Prospective Validation of the Surgical Trauma Alert Classification (STAC) Scoring System in Predicting Major Trauma Resuscitation

2007 ◽  
Vol 14 (5 Supplement 1) ◽  
pp. S140-S140
Author(s):  
V. Coba ◽  
C. Irvin ◽  
R. Steele ◽  
E. Edhayan ◽  
M. K. Mulqueen
Keyword(s):  
Scoring System ◽  
Major Trauma ◽  
Surgical Trauma ◽  
Trauma Resuscitation

Are we giving enough coagulation factors during major trauma resuscitation?

2005 ◽  
Vol 190 (3) ◽  
pp. 479-484 ◽  
Author(s):  
Anthony M.-H. Ho ◽  
Manoj K. Karmakar ◽  
Peter W. Dion
Keyword(s):  
Major Trauma ◽  
Coagulation Factors ◽  
Trauma Resuscitation

scholarly journals Demystifying damage control in musculoskeletal trauma

2016 ◽  
Vol 98 (5) ◽  
pp. 291-294 ◽  
Author(s):  
P Bates ◽  
P Parker ◽  
I McFadyen ◽  
I Pallister
Keyword(s):  
Large Scale ◽  
Major Trauma ◽  
Damage Control ◽  
Trauma Surgery ◽  
Major Surgery ◽  
Surgical Trauma ◽  
Trauma Patients ◽  
Appropriate Care ◽  
Fracture Management ◽  
Early Appropriate Care

Trauma care has evolved rapidly over the past decade. The benefits of operative fracture management in major trauma patients are well recognised. Concerns over early total care arose when applied broadly. The burden of additional surgical trauma could constitute a second hit, fuelling the inflammatory response and precipitating a decline into acute respiratory distress syndrome, sepsis and multiple organ dysfunction syndrome. Temporary external fixation aimed to deliver the benefits of fracture stabilisation without the risk of major surgery. This damage control orthopaedics approach was advocated for those in extremis and a poorly defined borderline group. An increasing understanding of the physiological response to major trauma means there is now a need to refine our treatment options. A number of large scale retrospective reviews indicate that early definitive fracture fixation is beneficial in the majority of major trauma patients. It is recommended that patients are selected appropriately on the basis of their response to resuscitation. The hope is that this approach (dubbed ‘safe definitive fracture surgery’ or ‘early appropriate care’) will herald an era when care is individualised for each patient and their circumstances. The novel Damage Control in Orthopaedic Trauma Surgery course at The Royal College of Surgeons of England aims to equip senior surgeons with the insights and mindset necessary to contribute to this key decision making process as well as also the technical skills to provide damage control interventions when needed, relying on the improved techniques of damage control resuscitation and advances in the understanding of early appropriate care.

Topical Therapy of Traumatic Wounds in Disaster

1985 ◽  
Vol 1 (S1) ◽  
pp. 188
Author(s):  
Charles L. Fox
Keyword(s):  
Systemic Therapy ◽  
Wound Closure ◽  
Major Trauma ◽  
Topical Therapy ◽  
Silver Sulfadiazine ◽  
Surgical Trauma ◽  
Burn Wounds ◽  
Infected Wounds ◽  
Limited Series ◽  
Systemic Antibiotics

Major trauma in disasters leading to open wounds is frequently followed by infection with a variety of microorganisms. Usually, antibiotics are administered systemically to prevent the onset of sepsis. In thermal burns, topical therapy with 1% silver sulfadiazine (AgSD) cream has proven effective and now supersedes systemic therapy. Experimentally standardized traumatic wounds in animals have been difficult to obtain. Standardized burn wounds in mice subsequently infected with pseudomonas facilitated demonstration of the efficacy of silver or zinc sulfadiazine (ZnSD) which has also shown an advantage in improved wound closure. (Fox CL, fr: Burns 1978;4:223). In a limited series of 18 patients with a variety of surgical trauma and infected wounds, topical silver sulfadiazine was utilized after prolonged systemic antibiotics had failed to eradicate the infection.

scholarly journals (A39) Civil-Military Collaboration in Trauma Training

2011 ◽  
Vol 26 (S1) ◽  
pp. s11-s12
Author(s):  
L. Lundberg ◽  
P. Ortenwall
Keyword(s):  
Major Trauma ◽  
Trauma Surgery ◽  
Armed Forces ◽  
Medical Personnel ◽  
Health Staff ◽  
Surgical Trauma ◽  
Trauma Patients ◽  
Military Health ◽  
Medical Organisation ◽  
The Military

In the present Swedish military medical organisation all medical personnel, including surgeons, have to be recruited from civilian hospitals. Even if there are many civilian surgeons well qualified to perform trauma surgery, the injury patterns seen in e.g. Afghanistan are quite different compared to what is generally seen in trauma patients arriving to the ED at a civilian hospital. In order to upgrade the major trauma skills of the civilian surgeons recruited to and trained for participating in international missions, the (extended) military version of the Definitive Surgical Trauma Care (DSTC) Course has been implemented. DSTC is given with the intention not to duplicate ATLS, nor to provide an in depth course in surgery, but rather to teach those techniques particularly applicable to the patient who requires surgery and intensive care for major trauma, in a setting where such care is not commonly practised or even necessarily available. The course, made up by a mix of lectures, case discussions and skill stations has been given at the Swedish Armed Forces Centre for Defence Medicine in Gothenburg since 2007. It has gradually evolved to incorporate also anaesthesiologists and nursing staff into an integrated team. The faculty during these courses has been made up by a mix of international and Swedish instructors. Course candidates have primarily been military health staff, but vacant slots have been offered clinicians working in civilian hospitals in the western part of Sweden. During the last course in September 2010 17/20 (85%) of the physicians and 13/17 (76%) of the nurses rated the course as very beneficial or indispensible. The Swedish Armed Forces Centre for Defence Medicine will continue to run the military version of the DSTC course. Due to a certain over-capacity, course participation can be offered the civilian health care system.

scholarly journals Universal Precaution Compliance by Orthopaedic Trauma Team Members in a Major Trauma Resuscitation Scenario

2007 ◽  
Vol 89 (3) ◽  
pp. 262-267 ◽  
Author(s):  
RO Sundaram ◽  
RW Parkinson
Keyword(s):  
Major Trauma ◽  
Current Practice ◽  
Trauma Team ◽  
Orthopaedic Trauma ◽  
Trauma Resuscitation ◽  
Universal Precautions ◽  
Team Members ◽  
Major Trauma Patient ◽  
Practice Experience ◽  
Accident And Emergency

INTRODUCTION We determined the compliance rates of orthopaedic trauma team members in applying universal precautions in major trauma resuscitation scenarios and the availability of universal precautions in accident and emergency (A&E) departments throughout England. MATERIALS AND METHODS A national telephone survey was implemented contacting the first on-call orthopaedic surgeon and A&E departments in hospital trusts accepting major trauma throughout England. A questionnaire was employed to ascertain current practice, experience and availability of universal precautions when managing a major trauma patient. RESULTS Overall, 112 first on-call orthopaedic surgeons and 99 A&E departments responded. There was good compliance for using gloves (99%) and aprons (86%). There was poor compliance in using eye protectors (21%), face masks (18%), shoe covers (4%) and head caps (4%). Trainees applied universal precautions according to the level of risk they subjectively perceived. All A&E departments had gloves and aprons but the availability of the other universal precautions was less. Of trainees, 76 reported that all universal precautions were not readily available in the A&E department. CONCLUSION Orthopaedic trauma team members are very compliant in using gloves and aprons, but should be more compliant in using eye protectors. It is questionable whether face masks, head caps and shoe covers need to be used in all trauma scenarios. In general, universal precautions should be more available in the A&E departments. There should be better communication between A&E departments and the trauma team regarding the availability of universal precautions.

scholarly journals Pit Crew Approach to Pre Hospital Trauma Resuscitation

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Ray Quinn ◽  
David Menzies ◽  
Angela Sheridan ◽  
Mark O'Byrne ◽  
Mark O'Neill ◽  
...  
Keyword(s):  
Trauma Care ◽  
Major Trauma ◽  
Ad Hoc ◽  
Injured Patient ◽  
Trauma Patients ◽  
Medical Team ◽  
Trauma Resuscitation ◽  
Road Racing ◽  
Road Races ◽  
Multiple Patients

<p><strong>Introduction</strong></p><p>Pre hospital trauma care is often delivered by dual crewed ambulances supported by additional resources as necessary and available. Coordinating resuscitation of a critically injured patient may require multiple simultaneous actions. Equally, a large number of practitioners can hinder patient care if not coordinated.</p><p><strong>Aims</strong></p><p>To describe a multi disciplinary, scaleabe approach to pre hospital trauma care suitable for small and large multi disciplinary teams. Methods The MCI medical team (as part of Motorsport Rescue Services) is a PHECC-registered multidisciplinary team, which provides medical cover at Motorcycle road racing events in Ireland. The MCI medical team has significant experience of major trauma and routinely performs prehospital anaesthesia for trauma patients. We have evolved a pit crew approach to trauma care with pre defined roles and interventions assigned to a five person team, three clinical members, a scribe and a team lead. The approach is both scalable and collapsible, meaning that if multiple patients are present, roles can be merged; if additional clinical input is required, roles can also be supplemented. Each team member carries equipment and medications specific to their role, allowing efficiencies at the patients side.</p><p><strong>Results</strong></p><p>The pit crew approach to pre hospital trauma care has evolved over a decade and is routinely implemented at motorcycle road races in Ireland.</p><p><strong>Conclusions</strong></p><p>The pit crew trauma approach, although applicable to a pre defined five person team in unique circumstances, may also be applicable to ad hoc clinical teams that typically form in the pre hospital arena.</p>

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