Journal of Trauma-injury Infection and Critical Care, Nov 1, 1995
A rare case of blunt chest trauma resulting in internal mammary artery hemorrhage and cardiac tam... more A rare case of blunt chest trauma resulting in internal mammary artery hemorrhage and cardiac tamponade is presented. Thoracotomy revealed anterior mediastinal hemorrhage but no pericardial hematoma. The significance of chest wall vessel hemorrhage as a cause of widened mediastinum is reiterated. The importance of accurate angiographic assessment and vigilant care of victims of blunt chest trauma who present with a widened mediastinum is emphasized.
Journal of Trauma-injury Infection and Critical Care, Oct 1, 1996
The purpose of this prospective study was to assess the impact of a two-tiered trauma response pr... more The purpose of this prospective study was to assess the impact of a two-tiered trauma response protocol on the expediency of identification, evaluation, and treatment of trauma patients in the Emergency Department. At a Level I Trauma Center serving a suburban/urban population of approximately one million people, Emergency Department length of stay was tabulated for all consecutive Trauma Service admissions 6 months before and 6 months after implementation of a two-tiered trauma response protocol. This protocol, which uses specific triage criteria, consisted of the standard Surgery-supervised trauma code response and an additional Emergency Medicine-supervised trauma alert response. Trauma Service admissions numbered 532 in the pre-protocol period and 512 in the period after implementation of the protocol. In the first period, the Emergency Department length of stay was 289 minutes; in the second period, it was 241 minutes. Of the 512 patients in the post-protocol period, 183 were triaged to the new trauma alert group, reducing the number of Trauma Service consultations and decreasing Emergency Department length of stay by 139 minutes. The two levels of trauma response allowed accurate identification of the most seriously injured patients and improved the ability to predict those patients who would require direct disposition to the operating room or intensive care unit. Implementation of a two-tiered trauma response significantly decreased Emergency Department length of stay, allowed Emergency Medicine physicians to more rapidly identify, evaluate, and treat trauma patients requiring hospitalization, improved identification of patients requiring operating room or intensive care unit resources, and was time efficient and resource efficient.
DISCLOSURES: None BACKGROUND Acute wounds, chronic wounds, and deep tissue injuries (DTI’s) threa... more DISCLOSURES: None BACKGROUND Acute wounds, chronic wounds, and deep tissue injuries (DTI’s) threaten patients’ quality of life, increase morbidity, and impact hospital resource consumption. The lack of national standardization of wound care and the recent focus on biofilm as a contributing factor to the chronicity of wounds, has challenged health care providers to prevent deterioration of potential and existing wounds. Clinical studies have shown that noncontact low-frequency ultrasound (NLFU) positively accelerates wound healing and prevents wound progression by interrupting biofilm formation, increasing wound bed circulation, and reducing inflammation..
- The impact of paralysis followed by intubation was studied in patients who ‘uad been Eraumatize... more - The impact of paralysis followed by intubation was studied in patients who ‘uad been Eraumatized and subsequently admitted to Lehigh Valley IIospital Center. Trauma admission records between January I987 and June 1988 were reviewed, Fifty-seven patients, intubated for control of agitation and combativeness, were divided into high injury severity (HIS) and low injury severity (LIS) subgroups using admission trauma (TS) and injury severity scores (ISS). Thirty-eight (70%) were classified as HIS and 19 iSO%) as LIS, All HIS patients had significant injuries diagnosed following paralysis with intubation @‘WI). Mortality in the HIS group was 9%. The LIS subgroup was compared to a randomly selected group of similarly injured bhmt trauma patients who did not require PWI. There were significant differences (P 100 mg%. Emergency paralysis with intubation is an effective method for controlling the uncooperative, combative, seriously injured patient. Mowever, patients with low injury severity who require restraint have higher costs and require more care if they are paralyzed and intubated than if they are not.
For decades, the American College of Surgeons Committee on Trauma (ACSCOT) has published Resource... more For decades, the American College of Surgeons Committee on Trauma (ACSCOT) has published Resources for Optimal Care of the Injured Patient, which outlines specific criteria necessary to be verified by the college as a trauma center, including having an organized and effective approach to prevention of trauma. However, the document provides little public health-specific guidance to assist trauma centers with developing these approaches. An advisory panel was convened in 2017 with representatives from national trauma and public health organizations with the purpose of identifying strategies to support trauma centers in the development of a public health approach to injury and violence prevention and to better integrate these efforts with those of local and state public health departments. This panel developed the Standards and Indicators for Model Level I and II Trauma Center Injury and Violence Prevention Programs. The document outlines five, consensus-based core components of a mode...
Journal of Trauma-injury Infection and Critical Care, Nov 1, 1995
A rare case of blunt chest trauma resulting in internal mammary artery hemorrhage and cardiac tam... more A rare case of blunt chest trauma resulting in internal mammary artery hemorrhage and cardiac tamponade is presented. Thoracotomy revealed anterior mediastinal hemorrhage but no pericardial hematoma. The significance of chest wall vessel hemorrhage as a cause of widened mediastinum is reiterated. The importance of accurate angiographic assessment and vigilant care of victims of blunt chest trauma who present with a widened mediastinum is emphasized.
Journal of Trauma-injury Infection and Critical Care, Oct 1, 1996
The purpose of this prospective study was to assess the impact of a two-tiered trauma response pr... more The purpose of this prospective study was to assess the impact of a two-tiered trauma response protocol on the expediency of identification, evaluation, and treatment of trauma patients in the Emergency Department. At a Level I Trauma Center serving a suburban/urban population of approximately one million people, Emergency Department length of stay was tabulated for all consecutive Trauma Service admissions 6 months before and 6 months after implementation of a two-tiered trauma response protocol. This protocol, which uses specific triage criteria, consisted of the standard Surgery-supervised trauma code response and an additional Emergency Medicine-supervised trauma alert response. Trauma Service admissions numbered 532 in the pre-protocol period and 512 in the period after implementation of the protocol. In the first period, the Emergency Department length of stay was 289 minutes; in the second period, it was 241 minutes. Of the 512 patients in the post-protocol period, 183 were triaged to the new trauma alert group, reducing the number of Trauma Service consultations and decreasing Emergency Department length of stay by 139 minutes. The two levels of trauma response allowed accurate identification of the most seriously injured patients and improved the ability to predict those patients who would require direct disposition to the operating room or intensive care unit. Implementation of a two-tiered trauma response significantly decreased Emergency Department length of stay, allowed Emergency Medicine physicians to more rapidly identify, evaluate, and treat trauma patients requiring hospitalization, improved identification of patients requiring operating room or intensive care unit resources, and was time efficient and resource efficient.
DISCLOSURES: None BACKGROUND Acute wounds, chronic wounds, and deep tissue injuries (DTI’s) threa... more DISCLOSURES: None BACKGROUND Acute wounds, chronic wounds, and deep tissue injuries (DTI’s) threaten patients’ quality of life, increase morbidity, and impact hospital resource consumption. The lack of national standardization of wound care and the recent focus on biofilm as a contributing factor to the chronicity of wounds, has challenged health care providers to prevent deterioration of potential and existing wounds. Clinical studies have shown that noncontact low-frequency ultrasound (NLFU) positively accelerates wound healing and prevents wound progression by interrupting biofilm formation, increasing wound bed circulation, and reducing inflammation..
- The impact of paralysis followed by intubation was studied in patients who ‘uad been Eraumatize... more - The impact of paralysis followed by intubation was studied in patients who ‘uad been Eraumatized and subsequently admitted to Lehigh Valley IIospital Center. Trauma admission records between January I987 and June 1988 were reviewed, Fifty-seven patients, intubated for control of agitation and combativeness, were divided into high injury severity (HIS) and low injury severity (LIS) subgroups using admission trauma (TS) and injury severity scores (ISS). Thirty-eight (70%) were classified as HIS and 19 iSO%) as LIS, All HIS patients had significant injuries diagnosed following paralysis with intubation @‘WI). Mortality in the HIS group was 9%. The LIS subgroup was compared to a randomly selected group of similarly injured bhmt trauma patients who did not require PWI. There were significant differences (P 100 mg%. Emergency paralysis with intubation is an effective method for controlling the uncooperative, combative, seriously injured patient. Mowever, patients with low injury severity who require restraint have higher costs and require more care if they are paralyzed and intubated than if they are not.
For decades, the American College of Surgeons Committee on Trauma (ACSCOT) has published Resource... more For decades, the American College of Surgeons Committee on Trauma (ACSCOT) has published Resources for Optimal Care of the Injured Patient, which outlines specific criteria necessary to be verified by the college as a trauma center, including having an organized and effective approach to prevention of trauma. However, the document provides little public health-specific guidance to assist trauma centers with developing these approaches. An advisory panel was convened in 2017 with representatives from national trauma and public health organizations with the purpose of identifying strategies to support trauma centers in the development of a public health approach to injury and violence prevention and to better integrate these efforts with those of local and state public health departments. This panel developed the Standards and Indicators for Model Level I and II Trauma Center Injury and Violence Prevention Programs. The document outlines five, consensus-based core components of a mode...
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Papers by Glen Tinkoff