Trauma Surgery & Acute Care Open最新文献

{"title":"Remodeling the trauma bay to improve communication and patient care: a novel approach to trauma resuscitations.","authors":"Lillie Tien, Mikenzie Sturdevant, Maanasa Javangula, Brittany Ange, Jonathon McKenzie, Regina Medeiros, Bao-Ling Adam, Adil Abuzeid, Erin Switzer, Amanda Lee, Erika Simmerman Mabes","doi":"10.1136/tsaco-2024-001689","DOIUrl":"10.1136/tsaco-2024-001689","url":null,"abstract":"<p><p>Established roles and personal protective equipment are imperative to safely and effectively perform trauma resuscitations. Thus, we remodeled our trauma bay to achieve these goals. We supplied our level 1 trauma bay with color-coded floor signs and corresponding lead to denote the seven critical bedside trauma team members' roles/positions. We administered surveys to team members who experienced the transition to gather data on how the implementation of color-coded signs and lead aprons impacted trauma resuscitations. Prior to the implementation of color-coded floor signs, 48% agreed/strongly agreed that it was clear where members were supposed to stand, increasing to 90% after implementation. Before providing color-coded lead, 80% disagreed/strongly disagreed that trauma team members routinely wore lead. After providing the lead aprons, 76% agreed that members routinely wore lead, and 80% agreed/strongly agreed that having this lead helped reduce disruptions. Team members agreed that dedicated lead and floor signs improved resuscitation flow and patient care.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001689"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening India's trauma system: consolidating progress into accountable systems.","authors":"Divya Kewalramani, Mayur Narayan","doi":"10.1136/tsaco-2025-001953","DOIUrl":"10.1136/tsaco-2025-001953","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001953"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma).","authors":"Vanessa P Ho, Cynthia Lizette Villarreal, Pam J Bixby, Michelle A Price","doi":"10.1136/tsaco-2024-001427","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001427","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001427"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative assessment of point of injury to Role 2+ combat casualty care in Ukraine.","authors":"Lynn Lieberman Lawry, Jessica Korona-Bailey, Amandari Kanagaratnam, John Maddox, Tiffany E Hamm, Miranda Janvrin, Luke Juman, Oleh Berezyuk, Zoe Amowitz, Andrew J Schoenfeld, Tracey Pérez Koehlmoos","doi":"10.1136/tsaco-2024-001674","DOIUrl":"10.1136/tsaco-2024-001674","url":null,"abstract":"<p><strong>Background: </strong>The ongoing Russian-Ukrainian war created an extended battlefield with the prolific use of missiles and drones. Such tactics require placement of care facilities far from the frontline, thereby delaying definitive trauma care and necessitating prolonged casualty care (PCC).</p><p><strong>Methods: </strong>Between June 2023 and February 2024, we conducted qualitative key informant interviews with Ukrainian healthcare personnel using an expanded version of the Global Trauma System Evaluation Tool. Analysis focused on identifying and understanding casualty care from point of injury through Roles 1, 2, and 2+. We included 36 civilian and military healthcare or healthcare-affiliated participants. Sampling continued until thematic saturation was achieved.</p><p><strong>Results: </strong>Respondents indicated medics lacked a standardized formal training system for prehospital care across emergency services and regions. Reliance on \"walking blood banks to collect fresh whole blood for blood banking and direct transfusion was noted frequently. Of respondents at Roles 1, 2, and 2+, 73% stated damage control resuscitation was done at their level, and 71% of respondents in these same Roles stated they were doing some level of damage control surgery. Security and the tactical situation were common limitations to prehospital care leading to PCC.</p><p><strong>Conclusion: </strong>The experience in Ukraine shows that, in the face of large-scale combat, the effectiveness of Role 2+ and lower facilities degrades very quickly. Future attention should be focused on improvements to prehospital care training, safe and timely patient movement in the absence of air superiority, PCC, blood supply, and medevac coordination. Efficient combat casualty care may require enhancing the capabilities of current Role 2+ units, or moving Role 3 facilities closer to the battlefront.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001674"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma care disparities: is equity the key? Output from SAFER-Trauma.","authors":"Anamaria J Robles, Sydney Timmer-Murillo, Kathryn M Stadeli, Tandis Soltani, Bethany L Strong, Jacob Higgins, Vanessa P Ho, Cherisse Berry, Zara Cooper, Cynthia Lizette Villarreal, Michelle A Price","doi":"10.1136/tsaco-2024-001450","DOIUrl":"10.1136/tsaco-2024-001450","url":null,"abstract":"<p><p>Despite remarkable advances in clinical care, injury remains a leading cause of death in the USA. Recent studies in the care of the injured patient have begun to unearth the crucial influence of health disparities and health inequity on outcomes after injury. Importantly, it is known that there are strikingly disparate outcomes following injury based on demographic backgrounds, with racial and ethnic minoritized groups having a higher risk of death from traumatic injury. This paper highlights the problem of health inequity after injury by addressing health and health care disparities in trauma with a focus on the proceedings from the Summit on the Advancement of Focused Equity Research in Trauma organized by Coalition for National Trauma Research's Equity, Diversity and Inclusion Committee. Included in this work is an assessment of the structural determinants of health inequities and the evidence for widespread inequities across the continuum of trauma care; with an emphasis on five vital, actionable steps towards health equity that can be taken now by the trauma community, including firearm injury prevention, Medicaid expansion, trauma-informed care, equity measurement and benchmarking, and improving trauma survivorship. Ultimately, to move towards improved quality of care for all injured patients, we must eliminate health care disparities in trauma care across the continuum and work towards more equitable care for all.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001450"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative approaches to equity research in trauma: current work and aspirations from the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma).","authors":"Kathryn M Stadeli, Tandis Soltani, Bethany L Strong, Anamaria J Robles, Sydney Timmer-Murillo, Susan E Cronn, Cynthia Lizette Villarreal, Vanessa P Ho, Michaela A West, Michelle A Price, Arpana Jain, Rachael A Callcut","doi":"10.1136/tsaco-2024-001469","DOIUrl":"10.1136/tsaco-2024-001469","url":null,"abstract":"<p><p>On August 2-3, 2023, the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma) convened to discuss strategies to support research to eliminate disparities in trauma care. An ongoing challenge for performing high-quality equity-based research is the uncomfortable recognition that implicit bias and structural racism are deeply ingrained in our society and culture and are therefore often unrecognized in medicine and research practices. Throughout SAFER-Trauma, several examples of strategies to overcome these challenges were presented. In this article, we will relate a diverse array of examples through three distinct angles. The first focuses on innovations that harness existing data in novel and groundbreaking ways, uncovering fresh insights and applications from information already at our disposal. The second examines innovations that arise from traditional healthcare systems and research methods, showing how research in the healthcare sphere can adapt to meet modern needs. The third will explore projects that emerged from communities, driven by the pressing needs and aspirations of the people they serve.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001469"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access, delivery and outcomes: the summit on the advancement of Focused Equity Research in Trauma (SAFER-Trauma).","authors":"Cynthia Lizette Villarreal, Michelle A Price, Ashley N Moreno, Pam J Bixby, Esther S Tseng, Brianna R Fram, Bethany Lauren Strong, Rachael A Callcut, Michaela A West, Vanessa P Ho","doi":"10.1136/tsaco-2024-001430","DOIUrl":"10.1136/tsaco-2024-001430","url":null,"abstract":"<p><p>On August 2-3, 2023, the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma) was convened in Chicago, Illinois, USA. Thought leaders comprised of over 50 in-person and over 80 virtual attendees, including trauma surgeons, nurses, trauma program managers, researchers, and survivors convened at the American College of Surgeons headquarters in Chicago to take stock of existing disparities in injury care and research and consider innovative solutions to address them. To achieve these goals, the first day of the conference focused on the Current State of Trauma Research and Disparities, and the second day focused on A Unified Response to Address Disparities in Trauma Research. Video recordings of all presentations are freely available on the conference website (https://www.nattrauma.org/safer-trauma-new/). SAFER-Trauma was designed by the Coalition for National Trauma Research's Equity, Diversity and Inclusion Committee, chaired by Vanessa Ho, MD, PhD, MPH, FACS, and was made possible by a conference grant funded through the Agency for Healthcare Research and Quality (1-R13-HS029444). This article, along with the entire series of articles from the conference, constitutes the conference proceedings which include major topic areas, outline the current literature, and provide a roadmap to drive progress toward equity in trauma research.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001430"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining our lens: how bias heightens disparities in trauma research.","authors":"Sydney Timmer-Murillo, Kathryn M Stadeli, Jacob Higgins, Bethany L Strong, Shayan Rakhit, Brianna R Fram, Garrett D Hall, Anamaria J Robles, Tandis Soltani, Rachael A Callcut, Vanessa P Ho, Cynthia Lizette Villarreal, Michelle A Price, Susan E Cronn","doi":"10.1136/tsaco-2024-001452","DOIUrl":"10.1136/tsaco-2024-001452","url":null,"abstract":"<p><p>Trauma research is an expansive discipline that informs injury prevention, best practices in care, and novel interventions. However, implicit bias, or the unconscious stereotypical beliefs about groups of people, can have profound implications for traumatic injury research. Several forms of implicit bias can emerge in trauma research, which deepens existing disparities based on race or ethnicity, sex, ability status, socioeconomic status, and other factors. This paper reviews how implicit bias affects the development of research and the application of findings, potentially leading to suboptimal care and misdirected preventive strategies in trauma. We present the recent dialogue and progress on implicit bias in research at the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma) conference, an Agency for Healthcare Research and Quality-funded assembly of multiple disciplines which was convened to tackle the challenges involved in addressing disparities in traumatic injury. Through this review, we seek to generate momentum for action toward reducing implicit bias and establishing comprehensive equity-focused standards of trauma research and practice.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001452"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the economic value of equitable care for the traumatically injured: is it cost-effective to decrease trauma disparities?","authors":"Tandis Soltani, Anamaria J Robles, Kathryn M Stadeli, Sydney Timmer-Murillo, Bethany Lauren Strong, Cynthia Lizette Villarreal, Shayan Rakhit, Vanessa P Ho, Michelle A Price, Arpana Jain, Michaela A West","doi":"10.1136/tsaco-2024-001470","DOIUrl":"10.1136/tsaco-2024-001470","url":null,"abstract":"<p><p>In the USA, traumatic injury results in a significant financial burden, which is unevenly distributed in our society. In this paper, we will highlight some of the data around the costs of injury associated with a focus on socially vulnerable and historically resilient groups at risk for disparate outcomes. We delve into the concept of economic return on investment from multiple perspectives: the patient perspective, the community perspective and from a national and policy perspective. Targeted policy changes and dedicated efforts towards minimizing gaps in trauma care and enhancing survivorship can yield substantial economic benefits. This paper also describes several national funding agencies and their current priorities related to funding in equity and trauma research. This manuscript will demonstrate that reducing disparities in trauma care not only serves a moral imperative but also a necessary and financially sound strategy with a good economic return on investment.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001470"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-sensitive surgery: the devil's in the details.","authors":"Anamika Veeramani, Laurie Antonik, Alistair Kent","doi":"10.1136/tsaco-2025-001920","DOIUrl":"10.1136/tsaco-2025-001920","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001920"},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}