Journal of Trauma Nursing最新文献

Whole Blood Program: Implementation in a Rural Trauma Center. 全血计划：在农村创伤中心实施。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000814

引用次数: 0

Whole Blood Program: Implementation in a Rural Trauma Center. 全血计划：在农村创伤中心实施。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000810

Lanny C Orr,Alexa L Peterson,Tessa C Savell,Elizabeth L McCotter,Craig E Palm,Sadie L Arnold,Gordon M Riha,Simon J Thompson

{"title":"Whole Blood Program: Implementation in a Rural Trauma Center.","authors":"Lanny C Orr,Alexa L Peterson,Tessa C Savell,Elizabeth L McCotter,Craig E Palm,Sadie L Arnold,Gordon M Riha,Simon J Thompson","doi":"10.1097/jtn.0000000000000810","DOIUrl":"https://doi.org/10.1097/jtn.0000000000000810","url":null,"abstract":"BACKGROUNDThe balanced transfusion of blood components plays a leading role in traumatic hemostatic resuscitation. Yet, previous whole blood studies have only focused on urban trauma center settings.OBJECTIVETo compare component vs whole blood therapy on wastage rates and mortality in the rural setting.METHODSThis study was a nonrandomized, retrospective, observational, single-center study on a cold-stored whole blood program implementation for adult massive transfusions from 2020 to 2022 at a Level II trauma center. Trauma registry data determined the facility's whole blood needs and facilitated sustainable blood supplies. Whole blood use protocols were established, and utilization and laboratory compliance for incompatible ABO antibody hemolysis was monitored and reviewed monthly at stakeholder and trauma services meetings.RESULTSFrom 2018 to 2019, the facility initiated component therapy massive transfusions every 9 days (n = 41). Therefore, four units of low-titer, O-positive whole blood delivered fortnightly was determined to provide patient coverage and minimize wastage. Across the study time frame (2020-2022), there were n = 68 hemodynamically unstable patients, consisting of those receiving whole blood, n = 37, and patients receiving component therapy, n = 31. Mortality rates were significantly lower (p = .030) in the whole blood population (n = 3, 8%) compared to those solely receiving component therapy (n = 9, 29%). Wastage rates were constantly evaluated; in 2021, 43.4% was not utilized, and in 2022, this was reduced to 38.7%. Anecdotally, nurses appreciated the ease of administration and documentation of transfusing whole blood, as it negated ratio compliance.CONCLUSIONThis evidence-based whole blood program provides vital care to severely injured trauma patients in a vast, rural region.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing Trauma Activation Criteria for a Rural Trauma Center. 优化农村创伤中心的创伤启动标准。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000809

Erin Klarr,Heather Xenia Rhodes-Lyons,Rachel Symons

{"title":"Optimizing Trauma Activation Criteria for a Rural Trauma Center.","authors":"Erin Klarr,Heather Xenia Rhodes-Lyons,Rachel Symons","doi":"10.1097/jtn.0000000000000809","DOIUrl":"https://doi.org/10.1097/jtn.0000000000000809","url":null,"abstract":"BACKGROUNDThere is a need for activation criteria that reflect the different factors affecting rural trauma patients.OBJECTIVETo develop effective activation criteria for a rural trauma center among adults, incorporating variables specific to the geography, mechanisms of injury, and population served.METHODSThis is a single-center, retrospective cohort study conducted from (23 years) January 1, 2000, to July 31, 2023. The data collected patient demographics, injury details, morbidity, and preexisting comorbidity. This research included all adult (≥15 years) true Level I trauma activations defined as an injury severity score > 25 and met the need for trauma intervention criteria. The patients were grouped into adult and elderly categories. The analysis utilized a logistic regression model with the outcome of a true Level I trauma activation.RESULTSA total of 19,480 patients were included in the sample; 2,858 (14.6%) met the Level I activation criteria. Elderly Level I activation included assault, pedestrian struck, multiple pelvic fractures, traumatic pneumo/hemothorax, mediastinal fracture, sternum fracture, and flail rib fracture.CONCLUSIONUsing the findings of the logistic regression model, this center has made more robust activation guidelines adapted to its rural population.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stressing the System: Pediatric Trauma Centers May Be Unready to Implement Comprehensive Acute Stress Screening Programs for Pediatric Trauma Patients. 系统压力：儿科创伤中心可能尚未准备好为儿科创伤患者实施全面的急性压力筛查计划。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000811

Elizabeth Jay Renaud,Julie R Bromberg,Christina McRoberts,Geraldine Almonte,Timmy R Lin,Emily Hensler,Michael J Mello

{"title":"Stressing the System: Pediatric Trauma Centers May Be Unready to Implement Comprehensive Acute Stress Screening Programs for Pediatric Trauma Patients.","authors":"Elizabeth Jay Renaud,Julie R Bromberg,Christina McRoberts,Geraldine Almonte,Timmy R Lin,Emily Hensler,Michael J Mello","doi":"10.1097/jtn.0000000000000811","DOIUrl":"https://doi.org/10.1097/jtn.0000000000000811","url":null,"abstract":"BACKGROUNDChildren experiencing trauma are at risk of developing acute and chronic stress disorders. In 2022, the American College of Surgeons Committee on Trauma required verified pediatric trauma centers to screen at-risk patients and provide mental health provider referrals as needed.OBJECTIVEThe study objective is to assess the current readiness of pediatric trauma centers to meet the new American College of Surgeons requirements.METHODSThis study used an exploratory, electronic, cross-sectional survey design. The Pediatric Trauma Society distributed a survey on mental health screening practices to its members in February 2023. Results were summarized with descriptive statistics. Chi-square test was used to compare responses of Levels I and II pediatric trauma centers.RESULTSThere were 91 survey responses from the PTS membership of 1247 (response rate of 7.3%). Fifty-nine participants were from Level I and 27 from Level II pediatric trauma centers. 63.8% of Level I and 51.9% of Level II center respondents currently screened for acute stress (χ2(1) = 1.09, p = .30). Of these, 75.7% of Level I and 57.1% of Level II center respondents routinely screened all admitted trauma patients (χ2(1) = 1.68, p = .19). However, only 32.4% of Level I and 21.4% of Level II respondents reported having outpatient acute stress referral protocols. For pediatric trauma centers currently without screening, 65% of Level I and 46.2% of Level II pediatric trauma center respondents felt they needed more than six months to establish a program (χ2(1) = 1.15, p = .28). Most respondents (68.9%) reported staff shortages as a barrier to the delivery of acute stress services.CONCLUSIONSPediatric trauma center compliance with acute stress screening requirements for verification is variable. Pediatric trauma centers may benefit from technical assistance with acute stress screening.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy. 不必要的治疗：评估院前针刺胸腔造口术。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000808

Gabriel E Vazquez,John R Calhoun,Elizabeth A Fuchsen,Jeannette M Capella,Cory C Vaudt,Richard A Sidwell,Hayden L Smith,Carlos A Pelaez

{"title":"Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy.","authors":"Gabriel E Vazquez,John R Calhoun,Elizabeth A Fuchsen,Jeannette M Capella,Cory C Vaudt,Richard A Sidwell,Hayden L Smith,Carlos A Pelaez","doi":"10.1097/jtn.0000000000000808","DOIUrl":"https://doi.org/10.1097/jtn.0000000000000808","url":null,"abstract":"BACKGROUNDNeedle thoracostomy is a potentially life-saving intervention for tension pneumothorax but may be overused, potentially leading to unnecessary morbidity.OBJECTIVETo review prehospital needle thoracostomy indications, effectiveness, and adverse outcomes.METHODSA retrospective cohort study was conducted based on registry data for a United States Midwestern Level I trauma center for a 7.5-year period (January 2015 to May 2022). Included were patients who received prehospital needle thoracostomy and trauma activation before hospital arrival. The primary outcomes were correct indications and improvement in vital signs. Secondary outcomes were the need for chest tubes, correct needle placement, complications, and survival.RESULTSA total of n = 67 patients were reviewed, of which n = 63 (94%) received a prehospital thoracostomy. Of the 63 prehospital thoracostomies, 54 (86%) survived to arrival. Of these 54, 44 (n = 81%) had documented reduced/absent breath sounds, 15 (28%) hypotension, and 19 (35%) with difficulty breathing/ventilating. Only four patients met all three prehospital trauma life support criteria: hypotension, difficulty ventilating, and absent breath sounds. There were no significant changes in prehospital vitals before and after receiving needle thoracostomy. In patients receiving imaging (n = 54), there was evidence of 15 (28%) lung lacerations, 6 (11%) of which had a pneumothorax and 3 (5%) near misses of important structures. Review of needle catheters visible on computer tomography imaging found 11 outside the chest and 1 in the abdominal cavity.CONCLUSIONThe study presents evidence of potential needle thoracostomy overuse and morbidity. Adherence to specific guidelines for needle decompression is needed.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Field Setting: A Case Report From China. 在野外环境中进行主动脉血管内球囊闭塞复苏术（REBOA）：中国病例报告。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000803

Xixi Li,Nan Xie,Tong Zhou,Bo Yang

引用次数: 0

Differences in Injury Patterns and Delays in Care-Seeking Behaviors in the Anabaptist Population. 再洗礼派人群的受伤模式和延迟就医行为的差异。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000807

Marsha Salzwedel,Heather Xenia Rhodes-Lyons,Elizabeth Kracht

{"title":"Differences in Injury Patterns and Delays in Care-Seeking Behaviors in the Anabaptist Population.","authors":"Marsha Salzwedel,Heather Xenia Rhodes-Lyons,Elizabeth Kracht","doi":"10.1097/jtn.0000000000000807","DOIUrl":"https://doi.org/10.1097/jtn.0000000000000807","url":null,"abstract":"BACKGROUNDThe lifestyle differences of Anabaptists and their views on health care may yield different injury patterns than standard populations and require a customized approach to injury prevention and health care delivery.OBJECTIVETo identify differences in injury patterns and delays in care-seeking behaviors among the Anabaptists in Wisconsin.METHODSThis single-center retrospective cohort study was conducted from (23 years) January 1, 2000, to December 31, 2023. Local Trauma Registry data collected patient demographics, injury details, morbidity outcomes, in-hospital mortality, and preexisting comorbidity. Anabaptist trauma patients were isolated by confirmed identification in the Trauma Registry. The analysis utilized both descriptive statistics and a logistic regression model with the outcome of Anabaptist.RESULTSA total of 14,431 patients were included in the analysis; 81 (0.4%) were confirmed as Anabaptist. The Anabaptist population showed a higher likelihood of helicopter transportation (odds ratio [OR] 4.64, p < .01) and an activation of Pediatric Level I (OR 4.07, p < .01). As the emergency department shock index increased by one unit, the odds of being Anabaptist increased by 9.87 (p < .01). The injury mechanisms that were associated with the Anabaptist population included buggy collisions (OR 312.58, p < .01), caught or crushed (OR 5.21, p = .01), machinery (OR 5.38, p < .01), near drowning (OR 14.09, p < .01), scooter (OR 13.93, p = .04), and woodworking (OR 12.81, p = .01).CONCLUSIONSThis study identified differences in injury patterns and delays in care-seeking behaviors in the Anabaptist population.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy. 不必要的治疗：评估院前针刺胸腔造口术。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000812

引用次数: 0

Lessons in Running and Nursing. 跑步和护理课程

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.1097/JTN.0000000000000806

LeAnne Young

引用次数: 0

Just-in-Time Video Using QR Codes: An Approach to Pediatric Trauma Nursing Education. 使用 QR 码的即时视频：儿科创伤护理教育方法。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI: 10.1097/JTN.0000000000000800

Nicholas Fraser Mudry, Linda Nancy Roney

{"title":"Just-in-Time Video Using QR Codes: An Approach to Pediatric Trauma Nursing Education.","authors":"Nicholas Fraser Mudry, Linda Nancy Roney","doi":"10.1097/JTN.0000000000000800","DOIUrl":"10.1097/JTN.0000000000000800","url":null,"abstract":"Background: High acuity trauma and patients in cardiopulmonary arrest are not frequently seen in all pediatric Level I trauma centers. Yet, nurses are required to manage these patients in fast-paced, high-pressure environments.Objective: This project aims to develop and evaluate an education program for high-risk, low-volume equipment and skills in the pediatric emergency department setting.Methods: This is a pre- and post-quality improvement study conducted in a Northeastern United States pediatric Level I trauma center. Emergency department nurses were invited to view videos detailing high-risk, low-volume equipment use. For the convenience of access, Quick Response (QR) codes linked to the videos were placed on each piece of equipment reviewed. General self-efficacy and levels of self-efficacy in using the equipment were assessed before the intervention and again after 4 weeks from January to February 2023.Results: A total of 43 pediatric emergency nurses participated in the education. The mean aggregate general self-efficacy score was 32.93. Mean scores in all areas (Level 1 rapid infuser, fluid warmer, blood administration, and securing an endotracheal tube) improved after the intervention.Conclusions: Easily accessible, brief refresher videos linked to QR codes in the pediatric emergency department can help empower nurses who need to use high-risk, low-volume equipment.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0