Prehospital clinical signs are a poor predictor of raised intracranial pressure following traumatic brain injury.

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For the prehospital diagnosis of raised intracranial pressure (ICP), clinicians are reliant on clinical signs such as the Glasgow Coma Score (GCS), pupillary response and/or Cushing’s triad (hypertension, bradycardia and […]

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Emergency department use during COVID-19 as described by syndromic surveillance.

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On 12 March 2020 the UK entered the ‘delay phase’ of the COVID-19 pandemic response. The Public Health England Emergency Department Syndromic Surveillance System (EDSSS) carries out daily (near real-time) […]

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Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect.

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Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special […]

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Does implementation of the PECARN rules for minor head trauma improve patient-centered outcomes in a lower resource emergency department: a retrospective cohort study.

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Managing children with minor head trauma remains challenging for physicians who evaluate for the need for computed tomography (CT) imaging for clinically important traumatic brain injury (ciTBI) identification. The Pediatric […]

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Waiting times in emergency departments: exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data.

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Long lengths of stay (also called waiting times) in emergency departments (EDs) are associated with higher patient mortality and worse outcomes.To add to the literature using high-frequency data from a […]

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Thromboelastography and Rotational Thromboelastometry in Bleeding Patients with Coagulopathy: Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

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Assessment of the immediate need for specific blood product transfusions in acutely bleeding patients is challenging. Clinical assessment and commonly used coagulation tests are inaccurate and time-consuming. The goal of […]

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Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

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There is wide variability among emergency medical systems (EMS) with respect to transport to hospital during out-of-hospital cardiac arrest (OHCA) resuscitative efforts. The benefit of intra-arrest transport during resuscitation compared […]

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Outcomes of an Emergency Department Observation Unit-Based Pathway for the Treatment of Uncomplicated Vaso-occlusive Events in Sickle Cell Disease.

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This was a prospective, pre-post, 13-year observational study documenting the multiyear implementation of an observation unit sickle cell pathway for patients with uncomplicated vaso-occlusive events.The sickle cell pathway begins with […]

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The Effect of Use of Individualized Pain Plans in Sickle Cell Patients Presenting to the Emergency Department.

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Sickle cell disease (SCD) is an inherited hematologic disorder that affects approximately 100,000 US individuals and results in greater than 200,000 emergency department (ED) visits annually in the United States, […]

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Association of Antibiotic Choice With Hospital Length of Stay and Risk Factors for Readmission in Patients With Sickle Cell Disease and Acute Chest Syndrome: An Observational Cohort Study.

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We determine the association between use of specific cephalosporins and macrolides and hospital length of stay in patients with sickle cell disease (SCD) who are admitted with acute chest syndrome, […]

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Utility of Point-of-Care Lung Ultrasonography for Evaluating Acute Chest Syndrome in Young Patients With Sickle Cell Disease.

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Acute chest syndrome is a leading cause of mortality in patients with sickle cell disease (SCD). Because early detection of acute chest syndrome is directly tied to prognosis, young patients […]

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Emergency Department Utilization for Patients Living With Sickle Cell Disease: Psychosocial Predictors of Health Care Behaviors.

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Individuals living with sickle cell disease (SCD) often require urgent care; however, some patients hesitate to present to the emergency department (ED), which may increase the risk of serious clinical […]

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A Multiyear Cross-sectional Study of Guideline Adherence for the Timeliness of Opioid Administration in Children With Sickle Cell Pain Crisis.

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The National Heart, Lung, and Blood Institute evidence-based guidelines for timeliness of opioid administration for sickle cell disease (SCD) pain crises recommend an initial opioid within 1 hour of arrival, […]

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A Survey-Based Needs Assessment of Barriers to Optimal Sickle Cell Disease Care in the Emergency Department.

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Guided by an implementation science framework, this needs assessment identifies institutional-, provider-, and patient-level barriers to care of sickle cell disease (SCD) in the emergency department (ED) to inform future […]

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End-tidal and arterial carbon dioxide gradient in serious traumatic brain injury after prehospital emergency anaesthesia: a retrospective observational study.

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In the UK, 20% of patients with severe traumatic brain injury (TBI) receive prehospital emergency anaesthesia (PHEA). Current guidance recommends an end-tidal carbon dioxide (ETCO2) of 4.0-4.5 kPa (30.0-33.8 mm Hg) to […]

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The management of occult hemothorax in adults with thoracic trauma: a systematic review and meta-analysis.

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Hemothorax is a common sequelae following thoracic trauma and is associated with significant morbidity and mortality. Current guidelines recommend all traumatic hemothoraces be considered for drainage with tube thoracostomy (TT), […]

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Plasmin TEG Rapidly Identifies Trauma Patients at Risk for Massive Transfusion, Mortality and Hyperfibrinolysis: A Diagnostic Tool to Resolve an International Debate on TXA?

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Trauma patients with hyperfibrinolysis and depletion of fibrinolytic inhibitors(DFI) measured by thrombelastography(TEG) gain clot strength with TXA, but TEG results take nearly an hour. We aimed to develop an assay, […]

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Application of the Modified NUTRIC (mNUTRIC) Score to Nutritional Risk Stratification of Trauma Victims: A multicenter observational study.

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The modified Nutrition Risk in Critically ill (mNUTRIC) score was developed to identify patients most likely to benefit from nutritional therapies and to stratify or select study subjects for clinical […]

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Regionalization of Trauma Care by Operative Experience: Does the Volume of Emergent Laparotomy Matter?

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The volume-outcome relationship led to the regionalization of trauma care. The relationship between trauma centers’ injury-specific laparotomy volume and outcomes has not been explored. The aim of our study was […]

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The critical threshold value of systolic blood pressure for aortic occlusion in trauma patients in profound hemorrhagic shock.

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To determine the critical threshold of systolic blood pressure (SBP) for aortic occlusion (AO) in severely injured patients with profound hemorrhagic shock.All adult patients (>15 years) undergoing AO via Resuscitative […]

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Comparing GIS-based estimates with trauma center registry data to assess the effects of additional trauma centers on system access.

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Geographic information systems (GIS) are often used to analyze trauma systems. GIS-based approaches can model access to a trauma center (TC), including estimates of transport time and population coverage, when […]

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Prospective Study of Short-Term Quality-of-Life After Traumatic Rib Fractures.

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Post-discharge convalescence after traumatic rib fractures remains unclear. We hypothesized that patients with rib fractures, even as an isolated injury, have associated poor QoL after discharge.We prospectively enrolled adult patients […]

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The management of occult hemothorax in adults with thoracic trauma: a systematic review and meta-analysis.

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Hemothorax is a common sequelae following thoracic trauma and is associated with significant morbidity and mortality. Current guidelines recommend all traumatic hemothoraces be considered for drainage with tube thoracostomy (TT), […]

» Read more

Plasmin TEG Rapidly Identifies Trauma Patients at Risk for Massive Transfusion, Mortality and Hyperfibrinolysis: A Diagnostic Tool to Resolve an International Debate on TXA?

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Trauma patients with hyperfibrinolysis and depletion of fibrinolytic inhibitors(DFI) measured by thrombelastography(TEG) gain clot strength with TXA, but TEG results take nearly an hour. We aimed to develop an assay, […]

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