Necessity of performing routine tests in trauma patients referring to emergency departments

AbstractCombining survey data with alternative data sources (e.g., wearable technology, apps, physiological, ecological monitoring, genomic, neurocognitive assessments, brain imaging, and psychophysical data) to paint a complete biobehavioral picture of trauma patients comes with many complex system challenges and solutions. Starting in emergency departments and incorporating these diverse, broad, and separate data streams presents technical, operational, and logistical challenges but allows for a greater scientific understanding of the long-term effects of trauma. Our manuscript describes incorporating and prospectively linking these multi-dimensional big data elements into a clinical, observational study at US emergency departments with the goal to understand, prevent, and predict adverse posttraumatic neuropsychiatric sequelae (APNS) that affects over 40 million Americans annually. We outline key data-driven system challenges and solutions and investigate eligibility considerations, compliance, and response rate outcomes incorporating these diverse “big data” measures using integrated data-driven cross-discipline system architecture.

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Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

Medicina ◽

10.3390/medicina57111178 ◽

2021 ◽

Vol 57 (11) ◽

pp. 1178

Author(s):

Heba Kalbouneh ◽

Omar Alajoulin ◽

Jamil Shawaqfeh ◽

Ayman Mustafa ◽

Shehab Jaber ◽

...

Keyword(s):

Emergency Departments ◽

Diagnostic Errors ◽

Kappa Statistic ◽

Incidence Rates ◽

Trauma Patients ◽

Foot And Ankle ◽

Avulsion Fractures ◽

Accessory Ossicles ◽

Os Peroneum ◽

Accessory Navicular

Background and Objectives: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. Materials and Methods: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. Results: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. Conclusions: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors.

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The use of whole-body CT for trauma patients: survey of UK emergency departments

Emergency Medicine Journal ◽

10.1136/emj.2011.111708 ◽

2011 ◽

Vol 29 (8) ◽

pp. 630-634 ◽

Cited By ~ 16

Author(s):

Christopher M Smith ◽

Suzanne Mason

Keyword(s):

Emergency Departments ◽

Whole Body ◽

Trauma Patients ◽

Whole Body Ct ◽

Body Ct

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Alcohol Interventions for Trauma Patients Treated in Emergency Departments

Annals of Surgery ◽

10.1097/01.sla.0000157134.06814.8b ◽

2005 ◽

Vol 241 (4) ◽

pp. 551-552 ◽

Cited By ~ 5

Author(s):

Mark A. Malangoni

Keyword(s):

Emergency Departments ◽

Trauma Patients ◽

Alcohol Interventions

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Validation of the Shock Index, Modified Shock Index, and Age Shock Index for Predicting Mortality of Geriatric Trauma Patients in Emergency Departments

Journal of Korean Medical Science ◽

10.3346/jkms.2016.31.12.2026 ◽

2016 ◽

Vol 31 (12) ◽

pp. 2026 ◽

Cited By ~ 10

Author(s):

Soon Yong Kim ◽

Ki Jeong Hong ◽

Sang Do Shin ◽

Young Sun Ro ◽

Ki Ok Ahn ◽

...

Keyword(s):

Emergency Departments ◽

Geriatric Trauma ◽

Trauma Patients ◽

Shock Index

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Full-Body X-Ray Imaging to Facilitate Triage: A Potential Aid in High-Volume Emergency Departments

Emergency Medicine International ◽

10.1155/2013/437078 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

S. P. Whiley ◽

H. Alves ◽

S. Grace

Keyword(s):

South African ◽

Emergency Departments ◽

Clinical Decision Making ◽

Traumatic Injury ◽

High Volume ◽

Trauma Centre ◽

Trauma Patients ◽

X Ray ◽

X Ray Imaging ◽

Full Body

The levels of traumatic injury seen in South African emergency departments (EDs) are epidemic. This is coupled with a severe lack of resources and adequately trained emergency staff. The Lodox Statscan (LS) is an X-ray scanner capable of producing rapid, low-dose, and full-body X-ray images. In this paper, a new trauma protocol—the Johannesburg trauma protocol—that implements LS scanning on entry to the ED as a triage tool is reported. A case study illustrating the use of LS to triage 63 patients in a single Saturday shift at a level 1 Trauma Centre is also presented. Because of the ability to rapidly and safely provide X-ray imaging information to support clinical decision making, the LS could be a useful tool to aid in resource allocation to improve treatment of the high levels of trauma patients that present to South African EDs daily.

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