Performance of Advanced Nurse Practitioners in Minor Trauma Patients

2021 ◽  
Author(s):  
Nameer Choudhry ◽  
Caroline Charlton ◽  
David Bodansky ◽  
Saif Ul Islam ◽  
Jenna Doherty ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Trauma Patients ◽  
Minor Trauma

Lung ultrasound in blunt chest trauma: A clinical review

Ultrasound ◽  
2021 ◽  
pp. 1742271X2199460
Author(s):  
Serena Rovida ◽  
Daniele Orso ◽  
Salman Naeem ◽  
Luigi Vetrugno ◽  
Giovanni Volpicelli
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Lung Ultrasound ◽  
Lung Parenchyma ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Major Life ◽  
Diagnostic Modality ◽  
Life Threatening ◽  
Sternal Fractures

Introduction Bedside lung sonography is recognized as a reliable diagnostic modality in trauma settings due to its ability to detect alterations both in lung parenchyma and in pleural cavities. In severe blunt chest trauma, lung ultrasound can identify promptly life-threatening conditions which may need direct intervention, whereas in minor trauma, lung ultrasound contributes to detection of acute pathologies which are often initially radio-occult and helps in the selection of those patients that might need further investigation. Topic Description We did a literature search on databases EMBASE, PubMed, SCOPUS and Google Scholar using the terms ‘trauma’, ‘lung contusion’, ‘pneumothorax’, ‘hemothorax’ and ‘lung ultrasound’. The latest articles were reviewed and this article was written using the most current and validated information. Discussion Lung ultrasound is quite accurate in diagnosing pneumothorax by using a combination of four sonographic signs; absence of lung sliding, B-lines, lung pulse and presence of lung point. It provides a rapid diagnosis in hemodynamically unstable patients. Lung contusions and hemothorax can be diagnosed and assessed with lung ultrasound. Ultrasound is also very useful for evaluating rib and sternal fractures and for imaging the pericardium for effusion and tamponade. Conclusion Bedside lung ultrasound can lead to rapid and accurate diagnosis of major life-threatening pathologies in blunt chest trauma patients.

scholarly journals 291 Pre-Operative Venepuncture: An Audit of The Trauma and Orthopaedic Department at The Royal Sussex County Hospital, Brighton

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Harris ◽  
T Antonio ◽  
A Hagiga ◽  
D Crone
Keyword(s):  
Major Trauma ◽  
Elective Surgery ◽  
Financial Burden ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Inclusion Criteria ◽  
Blood Testing ◽  
Orthopaedic Department ◽  
Minor Surgery ◽  
Routine Coagulation

Abstract Background NICE recommends that patients undergoing intermediate or minor elective surgery do not need routine coagulation or transfusion blood testing unless they are ASA 3+ or taking anticoagulation mediation, where testing may be considered. Currently there is no guidance for trauma patients. Method We identified all patients that underwent intermediate or minor trauma and orthopaedic surgery within a three-month period from December 2019- February 2020 at the RSCH. We excluded major trauma patients, patients taking anticoagulants and patients with complex admission or past medical history. Computer records were used to identify pre-operative investigations and admission history. Results 843 patients met our inclusion criteria. In total, 92 clotting studies and 200 transfusion samples were taken preoperatively. The majority of tests were for patients undergoing ankle 130/292 (45%) or Tibia/Fibula 54/292 (18%) procedures. This equates to approximately 1168 blood tests per year. Based on the lab cost of £15.97 for a transfusion sample and £18 for a coagulation sample, this is a cost of approximately £19,616 each year on blood testing that is not indicated. Discussion We hope that by presenting these results we will help reduce the unnecessary time and financial burden of routine venipuncture in departments undertaking intermediate and minor surgery.

Orthopaedic assessment unit: a service model for the delivery of orthopaedic trauma care in a major trauma centre during the global pandemic (COVID-19)

2021 ◽  
Vol 103 (3) ◽  
pp. 167-172
Author(s):  
JW Lim ◽  
H Rehman ◽  
S Gaba ◽  
H Sargeant ◽  
IM Stevenson ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Trauma Care ◽  
Statistical Significance ◽  
High Standard ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Service Model ◽  
Global Pandemic ◽  
Major Trauma Centre ◽  
Assessment Unit

Introduction We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated musculoskeletal injuries were redirected to the OAU. Methods We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann–Whitney and Fisher Exact tests were used to test the statistical significance of data. Results A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (p=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (p<0.001). Conclusions Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.

scholarly journals (P2-91) EMS Trauma Triage: Does the Red-Blue Criteria Enable Overtriage?

2011 ◽  
Vol 26 (S1) ◽  
pp. s166-s166
Author(s):  
D.M. Higgins ◽  
R.E. Thaxton
Keyword(s):  
Trauma Center ◽  
Injury Severity ◽  
Initial Assessment ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Trauma Severity ◽  
Physician Assessment ◽  
Assessment Skills ◽  
Trauma Triage ◽  
Level 1

IntroductionWith the current need for effective trauma center utilization, understanding how current trauma triage criteria may promote overtriage will enable both field and hospital teams to provide the most appropriate patient care. It is hypothesized that current Southwest Texas trauma criteria promote overtriage by prehospital emergency medical services (EMS) of patients in favor of a Level 1 trauma facility when compared to physician assessment and Injury Severity Score (ISS).MethodsThis prospective, observational study at a Southwest Texas military Level 1 trauma center compared adult trauma patients' prehospital status noted by EMS personnel with the triage criteria documented by the treating emergency physician. The patients were divided into four groups: Prehospital Criteria Met or Not Met; Arrival Criteria Met or Not Met. Each patient's ISS and mechanism of injury were also collected and compared to initial assessment for predictive value. Descriptive statistics were used.ResultsThe study enrolled 278 adult trauma patients. EMS reported Level 1 trauma status similar to physician assessment (60.1% vs. 59.7%, respectively). The rates patients met Level 1 trauma status corresponded with trauma severity when compared to the ISS. Assessment between EMS and physicians for ISSs were similar among the four groups. Comparisons using multivariate analysis of the four groups found similar ISSs, except for the Prehospital Criteria Met/Arrival Criteria Not Met group. Seventy-five percent of these patients were assigned an ISS in the Minor (ISS < 9) category (p = 0.013).ConclusionTrauma triage criteria assessment skills were similar between EMS personnel and emergency physicians except for identifying minor trauma patients. While the criteria generally led to overtriage, EMS crews appear to overtriage minor trauma patients at a much higher rate.

scholarly journals LO027: Cervical spine injury in trauma patients 65 years and older immobilised in the prehospital setting

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S39-S39
Author(s):  
L. Lamy ◽  
J. Chauny ◽  
D. Ross
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Cervical Injury ◽  
Geriatric Population ◽  
Spinal Immobilisation ◽  
A Minor

Introduction: Following a protocol derived from the Canadian C-spine Rule (CCR), patients 65 years and older transported by ambulance after trauma require full spinal immobilisation. Immobilisation complicates the transport and the evaluation; potential side effects have been recognized. The aim of this study was to evaluate the effect of mechanism of trauma and age on the rate of cervical injury in a geriatric population. Methods: We conducted a retrospective observational study on patients 65 years and older transported by ambulance to a level-one trauma center from March 2008 to October 2013. The outcome was the rate of clinically important cervical spine injury (CICSI), defined as any fracture, dislocation or ligamentous injury needing treatment or specialised follow up. The rate was calculated in the geriatric population and in the subgroup of patients with minor trauma, defined as a fall from a standing height, a chair or a bed. We then looked at the rate of CICSI based on age to define a subgroup at lower risk of lesion. Results: We included 1221 patients with a mean age of 80 y.o. (SD = 8), 739 women (61%). CICSI was found in 53 patients (4.3%, 95% CI 3.2-5.4). This is similar to the rate found in patients 65 years and older in the NEXUS population (4.6%) and the CCR population (6.0%). The mechanism of injury was a minor trauma for 716 patients (59%). Of those, 24 patients (3.4%, 95% CI 2.1-4.7) had CICSI. The rate increased after 85 y.o in both the overall population (3.4% vs 6.4%) and the minor trauma subgroup (2.6% vs 4.4%). Conclusion: The subgroup of patients 65-84 y.o. with a minor trauma had the lower rate of cervical spine injury (2.6%). In a lot of prehospital systems, those patients are not systematically immobilised for transport. It will be interesting to review the files of all patients with CICSI to identify any possible case that would have been missed without the age criteria.

scholarly journals Trauma in the Obstetrical Patient

2009 ◽  
Vol 5 (3) ◽  
pp. 269-283 ◽  
Author(s):  
Christina C Hill
Keyword(s):  
Multidisciplinary Approach ◽  
Healthcare Providers ◽  
Organ System ◽  
Fetal Mortality ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Fetal Exposure ◽  
Trauma Victim ◽  
Assessment And Treatment ◽  
Obstetrical Patient

Trauma complicates approximately 6–7% of all pregnancies and is associated with significant maternal and fetal morbidity and mortality. While the majority of trauma is minor, it is minor trauma that contributes to the majority of fetal mortality. Since virtually every organ system is affected anatomically and physiologically by pregnancy, it is important for healthcare providers who care for trauma victims to be aware of these changes. While assessment and resuscitation considers the existence of two patients, stabilization of the mother takes priority. Diagnostic and radiologic procedures should be used as indicated, with fetal exposure to radiation limited as much as possible. Management of the pregnant trauma victim requires a multidisciplinary approach in order to optimize outcome for mother and fetus. This review discusses the epidemiology, assessment and treatment of pregnant trauma patients and reviews areas where prevention efforts may be focused.

scholarly journals Evaluation of the role of whole body computed tomography in the management of minor trauma patients.

2021 ◽  
Author(s):  
Gökhan AKSEL ◽  
İbrahim ALTUNOK ◽  
Şeref Kerem ÇORBACIOĞLU ◽  
Hatice Şeyma AKÇA ◽  
Öner BOZAN ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Whole Body ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Whole Body Computed Tomography

Is ultrasonography helpful in minor trauma patients with rib fractures?

2020 ◽  
Vol 5 (2) ◽  
pp. 80
Author(s):  
Eren İsmailoğlu ◽  
Onur Akçay
Keyword(s):  
Rib Fractures ◽  
Trauma Patients ◽  
Minor Trauma

How Did the COVID-19 Pandemic Affect Trauma Volume at an Urban Level I Trauma Center?

2022 ◽  
pp. 000313482110540
Author(s):  
Alexandra Hahn ◽  
Tommy Brown ◽  
Brett Chapman ◽  
Alan Marr ◽  
Lance Stuke ◽  
...  
Keyword(s):  
Health Care ◽  
Trauma Center ◽  
Penetrating Trauma ◽  
Retrospective Chart Review ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Significant Difference ◽  
Urban Level ◽  
Level 1 ◽  
Level 1 Trauma Center

Introduction The COVID-19 pandemic changed the face of health care worldwide. While the impacts from this catastrophe are still being measured, it is important to understand how this pandemic impacted existing health care systems. As such, the objective of this study was to quantify its effects on trauma volume at an urban Level 1 trauma center in one of the earliest and most significantly affected US cities. Methods A retrospective chart review of consecutive trauma patients admitted to a Level 1 trauma center from January 1, 2017 to December 31, 2020 was completed. The total trauma volume in the years prior to the pandemic (2017-2019) was compared to the volume in 2020. These data were then further stratified to compare quarterly volume across all 4 years. Results A total of 4138 trauma patients were treated in the emergency room throughout 2020 with 4124 seen during 2019, 3774 during 2018, and 3505 during 2017 in the pre-COVID-19 time period. No significant difference in the volume of minor trauma or trauma transfers was observed ( P < .05). However, there was a significant increase in the number of major traumas in 2020 as compared to prior years (38.5% vs 35.6%, P < .01) and in the volume of penetrating trauma (29.1% vs 24.0%, P < .01). Discussion During the COVID-19 outbreak, trauma remained a significant health care concern. This study found an increase in volume of penetrating trauma, specifically gunshot wounds throughout 2020. It remains important to continue to devote resources to trauma patients during the ongoing COVID-19 pandemic.

Sign in / Sign up

Export Citation Format

Share Document