Effect of a Checklist on Advanced Trauma Life Support Task Performance During Pediatric Trauma Resuscitation

2014 ◽  
Vol 21 (10) ◽  
pp. 1129-1134 ◽  
Author(s):  
Deirdre C. Kelleher ◽  
Elizabeth A. Carter ◽  
Lauren J. Waterhouse ◽  
Samantha E. Parsons ◽  
Jennifer L. Fritzeen ◽  
...  
Keyword(s):  
Task Performance ◽  
Life Support ◽  
Pediatric Trauma ◽  
Advanced Trauma Life Support ◽  
Trauma Resuscitation

Effect of Family Presence on Advanced Trauma Life Support Task Performance During Pediatric Trauma Team Evaluation

2017 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Karen J. O'Connell ◽  
Elizabeth A. Carter ◽  
Jennifer L. Fritzeen ◽  
Lauren J. Waterhouse ◽  
Randall S. Burd
Keyword(s):  
Task Performance ◽  
Life Support ◽  
Pediatric Trauma ◽  
Trauma Team ◽  
Advanced Trauma Life Support ◽  
Family Presence ◽  
Team Evaluation

Case Report: FAST Ultrasound Interpretation in Trauma Resuscitation

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 13-14
Author(s):  
Stuart Douglas, PGY4 ◽  
Joseph Newbigging, MD ◽  
David Robertson, MD
Keyword(s):  
Case Report ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Life Support ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Ultrasound Probe ◽  
Trauma Resuscitation ◽  
Highly Sensitive ◽  
Pouch Of Douglas

FAST Background: Focused Assessment with Sonography for Trauma (FAST) is an integral adjunct to primary survey in trauma patients (1-4) and is incorporated into Advanced Trauma Life Support (ATLS) algorithms (4). A collection of four discrete ultrasound probe examinations (pericardial sac, hepatorenal fossa (Morison’s pouch), splenorenal fossa, and pelvis/pouch of Douglas), it has been shown to be highly sensitive for detection of as little as 100cm3 of intraabdominal fluid (4,5), with a sensitivity quoted between 60-98%, specificity of 84-98%, and negative predictive value of 97-99% (3).

scholarly journals Teaching Emergency Surgical Skills for Trauma Resuscitation-Mechanical Simulator versus Animal Model

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jameel Ali ◽  
Anne Sorvari ◽  
Anand Pandya
Keyword(s):  
Animal Ethics ◽  
Porcine Model ◽  
Life Support ◽  
Surgical Skills ◽  
Advanced Trauma Life Support ◽  
Educational Effectiveness ◽  
Trauma Resuscitation ◽  
Suitable Alternative ◽  
Alternative Teaching ◽  
System 1

Background. Traditionally, surgical skills in trauma resuscitation have been taught using animal models in the advanced trauma life support (ATLS) course. We compare one mechanical model (TraumaMan simulator) as an alternative teaching tool for these skills. Method. Eighteen providers and 14 instructors performed four surgical procedures on TraumaMan and compared educational effectiveness with the porcine model. Evaluation was conducted (Likert system 1: very poor to 5: excellent). The participants indicated if TraumaMan was a suitable (scale 1: not suitable to 4: excellent) ATLS teaching model considering cost, animal ethics concerns, and other factors. Comments were solicited for both models. Results. Overall ratings for educational effectiveness of the 4 skills ranged from 3.58 to 4.36 for the porcine and 3.48 to 4.29 for the TraumaMan model. TraumaMan suitability was rated 3-4 (mean 3.38) by 84% participants. TraumaMan as a substitute for the porcine model was recommended by 85% participants. With no ethical or cost concerns, 44% students and 71% instructors preferred TraumaMan. Considering all factors, TraumaMan was preferred by 78% students and 93% instructors. Conclusions. TraumaMan is a suitable alternative to the porcine model and considering all factors it may be the preferred method for teaching ATLS emergency trauma surgical skills.

“A-OK”: Chest Radiograph during Primary Survey Facilitates Faster, More Accurate Endotracheal Tube Position in Injured Children

2019 ◽  
Vol 85 (5) ◽  
pp. 479-487
Author(s):  
Andrea N. Doud ◽  
Michaela Gaffley ◽  
Olivia Hostetter ◽  
Jennifer W. Talton ◽  
John K. Petty
Keyword(s):  
Endotracheal Tube ◽  
Life Support ◽  
Pediatric Trauma ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Primary Survey ◽  
Breath Sounds ◽  
Before And After ◽  
Chest X Ray ◽  
Baseline Characteristics

The Advanced Trauma Life Support algorithm recommends bedside confirmatory techniques to confirm correct endotracheal tube (ETT) depth, a critical component in the care of pediatric trauma patients. We hypothesized that bedside confirmatory techniques are inaccurate and that early chest X-ray (CXR) would overcome such inaccuracies, allowing for faster intervention of malpositioned ETTs. An “A-OK” algorithm of immediate CXR following intubation in injured children aged <16 years was implemented. Eligible patients the years before and after implementation were identified. The accuracy of bedside confirmatory techniques (use of length-based depths and auscultation of breath sounds) was assessed. Post-“A-OK” patients were compared with pre-“A-OK” controls regarding the speed of malpositioned ETTrepositioning. Twenty-eight post-“A-OK” cases and 23 pre-“A-OK” controls were identified. The groups did not differ in baseline characteristics. Bedside confirmatory techniques were accurate in only 61 per cent (length-based depth) and 58 per cent (auscultation of breath sounds) of patients. Time to ETT repositioning was significantly longer in pre-“A-OK” controls than in post-“A-OK” cases (35.2 ± 15.9 minutes vs 21.1 ± 11.8 minutes, P = 0.03). Bedside confirmatory techniques to determine ETT positioning are inaccurate in children. Inclusion of CXR in the primary survey is safe and allows for more rapid repositioning of malpositioned ETTs.

scholarly journals Mental practice: a simple tool to enhance team-based trauma resuscitation

CJEM ◽  
2015 ◽  
Vol 18 (2) ◽  
pp. 136-142 ◽  
Author(s):  
Gianni R. Lorello ◽  
Christopher M. Hicks ◽  
Sana-Ara Ahmed ◽  
Zoe Unger ◽  
Deven Chandra ◽  
...  
Keyword(s):  
High Performance ◽  
Rating Scale ◽  
Life Support ◽  
Mental Practice ◽  
Control Group ◽  
Advanced Trauma Life Support ◽  
Trauma Resuscitation ◽  
Nontechnical Skills ◽  
Video Recordings ◽  
Simulation Based

AbstractIntroductionEffective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated.MethodsWe randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group. The MP group engaged in 20 minutes of MP, and the control group received 20 minutes of Advanced Trauma Life Support (ATLS) training. All teams then participated in a high-fidelity simulated adult trauma resuscitation and received debriefing on communication, leadership, and teamwork. Two blinded raters independently scored video recordings of the simulated resuscitations using the Mayo High Performance Teamwork Scale (MHPTS), a validated team-based behavioural rating scale. The Mann-Whitney U-test was used to assess for between-group differences.ResultsSeventy-eight residents provided informed written consent and were recruited. The MP group outperformed the control group with significant effect on teamwork behaviour as assessed using the MHPTS: r=0.67, p<0.01.ConclusionsMP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.

Advanced Trauma Life Support Study: Trauma Resuscitation Time

2003 ◽  
Vol 29 (6) ◽  
pp. 379-384
Author(s):  
Ger D. J. van Olden ◽  
J. Dik Meeuwis ◽  
Hugo W. Bolhuis ◽  
Han Boxma ◽  
R. Jan A. Goris
Keyword(s):  
Life Support ◽  
Advanced Trauma Life Support ◽  
Trauma Resuscitation

Factors Affecting Team Size and Task Performance in Pediatric Trauma Resuscitation

2014 ◽  
Vol 30 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Deirdre C. Kelleher ◽  
Mark L. Kovler ◽  
Lauren J. Waterhouse ◽  
Elizabeth A. Carter ◽  
Randall S. Burd
Keyword(s):  
Task Performance ◽  
Pediatric Trauma ◽  
Team Size ◽  
Trauma Resuscitation ◽  
Factors Affecting ◽  
And Task

Pediatric Trauma

2017 ◽  
Author(s):  
Joanna C. Lim ◽  
Catherine Goodhue ◽  
Elizabeth Cleek ◽  
Erik R. Barthel ◽  
Barbara Gaines ◽  
...  
Keyword(s):  
Life Support ◽  
Pediatric Trauma ◽  
Penetrating Trauma ◽  
Initial Evaluation ◽  
Long Bone ◽  
Initial Assessment ◽  
Advanced Trauma Life Support ◽  
Assessment Protocol ◽  
Orderly Fashion ◽  
Life Threatening

Pediatric trauma is the leading cause of death in children 1 through 14 years old. This chapter includes key information focusing on initial evaluation, triage, and stabilization of children with blunt and penetrating trauma as well as burns (and the “rule of 9s”). The authors discuss specific injuries, including those to the head (traumatic brain injury), thorax, and abdomen; genitourinary area; and orthopedic/long-bone and nonaccidental trauma. Caring for injured children is best performed using advanced trauma life support protocols during the initial assessment. Protocol-driven examination, regardless of injury mechanism, ensures clinicians consider life-threatening injuries in an orderly fashion, starting with the primary survey and moving on to the secondary survey and definitive care. After injuries are identified, priorities shift toward involving the necessary specialists. Key mnemonics in trauma care are explained: the ABCDE initial evaluation, the AMPLE history, and the AVPU categorization of neurologic status.

Pediatric Trauma

2017 ◽  
Author(s):  
Kathleen Bryant ◽  
Jeremiah Smith ◽  
Michael Gibbs
Keyword(s):  
Cervical Spine ◽  
Head Trauma ◽  
Abdominal Trauma ◽  
Life Support ◽  
Pediatric Trauma ◽  
Research Network ◽  
Advanced Trauma Life Support ◽  
Primary Survey ◽  
Persistent Symptoms ◽  
National Emergency

Children have unique anatomy and physiologic responses to trauma that create different challenges for their management. It is important to follow the Advanced Trauma Life Support (ATLS) algorithm for assessing and treating a pediatric trauma patient, paying close attention to the primary survey. Once the primary survey is accomplished with adequate stabilization, the secondary survey proceeds with a focus on specific injuries. Head trauma is the leading cause of morbidity and mortality (M+M) in children. Early identification and prevention of secondary injury are important to optimize outcomes. The head and neck anatomic differences in a child cause a higher fulcrum of their cervical spine, leading to higher cervical spine injuries (CSIs). CSI is rare but carries a higher M+M due to higher spinal cord injuries. The National Emergency X-radiography Utilization Study (NEXUS) and Canadian C-spine Rule (CCR) are useful decision rules to clear cervical spines in adults but have limited strength in young children. PECARN has derived a pediatric cervical spine clearance rule, but this has yet to be prospectively validated. Similar to CSIs, thoracic injuries in children are rare but carry a higher M+M due to anatomic differences in children. A child’s chest anatomy and increased compliance cause more difficulty in injury identification. Abdominal trauma is common in children and can also be difficult to identify. Unlike adults, children can compensate for blood loss much longer while maintaining their blood pressure. Serial abdominal examinations are useful when imaging is negative and a patient has persistent symptoms. This review contains 5 highly rendered figures, 18 tables, and 92 references. Key words: abdominal trauma, Advanced Trauma Life Support (ATLS), cervical spine injury, head trauma, National Emergency X-radiography Utilization Study (NEXUS),  Pediatric Emergency Care Applied Research Network (PECARN), thoracic trauma, traumatic brain injury

scholarly journals Successful extracorporeal life support in a pediatric trauma patient following angioembolization of pelvic hemorrhage

2021 ◽  
Vol 67 ◽  
pp. 101812
Author(s):  
Christina M. Theodorou ◽  
Lauren E. Coleman ◽  
Stephanie N. Mateev ◽  
Jessica K. Signoff ◽  
Edgardo S. Salcedo
Keyword(s):  
Trauma Patient ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Pediatric Trauma ◽  
Pelvic Hemorrhage
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