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Getting the Best Out of People
Published in Bill Runciman, Alan Merry, Merrilyn Walton, Safety and Ethics in Healthcare, 2007
Bill Runciman, Alan Merry, Merrilyn Walton
In designated trauma hospitals, there are criteria for calling a trauma team to assemble, usually in the minutes before a trauma patient arrives at the hospital. This is another area in which protocols exist for systematically assessing and resuscitating patients. The best established approach is known as the early management of severe trauma (EMST),25 or advanced trauma life support (ATLS),26 essentially different names for the same process.
Abusive head trauma in India: imaging raises the curtain
Published in International Journal of Injury Control and Safety Promotion, 2022
Hima Pendharkar, Shumyla Jabeen, Nupur Pruthi, K. V. L. N Narasinga Rao, Dhaval Shukla, Nitish Kamble, Kavita V. Jangam, John Vijay Sagar Kommu, Thennarasu Kandavel, Senthil Amudhan
This was a retrospective study of CT scan of all children aged 1 month to 3 years who were evaluated by neurosurgery emergency and trauma team at a tertiary referral centre for neurotrauma in southern India between January 2013 and May 2021. Based on the imaging findings [which included presence of SDH (isolated or in association with hemorrhage in other compartments) and hypoxia (associated with SDH or otherwise)] where AHT was suspected, a consensual decision was made to manually screen the medical records of these children. The imaging was reviewed by two neuroradiologists (SJ and HSP). Our review sought clinical details about the child’s history, symptoms and signs and the details of the associated work up. Information on retinal findings and history suggestive of abuse if available were included. Children < 1 month of age (to minimize the confounding with birth-related intracranial finding) and those children who had definite accidental injury corroborating with imaging findings were excluded. Any discrepancies in opinion about inclusion were resolved by a consensus by the team of experts. The final patient cohort comprised of all children with imaging findings suggestive of AHT and absence of witnessed injury. In addition to the head CT (which was assessed in brain and bone window) all other imaging that the children had undergone during evaluation or admission was also reviewed. This included MRI brain & spine, chest X-rays, skeletal surveys and CT spine when available. Image analysis was done in a systematic way for all children. All lab investigations recorded in the case files were also reviewed. As the study involved secondary analysis of a clinical dataset and did not contain the patient’s name or any other identifiers, ethical approval was waived by NIMHANS’ IRB.