Point-of-care ultrasound for treatment and triage in austere military environments.

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Assessment and triage in an austere environment represent a major challenge in casualty care. Modern conflicts involve a significant proportion of multiple wounds, either superficial or penetrating, which complicate clinical […]

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Predicting Success of REBOA: Timing supersedes variable techniques in predicting patient survival.

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REBOA is used for temporary aortic occlusion of trauma patients in the management of non-compressible hemorrhage. Previous studies have focused on how to properly perform REBOA in the trauma environment […]

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The implementation of a pathway and care bundle for the management of acute occlusive arterial mesenteric ischemia reduced mortality.

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Acute mesenteric ischemia (AMI) is a disease with high mortality and requires a multidisciplinary approach for effective management. A pathway and care bundle were developed and implemented with the objective […]

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Whole Blood Hemostatic Resuscitation in Pediatric Trauma: A Nationwide Propensity-Matched Analysis.

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Whole blood (WB) has shown promise in pediatric trauma resuscitation following its prominent role in the resuscitation of adult trauma patients. Although WB in children has been shown to be […]

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Best Case/Worst Case for the Trauma ICU: Development and Pilot Testing of a Communication Tool for Older Adults with Traumatic Injury.

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“Best Case/Worst Case” (BC/WC) is a communication tool to support shared decision making in older adults with surgical illness. We aimed to adapt and test BC/WC for use with critically […]

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Don’t Mess with the Pancreas! A Multicenter Analysis of the Management of Low-Grade Pancreatic Injuries.

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Current guidelines recommend nonoperative management (NOM) of low-grade (AAST-OIS grade I-II) pancreatic injuries (LGPIs), and drainage rather than resection for those undergoing operative management, but they are based on low […]

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Pain management for casualties receiving life-saving interventions in the prehospital scenario – raising awareness of our human nature.

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Life-saving interventions (LSIs) are the hallmark of medical care in trauma casualties, reducing mortality and morbidity. Analgesia is another essential treatment, which has been shown to improve outcomes and decrease […]

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ROLE OF ALBUMIN ON ENDOTHELIAL BASEMENT MEMBRANE AND HEMOSTASIS IN A RAT MODEL OF HEMORRHAGIC SHOCK.

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We sought to determine the extent of loss of endothelial basement membrane (BM), leukocyte recruitment and changes in coagulation after hemorrhagic shock (HS), followed by limited-volume resuscitation (LVR) with 5% […]

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SAFE BALLOON INFLATION PARAMETERS FOR RESUSCITATIVE ENDOVASCULAR BALLOON OCCLUSION OF THE AORTA.

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Non-compressible hemorrhage is a leading cause of preventable death in civilian and military trauma populations. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a promising method for controlling non-compressible […]

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Safety and efficacy of low-titer O whole blood resuscitation in a civilian level I trauma center.

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Military experience has shown low-titer O whole blood (LTOWB) to be safe and beneficial in the resuscitation of hemorrhaging trauma patients. However, few civilian centers utilize LTOWB for trauma resuscitation. […]

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Saving the brain after mild-to-moderate traumatic injury: a report on new insights of the physiology underlying adequate maintenance of cerebral perfusion.

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Traumatic brain injury (TBI) is associated with increased morbidity and mortality in civilian trauma and battlefield settings. TBI has been classified across a continuum of dysfunctions, with as much as […]

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The timing of amputation of mangled lower extremities does not predict post-injury outcomes and mortality: a retrospective analysis from the ACS TQIP database.

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While limb salvage does not result in improved functional outcomes among patients with a mangled lower extremity, the impact of attempted limb salvage on mortality and complications is poorly understood. […]

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Trends in pre-hospital pain management following the introduction of new clinical practice guidelines.

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Early pain treatment following injury has been shown to improve long-term outcomes, while untreated pain can facilitate higher post-traumatic stress disorder (PTSD) rates and worsen outcomes. Nonetheless, trauma casualties frequently […]

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Venous Thromboembolic Risk Stratification in Pediatric Trauma: A Pediatric Trauma Society Research Committee Multicenter Analysis.

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Venous thromboembolism (VTE) in injured children is rare, but its consequences are significant. Several risk stratification algorithms for VTE in pediatric trauma exist with little consensus, and all are hindered […]

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Blunt cerebrovascular injuries: Outcomes from the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) multicenter registry.

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Administering antithrombotics (AT) to the multiply injured patient with blunt cerebrovascular injury (BCVI) requires a thoughtful assessment of the risk of stroke and death associated with nontreatment. Large, multicenter analysis […]

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Development of a field artificial intelligence triage tool: Confidence in the prediction of shock, transfusion, and definitive surgical therapy in patients with truncal gunshot wounds.

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In-field triage tools for trauma patients are limited by availability of information, linear risk classification, and a lack of confidence reporting. We therefore set out to develop and test a […]

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Emergency general surgery: Impact of hospital and surgeon admission case volume on mortality.

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Emergency general surgery (EGS) is a high-volume and high-risk surgical service. Interhospital variation in EGS outcomes exists, but there is disagreement in the literature as to whether hospital admission volume […]

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Empowering the affected: Informing community-based solutions through interviews with survivors of interpersonal firearm violence-Perspectives of survivors of firearm injuries.

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Firearm violence remains epidemic in the United States, with interpersonal gun violence leading to significant morbidity and mortality. Interpersonal violence has strong associations with social determinants of health, and community-specific […]

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Epidemiology and management of isolated blunt renal artery injuries.

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Isolated blunt renal artery injury (BRAI) is uncommon. Treatment options include observation, nephrectomy, surgical reconstruction and endovascular stenting. Over the last decade, there has been an increasing use of angiointervention […]

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Extrathoracic multiple trauma dysregulates neutrophil function and exacerbates pneumonia-induced lung injury.

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Forty percent of critically ill trauma patients will develop an infectious complication. Pneumonia is the most common cause of death of trauma patients surviving their initial insult. We previously demonstrated […]

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Impact of US hospital center and interhospital transfer on spinal cord injury management: An analysis of the National Trauma Data Bank.

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Traumatic spinal cord injury (SCI) is a serious public health problem. Outcomes are determined by severity of immediate injury, mitigation of secondary downstream effects, and rehabilitation. This study aimed to […]

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Improving trauma tertiary survey performance and missed injury identification using an education-based quality improvement initiative.

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Performance of a trauma tertiary survey (TTS) reduces rates of missed injuries, but performance has been inconsistent at trauma centers. The objectives of this study were to assess whether quality […]

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Making the call in the field: Validating emergency medical services identification of anatomic trauma triage criteria.

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The National Field Triage Guidelines were created to inform triage decisions by emergency medical services (EMS) providers and include eight anatomic injuries that prompt transportation to a Level I/II trauma […]

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