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Explore chapters and articles related to this topic
What Promotes Joy
Published in Eve Shapiro, Joy in Medicine?, 2020
Every operating room has a culture. It’s a combination of the management team and the surgeons on the one hand, and how well you, as an individual, fit into that environment on the other. For instance, I’m at a level I trauma center. There’s not as much warm and fuzzy as you would find in a community hospital because it’s all about the critically ill. The culture here is very matter of fact, think on your feet, be quick, and think way beyond. There’s a higher expectation. A nurse who’s timid and shy wouldn’t survive here because everything is critical and matter of fact.
Torso trauma
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Severe subcutaneous emphysema with respiratory compromise can suggest tracheobronchial disruption. A chest drain placed on the affected side will reveal a large air leak and the collapsed lung may fail to re-expand. Bronchoscopy is diagnostic. Treatment involves intubation of the unaffected bronchus followed by operative repair. Referral to a trauma centre is advised.
The importance of neurological illnesses, emergencies, and treatments
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
S. Shelby Burks, Michael Y. Wang
These facets of neurological and neurosurgical care have led to the concentration of specialization at tertiary care centers. In fact, one of the major differentiators in the designation of a level I trauma center versus a level II trauma center is the availability of 24-hour emergency neurosurgical care.
Clinical factors associated with delayed emergency department visit in intracranial traumatic brain injury: from a multicenter injury surveillance registry
Published in Brain Injury, 2023
Jieun Pak, Tae Han Kim, Kyoung Jun Song, Seung Chul Lee, Ki Jeong Hong, Sung Wook Song, Dong Hoon Kim, Stephen Gyung Won Lee
In this study, we categorized the interval between injury onset to ED visit into four groups with time thresholds of 1 h, 3 h, and 12 h from injury onset. A delayed ED visit was defined as an ED visit after 12 h of injury. The concept of the “golden hour” of trauma is that patient outcomes are improved when patient transport to a designated trauma center is completed within an hour of injury (21). In addition, the clinical outcome of patients with TBI can be determined by the severity of the injury, the amount of traumatic penumbra remaining in the brain tissue, or secondary ischemic events (22,23). In a previous study, cerebral blood flow (CBF) values had a wide range of variability within the first 12 h after severe TBI, showing that quantitative cerebral cortical CBF measurement within 12 h could be used as a predictor of future outcomes in patients with TBI (24).
Association between Torso Gunshot Wound Volumes of Trauma Centers and Outcomes of Torso Gunshot Wound Patients. A Propensity-Matched Nationwide Cohort Study
Published in Prehospital Emergency Care, 2021
Chih-Yuan Fu, Francesco Bajani, Marissa Bokhari, Caroline Butler, Frederick Starr, Thomas Messer, Matthew Kaminsky, Andrew Dennis, Victoria Schlanser, Stathis Poulakidas, Justin Mis, Faran Bokhari
Trauma centers can provide complex medical care at the correct time and the correct place (18–20). A mature trauma center confers benefits with regard to mortality and morbidity, efficiencies of care, and economic outcomes (19–22). Previous reports suggested that the establishment of a trauma center that centralizes trauma care could improve survival and quality of care for patients (23–25). Among trauma centers, the designation levels refer to the types of resources available and the number of patients admitted yearly (2). Trauma centers should have the resources to treat patients with major multisystem trauma within organized trauma systems. A high-level trauma center is a comprehensive regional resource that is central to the trauma system (1, 2, 23–25). Better outcomes of trauma patients are expected in high-level trauma centers. Based on current trauma triage guidelines, patients with unstable hemodynamics, moderate to severe traumatic brain injury or high-risk mechanisms of injury should be sent to trauma centers (19). In addition, mis-triaged patients use interfacility transport (from low-level trauma centers to high-level trauma centers) to access expert care (26).
Regionalization Patterns for Children with Serious Trauma in California (2005–2015): A Retrospective Cohort Study
Published in Prehospital Emergency Care, 2021
N. Ewen Wang, Clifton Ewbank, Christopher R. Newton, David A. Spain, Elizabeth Pirrotta, Monika Thomas-Uribe
California is a large and diverse state, and is home to one eighth of the pediatric population of the United States (12). Instead of a statewide trauma system, 33 LEMSAs administrate trauma services for 58 counties with guidance from the California EMS authority (13). The American College of Surgeons (ACS) “verifies” trauma centers at the request of the trauma center to assess compliance with ACS trauma center guidelines (14). However, the LEMSA “designates” a trauma center, or issues the protocols regarding where paramedics should transport trauma patients from the field. In the majority of cases a trauma center will have both ACS verification and LEMSA designation; however, specific designation protocols depend on resource availability. In 2005, California had 46 level I and II trauma centers and 11 pediatric trauma centers (11, 14). Level III and IV trauma centers are smaller facilities that do not have all the resources of a level I or II trauma center, but have specific agreements with level I and II trauma centers. Pediatric non-trauma hospitals were defined as hospitals not designated as a trauma center, but which belonged to the Children’s Hospital Association. Adult non-trauma hospitals were defined as hospitals lacking both a trauma center and a pediatric designation.