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Author: Maureen R. Murphy Publisher: ISBN: 9781267662583 Category : Languages : en Pages :
Book Description
Background: The older adult is often undertriaged and is susceptible to serious injury from low level falls. Age-related physiologic changes and co-morbidities contribute to increased complication and mortality rates. Objective: The overarching goal of this study was to identify additional criteria that may increase the sensitivity of trauma triage guidelines for older adults who have fallen. The purpose was to examine associations between frequently used triage criteria (fall height, Glasgow Coma Scale "GCS" scores, blood pressure, heart rate, and age) and commonly used outcomes (Injury Severity Score "ISS", hospital length of stay "LOS", and hospital mortality) in older adults who have fallen. Method: This study used a cross-sectional retrospective review of a level 1 trauma center database and electronic medical record. The study sample included 1,088 patients age 50 years and older who had fallen from any height and experienced injury requiring admission to a level I trauma center between June 2006 and December 2010. Age, fall height, heart rate, blood pressure, GCS score, ISS, LOS, and hospital mortality data were collected. All study variables were analyzed for statistically significant relationships using Pearson's r correlation coefficient. Results: Seventy-nine percent of the sample fell five feet or less and ground level falls were the most common type of fall. There was a moderate negative correlation between fall height and age (p .01). A GCS of 14 was the most common score less than 15 and occurred 17% of the time. There was a moderate positive correlation between GCS and mortality (p .01). Hypotension and tachycardia rarely occurred. Conclusions: The findings from this study may provide insight into ways to increase the sensitivity of current trauma triage guidelines to more clearly identify the injured older adult, including adjustments to current triage variables, and/or combinations of triage criteria.
Author: Maureen R. Murphy Publisher: ISBN: 9781267662583 Category : Languages : en Pages :
Book Description
Background: The older adult is often undertriaged and is susceptible to serious injury from low level falls. Age-related physiologic changes and co-morbidities contribute to increased complication and mortality rates. Objective: The overarching goal of this study was to identify additional criteria that may increase the sensitivity of trauma triage guidelines for older adults who have fallen. The purpose was to examine associations between frequently used triage criteria (fall height, Glasgow Coma Scale "GCS" scores, blood pressure, heart rate, and age) and commonly used outcomes (Injury Severity Score "ISS", hospital length of stay "LOS", and hospital mortality) in older adults who have fallen. Method: This study used a cross-sectional retrospective review of a level 1 trauma center database and electronic medical record. The study sample included 1,088 patients age 50 years and older who had fallen from any height and experienced injury requiring admission to a level I trauma center between June 2006 and December 2010. Age, fall height, heart rate, blood pressure, GCS score, ISS, LOS, and hospital mortality data were collected. All study variables were analyzed for statistically significant relationships using Pearson's r correlation coefficient. Results: Seventy-nine percent of the sample fell five feet or less and ground level falls were the most common type of fall. There was a moderate negative correlation between fall height and age (p .01). A GCS of 14 was the most common score less than 15 and occurred 17% of the time. There was a moderate positive correlation between GCS and mortality (p .01). Hypotension and tachycardia rarely occurred. Conclusions: The findings from this study may provide insight into ways to increase the sensitivity of current trauma triage guidelines to more clearly identify the injured older adult, including adjustments to current triage variables, and/or combinations of triage criteria.
Author: Juan A. Asensio Publisher: Elsevier Health Sciences ISBN: 0323846416 Category : Medical Languages : en Pages : 1391
Book Description
Drawing on the experience and knowledge of master world-renowned trauma surgeons, Current Therapy of Trauma and Surgical Critical Care, 3rd Edition, offers a comprehensive summary of optimal treatment and post-operative management of traumatic injuries. Ideally suited for everyday use, this practical, concise reference highlights the most important aspects of urgent surgical care, from damage control to noninvasive techniques to chemical and biological injuries. A focus on the surgical techniques required to manage even the most complex injuries makes it both an excellent resource for quick review before entering the operating room and a valuable review tool for board certification or recertification. Covers the entire spectrum of Trauma Surgery and Surgical Critical Care—from initial evaluation, military and civilian field and trauma center evaluation and resuscitation, to diagnosis, operative, and postoperative critical care and outcomes—in nearly 100 print and 39 online-exclusive chapters, all newly streamlined to emphasize frontline procedural treatment. Features extensive new data and updates to Cardiac, Thoracic, Vascular, and Military Surgery chapters, plus numerous new intraoperative photographs and high-quality line drawings that highlight the most important aspects of urgent surgical care. Contains 14 new chapters, including Innovations in Trauma Surgery Simulation; Air Evacuation and Critical Care in Military Casualties; REBOA: Indications and Controversies; Penetrating Extracranial Vertebral Artery; Penetrating Arterio-Venous Fistulas; The Genomics of Profound Shock and Trauma; ECMO; and newer strategies, such as nerve blocks for pain management to combat the opioid epidemic. Incorporates a wealth of military knowledge from both recent and past military conflicts, as well as from asymmetric warfare; many of the authors and co-authors have extensive past and present military experience. Uses a consistent, easy-to-follow chapter format throughout, for quick and easy reference and review. Reviews the essential principles of diagnosis and treatment, as well as the specifics of surgical therapy, making it useful for surgeons across all specialties. Integrates evidence-based practice guidelines into the text whenever possible, as well as comprehensive utilization of the American Association for the Surgery of Trauma – Organ Injury Scales (AAST-OIS). Contains such a wealth of operative photographs and line drawings, both in the printed version and many more in the electronic version, that it could be considered an Atlas of Trauma Surgery.
Author: Ronda Hughes Publisher: Department of Health and Human Services ISBN: Category : Medical Languages : en Pages : 592
Book Description
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Author: Christopher Hicks Publisher: Elsevier Health Sciences ISBN: 0323939708 Category : Medical Languages : en Pages : 241
Book Description
In this issue of Emergency Medicine Clinics, guest editors Drs. Kimberly A. Boswell and Christopher Hicks bring their considerable expertise to Trauma Emergencies. Top experts in the field cover key topics such as management of the complex airway in the trauma setting; neck trauma; trauma in the aging population; pediatric trauma; trauma patients in shock; minor procedures in trauma; and more. Contains 15 relevant, practice-oriented topics including neurotrauma update; the Big Five: heroic procedures in the trauma bay; new approaches to pain management in trauma; new uses for ultrasound in trauma; intimate partner violence and human trafficking; and more. Provides in-depth clinical reviews on trauma emergencies, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
Author: Committee on Injury Prevention and Control Publisher: National Academies Press ISBN: 0309593468 Category : Medical Languages : en Pages : 336
Book Description
Injuries are the leading cause of death and disability among people under age 35 in the United States. Despite great strides in injury prevention over the decades, injuries result in 150,000 deaths, 2.6 million hospitalizations, and 36 million visits to the emergency room each year. Reducing the Burden of Injury describes the cost and magnitude of the injury problem in America and looks critically at the current response by the public and private sectors, including: Data and surveillance needs. Research priorities. Trauma care systems development. Infrastructure support, including training for injury professionals. Firearm safety. Coordination among federal agencies. The authors define the field of injury and establish boundaries for the field regarding intentional injuries. This book highlights the crosscutting nature of the injury field, identifies opportunities to leverage resources and expertise of the numerous parties involved, and discusses issues regarding leadership at the federal level.
Author: Jane H. Brice Publisher: John Wiley & Sons ISBN: 1119756243 Category : Medical Languages : en Pages : 1187
Book Description
The two-volume Emergency Medical Services: Clinical Practice and Systems Oversight delivers a thorough foundation upon which to succeed as an EMS medical director and prepare for the NAEMSP National EMS Medical Directors Course and Practicum. Focusing on EMS in the 'real world', the book offers specific management tools that will be useful in the reader's own local EMS system and provides contextual understanding of how EMS functions within the broader emergency care system at a state, local, and national level. The two volumes offer the core knowledge trainees will need to successfully complete their training and begin their career as EMS physicians, regardless of the EMS systems in use in their areas. A companion website rounds out the book's offerings with audio and video clips of EMS best practice in action. Readers will also benefit from the inclusion of: A thorough introduction to the history of EMS An exploration of EMS airway management, including procedures and challenges, as well as how to manage ventilation, oxygenation, and breathing in patients, including cases of respiratory distress Practical discussions of medical problems, including the challenges posed by the undifferentiated patient, altered mental status, cardiac arrest and dysrhythmias, seizures, stroke, and allergic reactions An examination of EMS systems, structure, and leadership
Author: Eric Legome Publisher: Cambridge University Press ISBN: 1139500724 Category : Medical Languages : en Pages : 737
Book Description
Trauma: A Comprehensive Emergency Medicine Approach is a fully illustrated, interdisciplinary overview of trauma. Using both evidence-based approaches and a practical understanding of the emergency department, it gives a broad and in-depth review of trauma care. The entire spectrum of trauma presentations is reviewed from minor soft-tissue injuries through to major life-threatening conditions. Written by over 50 expert contributors, it gives concrete and practical recommendations for evaluation, treatment, consultation and disposition decisions on both common and unusual conditions. Extensive use of photographs, illustrations and key information boxes is used to make the material accessible. Additional sections provide an overview of multiple other issues relating to emergency management of trauma including administrative, nursing, research and legal matters. This book provides an essential reference for anyone who is called upon to provide acute trauma care in the emergency department.
Author: Jeffrey B. Halter Publisher: McGraw Hill Professional ISBN: 0071833463 Category : Medical Languages : en Pages : 2097
Book Description
The gold-standard text on the diagnosis and treatment of disorders affecting the elderly – completely updated with a new full-color presentation A Doody's Core Title for 2021! The definitive treatise on the subject of geriatrics, this comprehensive text combines gerontology principles with clinical geriatrics, offering a uniquely holistic approach to this ever-expanding area of medicine. Written by some of the world’s most respected geriatricians, Hazzard’s Geriatric Medicine and Gerontology, Seventh Edition presents up-to-date, evidence-based information in a rich new full-color design. Unmatched as a textbook, this classic is also valuable to fellows in geriatric medicine. Hazzards’s Geriatric Medicine and Gerontology, Seventh Edition is logically divided into five parts: Principles of Gerontology, Principles of Geriatrics, Geriatric Syndromes, Principles of Palliative Medicine, and Organ Systems and Diseases. Within its pages, you will find balanced, authoritative coverage of every essential topic – from evaluation and management to nutrition and palliative medicine. Here’s why the Seventh Edition is the best edition ever: NEW full-color design with hundreds of color photographs NEW chapters: Quality of Care in Older Adults, Common Non-Pain Symptoms in Older Adults, Strategies of Effective Communication Around Advanced Illness, Palliative Medicine in the Continuum of Care Including Hospice, Coagulation Disorders, and Plasma Cell Disorders MORE chapters on Palliative Medicine NEW Learning Objectives and Key Points added to each chapter MORE tables, drawings, and clinical algorithms EVIDENCE-BASED through the use of the latest clinical practice guidelines , references to systemic reviews, and critically appraised topics UPDATED to reflect the most current clinical breakthroughs and advances for managing older adults in various settings