scholarly journals American Association for the Surgery of Trauma Prevention Committee review: Family Justice Centers—a not-so-novel, but unknown gem

2021 ◽  
Vol 6 (1) ◽  
pp. e000725
Author(s):  
Thomas K Duncan ◽  
Ronald Stewart ◽  
Kimberly Joseph ◽  
Deborah A Kuhls ◽  
Tracey Dechert ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Community Violence ◽  
American Association ◽  
Evaluation Research ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Injury Prevention Program ◽  
Programmatic Evaluation ◽  
Verification Process ◽  
The Impact

The American College of Surgeons Committee on Trauma requires that trauma centers demonstrate adequate financial support for an injury prevention program as part of the verification process. With the ongoing challenges that arise with important social determinants of health, trauma centers have the important task of navigating a patient through the complex process of obtaining services and tools for success. This summary from the American Association for the Surgery of Trauma Prevention Committee focuses on a model that has been present for several years, but has not been brought to full awareness in the trauma world. It highlights the importance of the Family Justice Center concept that brings a multitude of organizations under one roof, thus eliminating the hurdles encompassed by trauma patients, seeking life-changing resources necessary to mitigate the impact of both community violence exposure and intimate partner/domestic violence. It discusses the potential benefits of a partnership between trauma centers and Family Justice Centers and similar models. Finally, it also raises awareness of important programmatic evaluation research required in the arena of injury prevention targeting a population whose outcomes are difficult to measure.

scholarly journals EARLY RESULTS OF AN INJURY-PREVENTION PROGRAM IN HIGH SCHOOL TRACK ATHLETES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0014
Author(s):  
Celeste Quitiquit Dickason ◽  
Whitney Marois ◽  
Hannah Santos ◽  
Sadie Grace ◽  
Brian Krabak ◽  
...  
Keyword(s):  
High School ◽  
Injury Prevention ◽  
Prevention Program ◽  
Prevention Programs ◽  
Years Of Experience ◽  
Chi Square ◽  
Injury Rates ◽  
Injury Prevention Program ◽  
Chi Square Analysis ◽  
The Impact

Background Injury prevention programs have been shown to be effective for adolescent soccer, basketball, and handball athletes. Though injuries are common in high school runners, injury prevention programs have not been described for this population. Our objective was to trial an injury-prevention program styled after those found to be successful in other running and jumping sports to see if a group of running athletes sustained fewer and or less serious injuries during the course of a single high school track season. Methods Two suburban high school track coaches volunteered to participate in a program consisting of either injury-prevention exercises or no additional exercises as a part of pre-and in-season practice programs. All runners at each school were invited to participate, with informed consent obtained. The injury prevention program consisted of five jumping and plyometric exercises taught by a physical therapist, with a video of the exercises made available to the coach and team members throughout the season. Surveys pre- and post-season were collected which included demographic information, running history, diet, and injuries. Injuries were reported to coach and trainer at each school. Days of missed practice constituted an injured day, tallied for each runner and each team. A Chi-square analysis compared injury rates by team, and hence by intervention; injury rates by years of experience running; and injury rates by dietary preference. Results 24 runners, 13 from the intervention school and 11 from the control school participated. There was no significant difference in the number of running injuries reported when comparing the intervention group (4/13 runners) to the control group (3/11 runners, Chi-square = 0.035, p = 0.9). Runners with a greater number of years of competitive running experience trended towards having fewer injuries (p = 0.06). Those describing their diet as vegetarian (3/24) were significantly more likely to sustain an injury (p = 0.002). Conclusions / Significance With this limited comparison study examining the impact of an injury-prevention pre-season and in-season training program for running athletes participating on their high school track team, there was no evidence that the addition of a program of jumping and plyometric exercises had an impact on injury rates. However, combining the data from the two schools, we found a trend towards decreased injury likelihood in those with more years of experience running, and a significantly greater incidence of injuries in those who described their diet as vegetarian. These results suggest that novice runners should perhaps have a different set of expectations regarding the pre- and in-season training regimen, and that those whose diet is vegetarian consider review of their nutrition to optimize their energy level and reparative capacity with the increased activity of a high school track running program.

Are there Field Triage Criteria that Can Predict Low-Yield Air Medical Transports?

2019 ◽  
Vol 34 (6) ◽  
pp. 596-603
Author(s):  
Hiroko Miyagi ◽  
David C. Evans ◽  
Howard A. Werman
Keyword(s):  
Trauma Center ◽  
Early Discharge ◽  
Hospital Death ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Predictive Values ◽  
Field Triage ◽  
Number Of Patients ◽  
Medical Transport ◽  
The Impact

AbstractIntroduction:Air medical transport of trauma patients from the scene of injury plays a critical role in the delivery of severely injured patients to trauma centers. Over-triage of patients to trauma centers reduces the system efficiency and jeopardizes safety of air medical crews.Hypothesis:The objective of this study was to determine which triage factors utilized by Emergency Medical Services (EMS) providers are strong predictors of early discharge for trauma patients transported by helicopter to a trauma center.Methods:A retrospective chart review over a two-year period was performed for trauma patients flown from the injury site into a Level I trauma center by an air medical transport program. Demographic and clinical data were collected on each patient. Prehospital factors such as Glasgow Coma Score (GCS), Revised Trauma Score (RTS), intubation status, mechanism of injury, anatomic injuries, physiologic parameters, and any combinations of these factors were investigated to determine which triage criteria accurately predicted early discharge. Hospital factors such as Injury Severity Score (ISS), length-of-stay (LOS), survival, and emergency department disposition were also collected. Early discharge was defined as a hospital stay of less than 24 hours in a patient who survives their injuries. A more stringent definition of appropriate triage was defined as a patient with in-hospital death, an ISS >15, those taken to the operating room (OR) or intensive care unit (ICU), or those receiving blood products. Those patients who failed to meet these criteria were also used to determine over-triage rates.Results:An overall early discharge rate of 35% was found among the study population. Furthermore, when the more stringent definition was applied, over-triage rates were as high as 85%. Positive predictive values indicated that patients who met at least one anatomic and physiologic criteria were appropriately transported by helicopter as 94% of these patients had stays longer than 24 hours. No other criteria or combination of criteria had a high predictive value for early discharge.Conclusions:No individual triage criteria or combination of criteria examined demonstrated the ability to uniformly predict an early discharge. Although helicopter transport and subsequent hospital care is costly and resource consuming, it appears that a significant number of patients will be discharged within 24 hours of their transport to a trauma center. Future studies must determine the impact of eliminating “low-yield” triage criteria on under-triage of scene trauma patients.

scholarly journals Minor change in initial PEEP setting decreases rates of ventilator-associated events in mechanically ventilated trauma patients

2020 ◽  
Vol 5 (1) ◽  
pp. e000455
Author(s):  
Ethan Ferrel ◽  
Kristina M Chapple ◽  
Liviu Gabriel Calugaru ◽  
Jennifer Maxwell ◽  
Jessica A Johnson ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Injury Severity ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Level Of Evidence ◽  
Mechanically Ventilated ◽  
Change In Practice ◽  
Level 1 ◽  
The Impact ◽  
Level 1 Trauma Center

BackgroundSurveillance of ventilator-associated events (VAEs) as defined by the National Healthcare Safety Network (NHSN) is performed at many US trauma centers and considered a measure of healthcare quality. The surveillance algorithm relies in part on increases in positive end-expiratory pressure (PEEP) to identify VAEs. The purpose of this cohort study was to evaluate the effect of initiating mechanically ventilated trauma patients at marginally higher PEEP on incidence of VAEs.MethodsAnalysis of level-1 trauma center patients mechanically ventilated 2+ days from 2017 to 2018 was performed after an institutional ventilation protocol increased initial PEEP setting from 5 (2017) to 6 (2018)cm H2O. Incidence of VAEs per 1000 vent days was compared between PEEP groups. Logistic regression modelling was performed to evaluate the impact of the PEEP setting change adjusted to account for age, ventilator days, injury mechanism and injury severity.Results519 patients met study criteria (274 PEEP 5 and 245 PEEP 6). Rates of VAEs were significantly reduced among patients with initial PEEP 5 versus 6 (14.61 per 1000 vent days vs. 7.13 per 1000 vent days; p=0.039). Logistic regression demonstrated that initial PEEP 6 was associated with 62% reduction in VAEs.ConclusionsOur data suggest that an incrementally increased baseline PEEP setting was associated with a significantly decreased incidence of VAEs among trauma patients. This minor change in practice may have a major impact on a trauma center’s quality metrics.Level of evidenceIV.

scholarly journals Patterns of alcohol and drug utilization in trauma patients during the COVID-19 pandemic at six trauma centers

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Constance McGraw ◽  
Kristin Salottolo ◽  
Matthew Carrick ◽  
Mark Lieser ◽  
Robert Madayag ◽  
...  
Keyword(s):  
Longitudinal Research ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Trauma Patients ◽  
Blood Alcohol ◽  
Trauma Centers ◽  
Chi Squared ◽  
Level I ◽  
The Impact ◽  
At Home

Abstract Background Since the national stay-at-home order for COVID-19 was implemented, clinicians and public health authorities worldwide have expressed growing concern about the potential repercussions of drug and alcohol use due to social restrictions. We explored the impact of the national stay-at-home orders on alcohol or drug use and screenings among trauma admissions. Methods This was a retrospective cohort study at six Level I trauma centers across four states. Patients admitted during the period after the onset of the COVID-19 restrictions (defined as March 16, 2020-May 31, 2020) were compared with those admitted during the same time period in 2019. We compared 1) rate of urine drug screens and blood alcohol screens; 2) rate of positivity for drugs or alcohol (blood alcohol concentration ≥ 10 mg/dL); 3) characteristics of patients who were positive for drug or alcohol, by period using chi-squared tests or Fisher’s exact tests, as appropriate. Two-tailed tests with an alpha of p < 0.05 was used on all tests. Results There were 4762 trauma admissions across the study period; 2602 (55%) in 2019 and 2160 (45%) in 2020. From 2019 to 2020, there were statistically significant increases in alcohol screens (34% vs. 37%, p = 0.03) and drug screens (21% vs. 26%, p < 0.001). Overall, the rate of alcohol positive patients significantly increased from 2019 to 2020 (32% vs. 39%, p = 0.007), while the rate of drug positive patients was unchanged (57% vs. 52%, p = 0.13). Of the 1025 (22%) patients who were positive for alcohol or drugs, there were significant increases in a history of alcoholism (41% vs. 26%, p < 0.001), and substance abuse (11% vs. 23%, p < 0.001) in the 2020 period. No other statistically significant differences were identified among alcohol or drug positive patients during COVID-19 compared to the same period in 2019. Conclusions Our first wave of COVID-19 data suggests that trauma centers were admitting significantly more patients who were alcohol positive, as well those with substance use disorders, potentially due to the impact of social restrictions and guidelines. Further longitudinal research is warranted to assess the alcohol and drug positive rates of trauma patients over the COVID-19 pandemic.

scholarly journals The impact of the Safe Kids/Healthy Neighborhoods Injury Prevention Program in Harlem, 1988 through 1991.

1994 ◽  
Vol 84 (4) ◽  
pp. 580-586 ◽  
Author(s):  
L L Davidson ◽  
M S Durkin ◽  
L Kuhn ◽  
P O'Connor ◽  
B Barlow ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Prevention Program ◽  
Injury Prevention Program ◽  
The Impact

scholarly journals The Impact of the FIFA 11+ Program on the Injury in Soccer Players: A Systematic Review

2020 ◽  
Vol 22 (4) ◽  
pp. 55-61
Author(s):  
Hyunmin Kim ◽  
Juseoung Lee ◽  
Junghoon Kim
Keyword(s):  
Systematic Review ◽  
Injury Prevention ◽  
Physical Performance ◽  
Prevention Program ◽  
Intervention Group ◽  
Injury Rate ◽  
Hamstring Injury ◽  
Control Groups ◽  
Injury Prevention Program ◽  
The Impact

OBJECTIVES The purpose of this study was to integrate information about the effects of FIFA 11+ injury prevention program in soccer.DESIGN AND METHODS Systematic review. We used PubMed, Medline, PMC, and Web of Science to search randomized controlled trials comparing FIFA 11+ injury prevention program with control groups among soccer players.RESULTS Total of 13 studies was selected through eligibility criteria. 7 studies included overall, ankle, knee, and hamstring injury rate between FIFA 11+ versus control groups, while the other 6 studies included improvement of physical performance, such as vertical jump, 20m sprint, agility, hip adduction strength, and FMS total score between FIFA 11+ versus control groups. There was a lower rate of injury in the intervention group from all 7 studies. Couple of studies had different criteria to compare with other studies. Most values of physical performance were also significantly improved from all 6 studies except for the values of agility time.CONCLUSIONS Multiple studies have proven injury rate reduction and physical performance improvement of FIFA 11+ program between intervention and control groups. We also found that it at least required a few weeks of intervention time to be effective. Therefore, coaches and players might need to consider including FIFA 11+ program as a warm-up period to prepare the regular season.

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