Difficult Triage Decisions in the Combat or Austere Environment

2016 ◽  
pp. 47-55
Author(s):  
Matthew J. Martin ◽  
Matthew J. Eckert
Keyword(s):  
Austere Environment ◽  
Triage Decisions

scholarly journals Effects of state-wide implementation of the Los Angeles Motor Scale for triage of stroke patients in clinical practice

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Stefanie Behnke ◽  
Thomas Schlechtriemen ◽  
Andreas Binder ◽  
Monika Bachhuber ◽  
Mark Becker ◽  
...  
Keyword(s):  
Los Angeles ◽  
Acute Stroke ◽  
Unsolved Problem ◽  
Standard Operating Procedure ◽  
Stroke Management ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Standard Operating ◽  
Los Angeles Motor Scale ◽  
Triage Decisions

Abstract Background The prehospital identification of stroke patients with large-vessel occlusion (LVO), that should be immediately transported to a thrombectomy capable centre is an unsolved problem. Our aim was to determine whether implementation of a state-wide standard operating procedure (SOP) using the Los Angeles Motor Scale (LAMS) is feasible and enables correct triage of stroke patients to hospitals offering (comprehensive stroke centres, CSCs) or not offering (primary stroke centres, PSCs) thrombectomy. Methods Prospective study involving all patients with suspected acute stroke treated in a 4-month period in a state-wide network of all stroke-treating hospitals (eight PSCs and two CSCs). Primary endpoint was accuracy of the triage SOP in correctly transferring patients to CSCs or PSCs. Additional endpoints included the number of secondary transfers, the accuracy of the LAMS for detection of LVO, apart from stroke management metrics. Results In 1123 patients, use of a triage SOP based on the LAMS allowed triage decisions according to LVO status with a sensitivity of 69.2% (95% confidence interval (95%-CI): 59.0–79.5%) and a specificity of 84.9% (95%-CI: 82.6–87.3%). This was more favourable than the conventional approach of transferring every patient to the nearest stroke-treating hospital, as determined by geocoding for each patient (sensitivity, 17.9% (95%-CI: 9.4–26.5%); specificity, 100% (95%-CI: 100–100%)). Secondary transfers were required for 14 of the 78 (17.9%) LVO patients. Regarding the score itself, LAMS detected LVO with a sensitivity of 67.5% (95%-CI: 57.1–78.0%) and a specificity of 83.5% (95%-CI: 81.0–86.0%). Conclusions State-wide implementation of a triage SOP requesting use of the LAMS tool is feasible and improves triage decision-making in acute stroke regarding the most appropriate target hospital.

scholarly journals Development of an algorithm to aid triage decisions for intensive care unit admission: a clinical vignette and retrospective cohort study

Critical Care ◽  
2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Joao Gabriel Rosa Ramos ◽  
Beatriz Perondi ◽  
Roger Daglius Dias ◽  
Leandro Costa Miranda ◽  
Claudio Cohen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Vignette ◽  
Triage Decisions

Yesterday Meets Tomorrow in Sahelian Intellectual Currents

2021 ◽  
pp. 492-510
Author(s):  
Rahmane Idrissa
Keyword(s):  
The Past ◽  
Austere Environment

This chapter offers a review of Sahelian thought across the centuries from the griots and clerics of the past to contemporary intelligentsias. The review is paired with a reflection on how the Sahel shaped the work and consciousness of its thinkers—through its history as well as through more intangible but no less potent factors such as the aesthetics deriving from its austere environment. Given this focus, thinkers are not reviewed here just because they were born in the Sahel, but as participants in the particular intellectual consciousness attached to the region. Thus, some prominent Sahel-born thinkers—Senghor, Cheikh Anta Diop—are not included, but the discussion extends to film, Islam, and religious preaching in addition to the more conventional categories of novelists and theorists.

scholarly journals Proposal for a role of the Hsp90/Hsp70-based chaperone machinery in making triage decisions when proteins undergo oxidative and toxic damage

2010 ◽  
Vol 235 (3) ◽  
pp. 278-289 ◽  
Author(s):  
William B Pratt ◽  
Yoshihiro Morishima ◽  
Hwei-Ming Peng ◽  
Yoichi Osawa
Keyword(s):  
Toxic Damage ◽  
Triage Decisions

scholarly journals Craniomaxillofacial War Injuries in Misrata, Libya

2020 ◽  
pp. 1-4
Author(s):  
Abdulhakim W Zaggut ◽  
Abdulhakim W Zaggut ◽  
Muhammad M Rahman ◽  
Youssef G ◽  
Holmes S ◽  
...  
Keyword(s):  
Civil Conflict ◽  
Training Intervention ◽  
Blast Injuries ◽  
Injury Patterns ◽  
Mortality And Morbidity ◽  
War Injuries ◽  
Injury Type ◽  
Intensive Training ◽  
Austere Environment ◽  
The Impact

Injury to the craniomaxillofacial (CMF) area has major implications for mortality and morbidity depending on many factors that influence the level of treatment. In warzones, the extent of CMF injuries is amplified mainly due to the damage caused by bomb blasts. This study presents CMF injury as the result of war incidents to highlight the differences in injury type as well as the impact that an austere environment has on treatment. The author has unique insight and experience of treating CMF injuries in Misrata, Libya, where there is ongoing civil conflict. Surgeons in Libyan hospitals require intensive training intervention to effectively manage gunshot injuries, blast injuries and disasters and while these cases represent an austere environment, conclusions can be drawn for recent incidents involving terrorism. This study presents an analysis of injury patterns of patients presenting with CMF trauma during the Misrata battle of the Libyan conflict in 2011.

The impact of advanced age on trauma triage decisions and outcomes: A statewide analysis

2009 ◽  
Vol 197 (5) ◽  
pp. 571-575 ◽  
Author(s):  
Ryan Lehmann ◽  
Alec Beekley ◽  
Linda Casey ◽  
Ali Salim ◽  
Matthew Martin
Keyword(s):  
Advanced Age ◽  
Trauma Triage ◽  
The Impact ◽  
Triage Decisions

Tau Triage Decisions Mediated by the Chaperone Network

2012 ◽  
Vol 33 (s1) ◽  
pp. S145-S151 ◽  
Author(s):  
Casey Cook ◽  
Leonard Petrucelli
Keyword(s):  
Chaperone Network ◽  
Triage Decisions
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