Impact of telemedicine on diagnosis, clinical management and outcomes in rural trauma patients: A rapid review

2020 ◽  
Vol 25 (1) ◽  
pp. 31 ◽  
Author(s):  
Richard Fleet ◽  
Luc Lapointe ◽  
Marie-Helene Lavallee-Bourget ◽  
Alexia Pichard-Jolicoeur ◽  
Catherine Turgeon-Pelchat
Keyword(s):  
Clinical Management ◽  
Rapid Review ◽  
Trauma Patients

Educational Review of Predictive Value and Findings of Computed Tomography Scan in Diagnosing Bowel and Mesenteric Injuries after Blunt Trauma: Correlation with Trauma Surgery Findings in 163 Patients

2017 ◽  
Vol 68 (3) ◽  
pp. 276-285 ◽  
Author(s):  
Francesco Cinquantini ◽  
Gregorio Tugnoli ◽  
Alice Piccinini ◽  
Carlo Coniglio ◽  
Sergio Mannone ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Predictive Value ◽  
Gold Standard ◽  
Clinical Management ◽  
Trauma Surgery ◽  
Trauma Patients ◽  
Increased Risk

Background and Aims Laparotomy can detect bowel and mesenteric injuries in 1.2%–5% of patients following blunt abdominal trauma. Delayed diagnosis in such cases is strongly related to increased risk of ongoing sepsis, with subsequent higher morbidity and mortality. Computed tomography (CT) scanning is the gold standard in the evaluation of blunt abdominal trauma, being accurate in the diagnosis of bowel and mesenteric injuries in case of hemodynamically stable trauma patients. Aims of the present study are to 1) review the correlation between CT signs and intraoperative findings in case of bowel and mesenteric injuries following blunt abdominal trauma, analysing the correlation between radiological features and intraoperative findings from our experience on 25 trauma patients with small bowel and mesenteric injuries (SBMI); 2) identify the diagnostic specificity of those signs found at CT with practical considerations on the following clinical management; and 3) distinguish the bowel and mesenteric injuries requiring immediate surgical intervention from those amenable to initial nonoperative management. Materials and Methods Between January 1, 2008, and May 31, 2010, 163 patients required laparotomy following blunt abdominal trauma. Among them, 25 patients presented bowel or mesenteric injuries. Data were analysed retrospectively, correlating operative surgical reports with the preoperative CT findings. Results We are presenting a pictorial review of significant and frequent findings of bowel and mesenteric lesions at CT scan, confirmed intraoperatively at laparotomy. Moreover, the predictive value of CT scan for SBMI is assessed. Conclusions Multidetector CT scan is the gold standard in the assessment of intra-abdominal blunt abdominal trauma for not only parenchymal organs injuries but also detecting SBMI; in the presence of specific signs it provides an accurate assessment of hollow viscus injuries, helping the trauma surgeons to choose the correct initial clinical management.

Deviations from evidence-based clinical management guidelines increase mortality in critically injured trauma patients*

2012 ◽  
Vol 40 (3) ◽  
pp. 778-786 ◽  
Author(s):  
Todd W. Rice ◽  
Stephen Morris ◽  
Bartholomew J. Tortella ◽  
Arthur P. Wheeler ◽  
Michael C. Christensen
Keyword(s):  
Clinical Management ◽  
Evidence Based ◽  
Trauma Patients ◽  
Management Guidelines

scholarly journals Compliance with evidence-based clinical management guidelines in bleeding trauma patients

2016 ◽  
Vol 117 (5) ◽  
pp. 592-600 ◽  
Author(s):  
A. Godier ◽  
M. Bacus ◽  
E. Kipnis ◽  
B. Tavernier ◽  
A. Guidat ◽  
...  
Keyword(s):  
Clinical Management ◽  
Evidence Based ◽  
Trauma Patients ◽  
Management Guidelines

THE CLINICAL MANAGEMENT OF BLUNT TRAUMA PATIENTS WITH UNILATERAL MULTIPLE RIB FRACTURES

1991 ◽  
Vol 31 (12) ◽  
pp. 1716
Author(s):  
S Gabram ◽  
R Schwartz ◽  
L Jacobs ◽  
D Lawrence ◽  
W Kantor ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Clinical Management ◽  
Rib Fractures ◽  
Trauma Patients ◽  
Multiple Rib Fractures

PULMONARY EMBOLISM PREVENTION BY CLINICAL MANAGEMENT GUIDELINE IN HIGH RISK TRAUMA PATIENTS ADMITTED TO AN ICU USING DUPLEX SURVEILLANCE

1998 ◽  
Vol 26 (Supplement) ◽  
pp. 48A ◽  
Author(s):  
Rajan Gupta ◽  
GP Dabrowski ◽  
DH Jenkins ◽  
PM Reilly ◽  
S Gaskell ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Clinical Management ◽  
Trauma Patients ◽  
Management Guideline

Clinical management of blunt trauma patients with unilateral rib fractures: A randomized trial

1995 ◽  
Vol 19 (3) ◽  
pp. 388-393 ◽  
Author(s):  
Sheryl G. A. Gabram ◽  
Robert J. Schwartz ◽  
Lenworth M. Jacobs ◽  
Denise Lawrence ◽  
Marlene A. Murphy ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Blunt Trauma ◽  
Clinical Management ◽  
Rib Fractures ◽  
Trauma Patients

Clinical Management of Severe Bleeding in Trauma Patients

2015 ◽  
pp. 89-105
Author(s):  
Giuseppe Nardi ◽  
Vanessa Agostini ◽  
Alberto Grassetto ◽  
Emiliano Cingolani ◽  
Concetta Pellegrini
Keyword(s):  
Clinical Management ◽  
Severe Bleeding ◽  
Trauma Patients

scholarly journals Accessibility, inclusivity, and implementation of COVID-19 clinical management guidelines early in the pandemic: a global survey

2021 ◽  
Author(s):  
Caitlin Pilbeam ◽  
Deborah Malden ◽  
Katherine Newell ◽  
Andrew Dagens ◽  
Kalynn Kennon ◽  
...  
Keyword(s):  
At Risk ◽  
Supportive Care ◽  
Clinical Management ◽  
Rapid Review ◽  
Evidence Based ◽  
Science Literature ◽  
Management Guidelines ◽  
At Risk Populations ◽  
Evidence Based Care ◽  
Improve Access

AbstractBackgroundWith a rapidly changing evidence base, high-quality clinical management guidelines (CMGs) are key tools for aiding clinical decision making and increasing access to best available evidence-based care. A rapid review of COVID-19 CMGs found that most lacked methodological rigour, overlooked many at-risk populations, and had variations in treatment recommendations. Furthermore, social science literature highlights the complexity of implementing guidelines in local contexts where they were not developed and the resulting potential to compound health inequities. The aim of this study was to evaluate access to, inclusivity of, and implementation of Covid-19 CMGs in different settings.MethodsA cross-sectional survey of clinicians worldwide from 15 June to 20 July 2020, to explore access to and implementation of Covid-19 CMGs and treatment and supportive care recommendations provided. Data on accessibility, inclusivity, and implementation of CMGs. were analyzed by geographic location.ResultsSeventy-six clinicians, from 27 countries responded, 82% from high-income countries, 17% from low-middle income countries. Most respondents reported access to Covid-19 CMG and confidence in implementation of these. However, many respondents, particularly from LMICs reported barriers to implementation, including limited access to treatments and equipment. Only 20% of respondents reported having access to CMGs covering care for children, 25% for pregnant women and 50% for older adults (>65 years). Themes emerging were for CMGs to include recommendations for different at-risk populations, and settings, include supportive care guidance, be readily updated as evidence emerges, and CMG implementation supported by training, and access to treatments recommended.ConclusionOur findings highlight important gaps in Covid-19 CMG development and implementation challenges during a pandemic, particularly affecting different at-risk populations and lower resourced settings., to improve access in evidence-based care recommendations during an emergency. The findings identifies an urgent need for an improved framework for CMG development, that is inclusive and adaptable to emerging evidence and considers contextual implementation support, to improve access to evidence-based care globally.

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