Variation in use of damage control laparotomy for trauma by trauma centers in the United States, Canada, and Australasia

Background It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy. Methods A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy. Results Of the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States = 156 (78.4%), Canada = 26 (13.1%), and Australasia = 17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p = 0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada = 7.49; 95% confidence interval (CI) 1.39–40.27], level-1 verification status (OR = 6.02; 95% CI 2.01–18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score > 15) patients (OR per-100 patients = 1.62; 95% CI 1.20–2.18) and patients with penetrating injuries (OR per-5% increase = 1.27; 95% CI 1.01–1.58) in the last year. Conclusions The reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.

Effects or Blood Transrusion Amount on Coagulation Function and Safety in Patients with Severe Trauma

Objective: To investigate the effects of different blood transfusion volumes on coagulation function and safety in patients with severe trauma.Patients and Methods: One hundred and ten cases with severe trauma were selected as the research subjects. They were admitted to our hospital from April 2016 to April 2018. Sixty patients who needed massive transfusion (1-1.5 times of their own blood volume level) were assigned to the study group, and another 50 patients who needed small amount of transfusion (less than their own blood volume level) were assigned to the control group. The blood coagulation function index, thrombelastogram index, blood gas analysis index and the influence of adverse reactions were compared between patients in the two groups before transfusion and 24h after transfusion. Results:Twenty fourhoursafter transfusion, prothrombin time (PT), activated partial thrombin time (APTT) and thrombin time (TT) were prolonged in both groups. Both platelet (PLT) and fibrinogen (FIB) decreased(p<0.05). Both response time of blood coagulation factor (R) and fibrin polymerization reaction time (K) decreased and were lowerin the study group than those in the control group, while fibrous protein aggregation function (Angle), platelet aggregation function (MA) elevated and were higherin the study group than those in the control group (p<0.05). pH in both groups decreased, oxygen partial pressure (P02) and carbon dioxide partial pressure (PC02) in both groups increased (p<0.05). PaC02 and Pa02 in the study group were higher than those in the control group, and pH was lower than that in the control group (p<0.05). The incidence of total adverse reactions in the study group was higher than that in the control group (p<0.05). Conclusion:ln conclusion, massive transfusion for patients with severe trauma could reduce the patient’s platelet and affect their coagulation function.

Modeling of A LDR Based Liquid Level Detecting Device Using Power Function

All vehicles require liquid to move from one point to the other; and it is necessary for the driver of the vehicle to ascertain the volume (level) of the liquid in the tank before setting out on a journey, hence the need to know the level of the liquid in the tank. This paper therefore presents modeling and simulation of a sensory device, which evaluates the volume VLQD of any type of liquid in any type of a closed container that has a cross-sectional area A (m2) and height h (m). The main attraction of the approach is that it does not get in touch with the liquid, its simplicity and lower cost. The aim is achieved by using a sensor, Light Dependent Resistor (LDR); which operates on a principle which states that the voltage ELUX in Volts across a LDR is a function of luminance it receives from a light source, Light Emitting Diode (LED). This principle and a power function developed using experimental data were used to model VLQD; which reveals that VLQD in litres is a function of ELUX in Volts. The model of VLQD was simulated for the sake of validation in the Proteus 8.9 professional environment. The results obtained revealed that the proposed model correctly indicated the VLQD in litres in a closed container that its A (m2) and h (m) are known and specified in the model.

Variation in Use of Damage Control Laparotomy for Trauma By Trauma Centers in the United States, Canada, and Australasia

Background: It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy.Methods: A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy.Results: Of the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States=156 (78.4%), Canada=26 (13.1%), and Australasia=17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p=0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada=7.49; 95% confidence interval (CI)=1.39-40.27], level-1 verification status (OR=6.02; 95% CI=2.01-18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score >15) patients (OR per-100 patients=1.62; 95% CI=1.20-2.18) and patients with penetrating injuries (OR per-5% increase=1.27; 95% CI=1.01-1.58) in the last year.Conclusions: The reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.

Profile Of Maximum Volume Level Of Takraw Athlete State High School Of Sports Ability (SMANKO) Bengkulu Province

The purpose of this study was to determine the maximum oxygen uptake of athletesSepak takrawSports Talent State High School (SMANKO) Bengkulu Province. This study is a descriptive study. Collect data using a survey method with tests and measurements. This instrument is used to measure the maximum VO2 test using the Bleep test. The subject of this research is AthleteSepak takrawThe State High School of Sports Talent (SMANKO) of Bengkulu Province totaled 11 athletes. The data analysis technique used in this research is quantitative description analysis presented in percentage form. The conclusion that can be drawn is that the athletes' maximum oxygen uptake is as follows: In the very good category there are 0 athletes (0%), in the good category there are 0 athletes (0%), the moderate category there are 11 athletes (100%), in the poor category there are 0 athletes (0%) and very bad category there are 0 athletes (0%)

How Did the COVID-19 Pandemic Affect Trends in Facial Trauma?

Study Design: Retrospective cohort analysis. Objective: To examine the impact the COVID-19 pandemic and its accompanying societal measures had on the incidence, characteristics, and management of maxillofacial traumatic injuries. Methods: This cohort analysis compared facial trauma injuries presenting to the highest-volume Level I Trauma Center in New Jersey, USA from January 1 to July 31 in 2020 and 2019. Differences in demographics, mechanisms, and interventions were compared between the pandemic period (March 16–July 31, 2020) and the equivalent pre-pandemic date period in 2019 using X 2, Fishers Exact, and Mann–Whitney U testing. Results: In total, 616 subjects were included. The daily incidence of facial trauma consults during the 2020 pandemic (1.81 ± 1.1) decreased compared to 2019 (2.15 ± 1.3) ( p = 0.042). During the outbreak, there was an increase in the proportion of subjects with positive urine drug screens (21.5% vs. 12.2%; p = 0.011) and injuries related to domestic violence (10.2% vs. 4.5%; p = 0.023). Patients were 30% less likely to be transferred from local hospitals (RR, 0.70 [0.53–0.93]; p = 0.014). Although subjects had a 25% increased risk of presenting with injuries deemed procedural (RR, 1.25 [95% CI, 1.05–1.56]; p = 0.048), a greater proportion were discharged with operative procedures scheduled as outpatients (16.0% vs. 4.9%; p = 0.005). Conclusions: The COVID-19 pandemic has impacted both the epidemiology and management of maxillofacial traumatic injuries, perhaps secondary to modifications in personal and community behaviors or the effects on healthcare systems in our region.

PLTD Engine Tank Oil Volume Monitoring System using HC-SR04 Ultrasonic Sensor Based on Internet of Things (IoT)

The Diesel Power Plant is an oil-fired generator. The PLTD engine in Ranai uses Bio Solar fuel to produce 1 MW (MegaWatt) of power. The PLTD engine in Ranai each has one tank with a capacity of 1820 liters. Within 1 hour of using a machine with a power of ±, 750 KW (Kilo Watt) can consume ± 182 liters of oil. The IoT system serves to simplify the work in the oil distribution system. This IoT system uses the ESP8266 as a microcontroller, the HC-SR04 ultrasonic sensor as a volume level reader for the oil in the engine tank, and a relay as a replacement switch pump on or off. This tool works in real-time to help reduce the risk of negligence in refueling the engine. The Device testing results showed good results because the error value in the measurement distance test was 0%. The tool can provide fast and accurate information because it is equipped with an information system using Android and notifications from email messages.