Journal of trauma management & outcomes最新文献

{"title":"Vagus nerve stimulation improves coagulopathy in hemorrhagic shock: a thromboelastometric animal model study.","authors":"Joao B Rezende-Neto,&nbsp;Roger Lage Alves,&nbsp;Mario Carvalho,&nbsp;Thiago Almeida,&nbsp;Cyntia Trant,&nbsp;Christopher Kushmerick,&nbsp;Marcus Andrade,&nbsp;Sandro B Rizoli,&nbsp;Jose Cunha-Melo","doi":"10.1186/1752-2897-8-15","DOIUrl":"https://doi.org/10.1186/1752-2897-8-15","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammation plays a major role in the multifactorial process of trauma associated coagulopathy. The vagus nerve regulates the cholinergic anti-inflammatory pathway. We hypothesized that efferent vagus nerve stimulation (VNS) can improve coagulopathy by modulating the inflammatory response to hemorrhage.</p><p><strong>Methods: </strong>Wistar rats (n = 24) were divided in 3 groups: Group (G1) Sham hemorrhagic shock (HS); (G2) HS w/o VNS; (G3) HS followed by division of the vagus nerves and VNS of the distal stumps. Hemorrhage (45% of baseline MAPx15 minutes) was followed by normotensive resuscitation with LR. Vagus nerves were stimulated (3.5 mA, 5 Hz) for 30 sec 7 times. Samples were obtained at baseline and at 60 minutes for thromboelastometry (Rotem®) and cytokine assays (IL-1 and IL-10). ANOVA was used for statistical analysis; significance was set at p < 0.05.</p><p><strong>Results: </strong>Maximum clot firmness (MCF) significantly decreased in G2 after HS (71.5 ± 1.5 vs. 64 ± 1.6) (p < 0.05). MCF significantly increased in G3 compared to baseline (67.3 ± 2.7 vs. 71.5 ± 1.2) (p < 0.05). G3 also showed significant improvement in Alfa angle, and Clot Formation Time (CFT) compared to baseline. IL-1 increased significantly in group 2 and decrease in group 3, while IL-10 increased in group 3 (p < 0.05).</p><p><strong>Conclusions: </strong>Electrical stimulation of efferent vagus nerves, during resuscitation (G3), decreases inflammatory response to hemorrhage and improves coagulation.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2014-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32685780","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":"Compartmental anatomical classification of traumatic abdominal injuries from the academic point of view and its potential clinical implication.","authors":"Ayman El-Menyar,&nbsp;Husham Abdelrahman,&nbsp;Hassan Al-Thani,&nbsp;Ahmad Zarour,&nbsp;Ashok Parchani,&nbsp;Ruben Peralta,&nbsp;Rifat Latifi","doi":"10.1186/1752-2897-8-14","DOIUrl":"https://doi.org/10.1186/1752-2897-8-14","url":null,"abstract":"<p><strong>Background: </strong>The mechanism and outcome of traumatic abdominal injury (TAI) varies worldwide. Moreover, data comparing TAIs in each abdominal compartment are lacking. We aimed to assess from the academic point of view, TAI based on its anatomical compartments.</p><p><strong>Patients & methods: </strong>We conducted a retrospective study for TAI patients between 2008 and 2011 in Qatar. Patients were categorized according to the involved anatomical compartment (C): intrathoracic (ITC), retroperitoneal (RPC), true abdomen (TAC), and pelvic abdomen (PAC) group. Chi Square test, One-Way ANOVA and multivariate regression analysis were appropriately performed.</p><p><strong>Results: </strong>Of 6,888 patients admitted to the trauma unit, 1,036 (15%) had TAI that were grouped as ITC (65%), RPC (15%), TAC (13%), and PAC (7%). The mean age was lowest in ITC (29 ± 13) and highest in TAC (34 ± 11) group, (P = 0.001). Motor vehicle crash was the main mechanism of injury in all groups except for PAC, in which fall dominated. Vast majority of expatriates had PAC and TAC injuries. The main abdominal injuries included liver (35%; ITC), spleen (32%; ITC) and kidneys (18%; RPC). Extra-abdominal injuries involved the head in RPC and ITC, lung in ITC and RPC and extremities in PAC. Mean ISS was higher in RPC and ITC. Abdominal AIS was higher in TAC injuries. Overall hospital mortality was 10%: RPC (15%), TAC (11%), ITC (9.4%) and PAC (1.5%). Concurrent traumatic brain injury (OR 5.3; P = 0.001) and need for blood transfusion (OR 3.03; P = 0.003) were the main independent predictors of mortality.</p><p><strong>Conclusion: </strong>In addition to its academic value, the anatomical approach of TAI would be a complementary tool for better understanding and prediction of the pattern and outcome of TAI. This would be possible if further research find accurate, early diagnostic tool for this anatomical classification.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2014-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32709365","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":"Outcomes following liver trauma in equestrian accidents.","authors":"Anita Balakrishnan,&nbsp;Reyad Abbadi,&nbsp;Kathryn Oakland,&nbsp;Saurabh Jamdar,&nbsp;Simon Jf Harper,&nbsp;Neville V Jamieson,&nbsp;Emmanual L Huguet,&nbsp;Asif Jah,&nbsp;Raaj K Praseedom","doi":"10.1186/1752-2897-8-13","DOIUrl":"https://doi.org/10.1186/1752-2897-8-13","url":null,"abstract":"<p><strong>Background: </strong>Equestrian sports are common outdoor activities that may carry a risk of liver injury. Due to the relative infrequency of equestrian accidents the injury patterns and outcomes associated with liver trauma in these patients have not been well characterized.</p><p><strong>Methods: </strong>We examined our experience of the management of equestrian liver trauma in our regional hepatopancreaticobiliary unit at a tertiary referral center. The medical records of patients who sustained liver trauma secondary to equestrian activities were analysed for parameters such as demographic data, liver function tests, patterns of injury, radiological findings, the need for intervention and outcomes.</p><p><strong>Results: </strong>20 patients sustained liver trauma after falling from or being kicked by a horse. The majority of patients were haemodynamically stable on admission. Alanine transaminase (ALT) levels were elevated in all patients and right-sided rib fractures were a frequently associated finding. CT demonstrated laceration of the liver in 12 patients, contusion in 3 and subcapsular haematoma in 2. The right lobe of the liver was most commonly affected. Only two patients required laparotomy and liver resection; the remaining 18 were successfully managed conservatively.</p><p><strong>Conclusions: </strong>The risk of liver injury following a horse kick or falling off a horse should not be overlooked. Early CT imaging is advised in these patients, particularly in the presence of high ALT levels and concomitant chest injuries such as rib fractures. Despite significant liver trauma, conservative management in the form of close observation, ideally in a high-dependency setting, is often sufficient. Laparotomy is only rarely warranted and associated with a significantly higher risk of post-operative bile leaks.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2014-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32630967","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":"A necessary evil? Intra-abdominal hypertension complicating burn patient resuscitation.","authors":"Paul B McBeth,&nbsp;Kim Sass,&nbsp;Duncan Nickerson,&nbsp;Chad G Ball,&nbsp;Andrew W Kirkpatrick","doi":"10.1186/1752-2897-8-12","DOIUrl":"https://doi.org/10.1186/1752-2897-8-12","url":null,"abstract":"<p><strong>Objective: </strong>Severe burns are devastating injuries that result in considerable systemic inflammation and often require resuscitation with large volumes of fluid. The result of massive resuscitation is often raised intra-abdominal pressures leading to Intra-abdominal hypertension (IAH) and the secondary abdominal compartment syndrome. The objective of this study is to conduct (1) a 10 year retrospective study to investigate epidemiological factors contributing to burn injuries in Alberta, (2) to characterize fluid management and incidence of IAH and ACS and (3) to review fluid resuscitation with a goal to identify optimal strategies for fluid resuscitation.</p><p><strong>Design: </strong>A comprehensive 10-year retrospective review of burn injuries from 1999.</p><p><strong>Outcome measures: </strong>Age, sex, date, mechanism of injury, location of incident, on scene vitals and GCS, type of transport to hospital and routing, ISS, presenting vitals and GCS, diagnoses, procedures, complications, hospital LOS, ICU LOS, and events surrounding the injury.</p><p><strong>Results: </strong>One hundred and seventy five patients (79.4% M, 20.6% F) were identified as having traumatic burn injuries with a mean ISS score of 21.8 (±8.3). The mean age was 41.6 (±17.5) (range 14-94) years. Nearly half (49.7%) of patients suffered their injuries at home, 17.7% were related to industrial incidents and 14.3% were MVC related. One hundred and ten patients required ICU admission. ICU LOS 18.5 (±8.8) days. Hospital LOS 38.0 (±37.8) days. The mean extent of burn injury was 31.4 (±20.9) % TBSA. Nearly half of the patients suffered inhalational injuries (mild 12.5%, moderate 13.7%, severe 9.1%). Thirty-nine (22.2%) of patients died from their injuries. Routine IAP monitoring began in September, 2005 with 15 of 28 patients having at least two IAP measurements. The mean IAP was 16.5 (±5.7) cm H2O (range: 1-40) with an average of 58 (±97) IAP measurements per patient. Those patients with IAP monitoring had an average TBSA of 35.0 (±16.0)%, ISS of 47.5 (±7.5). The mean 48 hr fluid balance was 25.6 (±11.1)L exceeding predicted Parkland formula estimates by 86 (±32)%.</p><p><strong>Conclusions: </strong>Further evaluation of IAP monitoring is needed to further characterize IAP and fluid resuscitation in patients with burn injuries.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2014-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32593084","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":"Routinely recorded versus dedicated time registrations during trauma work-up.","authors":"Joanne C Sierink,&nbsp;Evin Wm de Jong,&nbsp;Niels Wl Schep,&nbsp;J Carel Goslings","doi":"10.1186/1752-2897-8-11","DOIUrl":"https://doi.org/10.1186/1752-2897-8-11","url":null,"abstract":"<p><strong>Introduction: </strong>Since time intervals are used to determine quality of trauma care, it is relevant to know how reliable those intervals can be measured. The aim of our study was to assess the reliability of time intervals as recorded in our hospital databases.</p><p><strong>Patients and methods: </strong>We conducted a prospective study on time intervals in our level-1 trauma centre and compared those with the routinely recorded data from February 2012 to June 2012. A convenience sample of all trauma patients admitted to our trauma room was included. The routinely recorded time intervals were retrieved from computerised hospital databases. The dedicated time registration was done on a standardised form on which five time intervals considered clinically relevant were evaluated for each patient by a dedicated person: trauma room time, time to start CT, imaging time, time from trauma room to ICU and time from trauma room to intervention.</p><p><strong>Results: </strong>In a sample of 100 trauma patients dedicated registered trauma room time was median 47 minutes (IQR = 32-63), compared to 42 minutes (IQR = 28-56) in routinely recorded in hospital databases (P < 0.001). Time to start of CT scanning differed significantly as well, with again an increased time interval measured dedicatedly (median 20 minutes (IQR = 15-28)) compared to the routinely recorded time registration (median 13 minutes (IQR = 4-21)). The other time intervals recorded did not differ between the dedicated and routinely recorded registration. Bland-Altman plots also showed that there is considerable discrepancy between the two measurement methods with wide limits of agreement.</p><p><strong>Conclusion: </strong>This study shows that routinely recorded time intervals in the trauma care setting differ statistically significant from dedicatedly registered intervals.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2014-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32671643","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":"Diagnostic significance of rib series in minor thorax trauma compared to plain chest film and computed tomography.","authors":"Patrick Hoffstetter,&nbsp;Christian Dornia,&nbsp;Stephan Schäfer,&nbsp;Merle Wagner,&nbsp;Lena M Dendl,&nbsp;Christian Stroszczynski,&nbsp;Andreas G Schreyer","doi":"10.1186/1752-2897-8-10","DOIUrl":"https://doi.org/10.1186/1752-2897-8-10","url":null,"abstract":"<p><strong>Background: </strong>Rib series (RS) are a special radiological technique to improve the visualization of the bony parts of the chest.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the diagnostic accuracy of rib series in minor thorax trauma.</p><p><strong>Methods: </strong>Retrospective study of 56 patients who received RS, 39 patients where additionally evaluated by plain chest film (PCF). All patients underwent a computed tomography (CT) of the chest. RS and PCF were re-read independently by three radiologists, the results were compared with the CT as goldstandard. Sensitivity, specificity, negative and positive predictive value were calculated. Significance in the differences of findings was determined by McNemar test, interobserver variability by Cohens kappa test.</p><p><strong>Results: </strong>56 patients were evaluated (34 men, 22 women, mean age =61 y.). In 22 patients one or more rib fracture could be identified by CT. In 18 of these cases (82%) the correct diagnosis was made by RS, in 16 cases (73%) the correct number of involved ribs was detected. These differences were significant (p = 0.03). Specificity was 100%, negative and positive predictive value were 85% and 100%. Kappa values for the interobserver agreement was 0.92-0.96. Sensitivity of PCF was 46% and was significantly lower (p = 0.008) compared to CT.</p><p><strong>Conclusions: </strong>Rib series does not seem to be an useful examination in evaluating minor thorax trauma. CT seems to be the method of choice to detect rib fractures, but the clinical value of the radiological proof has to be discussed and investigated in larger follow up studies.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2014-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32610353","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":"Abdominal injuries in a major Scandinavian trauma center - performance assessment over an 8 year period.","authors":"Sigrid Groven,&nbsp;Christine Gaarder,&nbsp;Torsten Eken,&nbsp;Nils Oddvar Skaga,&nbsp;Paal Aksel Naess","doi":"10.1186/1752-2897-8-9","DOIUrl":"https://doi.org/10.1186/1752-2897-8-9","url":null,"abstract":"<p><strong>Introduction: </strong>Damage control surgery and damage control resuscitation have reduced mortality in patients with severe abdominal injuries. The shift towards non-operative management in haemodynamically stable patients suffering blunt abdominal trauma has further contributed to the improved results. However, in many countries, low volume of trauma cases and limited exposure to trauma laparotomies constitute a threat to trauma competence. The aim of this study was to evaluate the institutional patient volume and performance for patients with abdominal injuries over an eight-year period.</p><p><strong>Methods: </strong>Data from 955 consecutive trauma patients admitted in Oslo University Hospital Ulleval with abdominal injuries during the eight-year period 2002-2009 were retrospectively explored. A separate analysis was performed on all trauma patients undergoing laparotomy during the same period, whether abdominal injuries were identified or not. Variable life-adjusted display (VLAD) was used in order to describe risk-adjusted survival trends throughout the period and the patients admitted before (Period 1) and after (Period 2) the institution of a formal Trauma Service (2005) were compared.</p><p><strong>Results: </strong>There was a steady increase in admitted patients with abdominal injuries, while the number of patients undergoing laparotomy was constant exposing the surgical trauma team leaders to an average of 8 trauma laparotomies per year. No increase in missed injuries or failures of non-operative management was detected. Unadjusted mortality rates decreased from period 1 to period 2 for all patients with abdominal injuries as well as for the patients undergoing laparotomy. However, this apparent decrease was not confirmed as significant in TRISS-based analysis of risk-adjusted mortality. VLAD demonstrated a steady performance throughout the study period.</p><p><strong>Conclusion: </strong>Even in a high volume trauma center the exposure to abdominal injuries and trauma laparotomies is limited. Due to increasing NOM, an increasing number of patients with abdominal injuries was not accompanied by an increase in number of laparotomies. However, we have demonstrated a stable performance throughout the study period as visualized by VLAD without an increase in missed injuries or failures of NOM.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2014-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32563109","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":"Traumatic injury among females: does gender matter?","authors":"Ayman El-Menyar,&nbsp;Hany El-Hennawy,&nbsp;Hassan Al-Thani,&nbsp;Mohammad Asim,&nbsp;Husham Abdelrahman,&nbsp;Ahmad Zarour,&nbsp;Ashok Parchani,&nbsp;Ruben Peralta,&nbsp;Rifat Latifi","doi":"10.1186/1752-2897-8-8","DOIUrl":"https://doi.org/10.1186/1752-2897-8-8","url":null,"abstract":"<p><strong>Background: </strong>Trauma remains one of the leading causes of morbidity and mortality worldwide. Generally, the incidence of traumatic injuries is disproportionately high in males. However, trauma in females is underreported.</p><p><strong>Aim: </strong>To study the epidemiology and outcome of different mechanisms and types of traumatic injuries in women.</p><p><strong>Methods: </strong>We conducted a traditional narrative review using PubMed, MEDLINE and EMBASE, searching for English-language publications for gender-specific trauma between January 1993 and January 2013 using key words \"trauma\", \"gender\", \"female\" and \"women\".</p><p><strong>Results: </strong>Among 1150 retrieved articles, 71 articles were relevant over 20 years. Although it is an important public health problem, traumatic injuries among females remain under-reported.</p><p><strong>Conclusion: </strong>There is a need for further research and evaluation of the exact burden of traumatic injuries among females together with the implementation of effective community based preventive programs.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2014-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32556817","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":"PHTLS ® (Prehospital Trauma Life Support) provider courses in Germany - who takes part and what do participants think about prehospital trauma care training?","authors":"Christian B Frank,&nbsp;Christoph G Wölfl,&nbsp;Aidan Hogan,&nbsp;Arnold J Suda,&nbsp;Thorsten Gühring,&nbsp;Bernhard Gliwitzky,&nbsp;Matthias Münzberg","doi":"10.1186/1752-2897-8-7","DOIUrl":"https://doi.org/10.1186/1752-2897-8-7","url":null,"abstract":"<p><strong>Background: </strong>The goal of this study was to examine PHTLS Provider courses in Germany and to proof the assumption that formation of physicians and paramedics in prehospital trauma care can be optimized.</p><p><strong>Methods: </strong>PHTLS participants were asked to fill out standardized questionnaires during their course preparation and directly after the course. There were some open questions regarding their professional background and closed questions concerning PHTLS itself. Further questions were to be answered on an analog scale in order to quantify subjective impressions of confidence, knowledge and also to describe individual levels of education and training.</p><p><strong>Results: </strong>247 questionnaires could be analyzed. Physicians noted significant (p < 0.001) more deficits in their professional training than paramedics. 80% of the paramedics affirmed to have had adequate training with respect to prehospital trauma care, all physicians claimed not to have had sufficient training for prehospital trauma care situations at Medical School. Physicians were statistically most significant dissatisfied then paramedics (p < 0.001). While most participants gave positive feedback, anesthetists were less convinced of PHTLS (p = 0.005), didn't benefit as much as the rest (p = 0.004) and stated more often, that the course was of less value for their daily work (p = 0.03). After the course confidence increased remarkably and reached higher rates than before the course (p < 0.001). After PHTLS both groups showed similar ratings concerning the course concept indicating that PHTLS could equalize some training deficits and help to gain confidence and assurance in prehospital trauma situations. 90% of the paramedics and 100% of the physicians would recommend PHTLS. Physicians and especially anesthetists revised their opinions with regard to providing PHTLS at Medical School after having taken part in a PHTLS course.</p><p><strong>Conclusion: </strong>The evaluation of PHTLS courses in Germany indicates the necessity for special prehospital trauma care training. Paramedics and physicians criticize deficits in their professional training, which can be compensated by PHTLS. With respect to relevant items like confidence and knowledge PHTLS leads to a statistically significant increase in ratings on a visual analogue scale. PHTLS should be integrated into the curriculum at Medical School.</p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2014-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32525131","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 surgery associations and societies: which organizations match your goals?","authors":"Chad G Ball,&nbsp;Sean C Grondin,&nbsp;Colin Schieman,&nbsp;David V Feliciano,&nbsp;Elijah Dixon,&nbsp;Andrew W Kirkpatrick,&nbsp;Rao R Ivatury,&nbsp;Jeffrey P Salomone,&nbsp;Lawrence R Reed","doi":"10.1186/1752-2897-8-6","DOIUrl":"https://doi.org/10.1186/1752-2897-8-6","url":null,"abstract":"<p><p>This focused summary is a multi-institutional, multi-national, and multi-generational project designed to briefly summarize current academic trauma societies for both trainees and faculty alike. The co-authorship is composed of former and/or current presidents from most major trauma organizations. It has particular relevance to trainees and/or recent graduates attempting to navigate the multitude of available trauma organizations. </p>","PeriodicalId":87652,"journal":{"name":"Journal of trauma management & outcomes","volume":"8 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2014-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1752-2897-8-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32447469","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}