. Given the importance of nutrition status on clinical outcomes and overall healthcare costs, a number of institutions have introduced and sustained strong nutrition training and support programs and teams, demonstrating both clinical and economic benefit. The benefits of NST, training and implementation strategies, and tips for justifying these clinically and economically beneficial groups to healthcare organizations and governing bodies are discussed in this review. PMID:24170578

  6. Simulation for team training and assessment: case studies of online training with virtual worlds.

    PubMed

    LeRoy Heinrichs, William; Youngblood, Patricia; Harter, Phillip M; Dev, Parvati

    2008-02-01

    Individuals in clinical training programs concerned with critical medical care must learn to manage clinical cases effectively as a member of a team. However, practice on live patients is often unpredictable and frequently repetitive. The widely substituted alternative for real patients-high-fidelity, manikin-based simulators (human patient simulator)-are expensive and require trainees to be in the same place at the same time, whereas online computer-based simulations, or virtual worlds, allow simultaneous participation from different locations. Here we present three virtual world studies for team training and assessment in acute-care medicine: (1) training emergency department (ED) teams to manage individual trauma cases; (2) prehospital and in-hospital disaster preparedness training; (3) training ED and hospital staff to manage mass casualties after chemical, biological, radiological, nuclear, or explosive incidents. The research team created realistic virtual victims of trauma (6 cases), nerve toxin exposure (10 cases), and blast trauma (10 cases); the latter two groups were supported by rules-based, pathophysiologic models of asphyxia and hypovolemia. Evaluation of these virtual world simulation exercises shows that trainees find them to be adequately realistic to "suspend disbelief," and they quickly learn to use Internet voice communication and user interface to navigate their online character/avatar to work effectively in a critical care team. Our findings demonstrate that these virtual ED environments fulfill their promise of providing repeated practice opportunities in dispersed locations with uncommon, life-threatening trauma cases in a safe, reproducible, flexible setting. PMID:18188640

  7. Factors Associated with the Use of Helicopter Inter-facility Transport of Trauma Patients to Tertiary Trauma Centers within an Organized Rural Trauma System

    PubMed Central

    Stewart, Kenneth; Garwe, Tabitha; Bhandari, Naresh; Danford, Brandon; Albrecht, Roxie

    2016-01-01

    Objective A review of the literature yielded little information regarding factors associated with the decision to use ground (GEMS) or helicopter (HEMS) emergency medical services for trauma patients transferred inter-facility. Furthermore, studies evaluating the impact of inter-facility transport mode on mortality have reported mixed findings. Since HEMS transport is generally reserved for more severely injured patients, this introduces indication bias, which may explain the mixed findings. Our objective was to identify factors at referring non-tertiary trauma centers (NTC) influencing transport mode decision. Methods This was a case-control study of trauma patients transferred from a Level III or IV NTC to a tertiary trauma center (TTC) within 24-hours reported to the Oklahoma State Trauma Registry between 2005 and 2012. Multivariable logistic regression was used to determine clinical and non-clinical factors associated with the decision to use HEMS. Results A total of 7380 patients met the study eligibility. Of these, 2803(38%) were transported inter-facility by HEMS. Penetrating injury, prehospital EMS transport, severe torso injury, hypovolemic shock, and TBI were significant predictors (p<0.05) of HEMS use regardless of distance to a TTC. Association between HEMS use and male gender, Level IV NTC, and local ground EMS resources varied by distance from the TTC. Many HEMS transported patients had minor injuries and normal vital signs. Conclusions Our results suggest that while distance remains the most influential factor associated with HEMS use, significant differences exist in clinical and non-clinical factors between patients transported by HEMS versus GEMS. To ensure comparability of study groups, studies evaluating outcome differences between HEMS and GEMS should take factors determining transport mode into account. The findings will be used to develop propensity scores to balance baseline risk between GEMS and HEMS patients for use in subsequent studies

  8. Vascular Injury in Orthopedic Trauma.

    PubMed

    Mavrogenis, Andreas F; Panagopoulos, George N; Kokkalis, Zinon T; Koulouvaris, Panayiotis; Megaloikonomos, Panayiotis D; Igoumenou, Vasilios; Mantas, George; Moulakakis, Konstantinos G; Sfyroeras, George S; Lazaris, Andreas; Soucacos, Panayotis N

    2016-07-01

    Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma. Spasm can occur after either blunt or penetrating trauma to an extremity and is more common in young patients. Clinical presentation of vascular injury may not be straightforward. Physical examination can be misleading or initially unimpressive; a normal pulse examination may be present in 5% to 15% of patients with vascular injury. Detection and treatment of vascular injuries should take place within the context of the overall resuscitation of the patient according to the established principles of the Advanced Trauma Life Support (ATLS) protocols. Advances in the field, made mostly during times of war, have made limb salvage the rule rather than the exception. Teamwork, familiarity with the often subtle signs of vascular injuries, a high index of suspicion, effective communication, appropriate use of imaging modalities, sound knowledge of relevant technique, and sequence of surgical repairs are among the essential factors that will lead to a successful outcome. This article provides a comprehensive literature review on a subject that generates significant controversy and confusion among clinicians involved in the care of trauma patients. [Orthopedics. 2016; 39(4):249-259.]. PMID:27322172

  9. Trauma-Informed or Trauma-Denied: Principles and Implementation of Trauma-Informed Services for Women

    ERIC Educational Resources Information Center

    Elliott, Denise E.; Bjelajac, Paula; Fallot, Roger D.; Markoff, Laurie S.; Reed, Beth Glover

    2005-01-01

    In this article, we attempt to bridge the gap between practice (service delivery) and philosophy (trauma theory, empowerment, and relational theory). Specifically, we identify 10 principles that define trauma-informed service, discuss the need for this type of service, and give some characteristics of trauma-informed services in eight different…

  10. Component separation in abdominal trauma.

    PubMed

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334