Physiotherapy management of patients with major chest trauma: Results from a global survey

Trauma ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Heleen van Aswegen ◽  
Julie Reeve ◽  
Lisa Beach ◽  
Romy Parker ◽  
Monika Fagevik Olsèn

Aim Major chest trauma is associated with significant morbidity and mortality. Management of patients with major chest trauma includes pain relief, ventilatory management, surgical fixation and early rehabilitation to improve both short- and long-term outcomes. Physiotherapy is widely considered an integral component of the multidisciplinary trauma team and aims to improve respiratory status and reduce the sequelae associated with immobility and reduced physical function. Despite this there is scarce evidence describing or investigating physiotherapy interventions and how these practices vary worldwide. The aim of this study was to ascertain the current physiotherapy management of patients having sustained major chest trauma and to investigate how such practices varied internationally. Methods A purpose designed online survey was administered to a group of experienced physiotherapists who work in the field of trauma. Results Response rate was 51% ( n = 49) and respondents represented all five continents. Respondents reported focussing on active coughing ( n = 46, 96%, r = 0.5, p = 0.98), body positioning ( n = 43, 94%, r = 0.7, p = 0.41), deep breathing exercises ( n = 44, 94%, r = 0.8, p = 0.66) and early mobilisation ( n = 47, 98%, r = 1, p = 0.64). Ambulation in hospital was reported to be common ( n = 46, 98%, r = 0.2, p = 0.99) but rehabilitation to address longer term sequelae following hospital discharge was reported to be rare ( n = 4, 8%). Conclusion This survey has highlighted those practices used by physiotherapists worldwide which aim to address the complications associated with major chest trauma. Having established global practice, the study provides a platform for future research investigating the efficacy of such interventions in improving both short- and long-term outcomes for patients following major chest injury.

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 986 ◽  
Author(s):  
Jennifer A. Schaub ◽  
Chirag R. Parikh

Acute kidney injury is strongly associated with increased mortality and other adverse outcomes. Medical researchers have intensively investigated novel biomarkers to predict short- and long-term outcomes of acute kidney injury in many patient care settings, such as cardiac surgery, intensive care units, heart failure, and transplant. Future research should focus on leveraging this relationship to improve enrollment for clinical trials of acute kidney injury.


2020 ◽  
Vol 112 (4) ◽  
pp. 380-386
Author(s):  
Guillermo M. Carriquiry ◽  
◽  
Julio Trostchansky

Rib fractures are the most common injuries in chest trauma. Fracture fixation has been traditionally performed in flail chest patients. Over the past years, the indication has been extended to multiple, severely displaced non-flail pattern fractures. Other less common indications for osteosynthesis have also been considered. Severe pneumonia and lung contusion requiring mechanical ventilation are considered contraindication for surgical fixation. The optimal timing for the intervention is the first week. Several devices have been developed for fracture fixation; titanium plates are the most commonly used. Rib fixation offers patients a more rapid recovery with shorter length of hospital stay and of intensive care unit stay with improved respiratory function and pain management in the short and long term.


Author(s):  
Brent Sanderson ◽  
Michael Bogard ◽  
Reza Jazayeri

Deltoid tendon rupture is an infrequent injury. We report on a young active white male who sustained a humeral sided deltoid avulsion tendon rupture while attempting a 450-pound barbell shoulder shrug. Early surgical fixation and a progressive rehabilitation program provided successful short and long-term outcomes in our young active patient.


Author(s):  
Oscar D. Guillamondegui

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.


2021 ◽  
pp. 000765032110018
Author(s):  
Farley Simon Nobre ◽  
Rodrigo L. Morais-da-Silva

Bottom of the Pyramid (BoP) organizations are the ones that develop a set of capabilities that contribute to create short- and long-term sustainability values inside and outside the boundaries of BoP ecosystems. Capabilities have an important role in BoP organizations’ strategies that aim to solve BoP issues. Notwithstanding its developments, BoP research still lacks theoretical contributions for the analysis of organizations. We suggest special attention to the need of advancing knowledge on capabilities of BoP organizations because this field is scattered and fragmented, misinterpreted, and still underdeveloped in the literature. We oriented our research formulating and seeking answers to our main question on what are the capabilities needed to enable organizations to create sustainability values in BoP ecosystems? We conducted an integrative review of BoP research for the period from 1998 to 2019, and we found 22 key capabilities of BoP organizations. We organized the capabilities into four major categories including BoP Responsible Consumption, BoP Responsible Business Model, BoP Responsible Management, and BoP Responsible Innovation. We advanced propositions and discussions regarding the capabilities and major categories’ popularity, interdependence and combination, short- and long-term temporal functions, sustainability roles, and effectiveness to address BoP issues. Our article organizes the field of capabilities of BoP organizations; advances contributions and implications for management, organizations, and policymaking; and opens fruitful avenues for future research.


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