The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings.

Background: Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care.

Methods: Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication.

Is portable ultrasonography accurate in the evaluation of Schanz pin placement during extremity fracture fixation in austere environments?

Objective: The purpose of this study was to investigate the efficacy of ultrasonography to confirm Schanz pin placement in a cadaveric model, and the interobserver repeatability of the ultrasound methodology.

Design: This investigation is a repeated measures cadaveric study with multiple examiners.

Participants: Cadaveric preparation and observations were done by an orthopaedic traumatologist and resident, and two general surgery traumatologists.

Professional values, value conflicts, and assessments of the duty-hour restrictions after six years: a multi-institutional study of surgical faculty and residents.

Background: the aim of this study was to explore professional values, value conflicts, and assessments of the Accreditation Council for Graduate Medical Education's duty-hour restrictions.

Methods: questionnaires distributed at 15 general surgery programs yielded a response rate of 82% (286 faculty members and 306 residents). Eighteen items were examined via mean differences, percentages in agreement, and significance tests.

A new professionalism? Surgical residents, duty hours restrictions, and shift transitions.

Background: Some anticipated that the Accreditation Council for Graduate Medical Education duty hours restrictions would foster a team-focused "new professionalism" among residents. This study explores the prevalence and challenges of a new professionalism and whether they vary by program size.

Method: Questionnaires distributed in 15 general surgery programs produced an 82% response rate (N = 306); 52 semistructured follow-up interviews were completed.

Pulmonary contusions and critical care management in thoracic trauma.

Many victims of thoracic trauma require ICU care and mechanical ventilatory support. Pressure and volume-limited modes assist in the prevention of ventilator-associated lung injury. Ventilator-associated pneumonia is a significant cause of posttraumatic morbidity and mortality.

A new method of continuous venovenous rewarming.

Purpose: Hypothermia is a significant problem in medicine and is part of a deadly triad, including hypothermia, acidosis, and coagulopathy. Multiple methods of rewarming are used to treat moderate hypothermia. The purpose of this study was to compare the effectiveness of continuous venovenous rewarming (CVVR) using the FMS 2000 (Belmont Instrument Corp.

Maximizing reimbursement from trauma response fees (UB-92: 68X) - lessons learned from a hospital comparison.

Background: The trauma response fee (UB-92:68x) recently has been approved, to be used by hospitals to cover expenses resulting from continuous trauma team availability. These charges may be made by designated trauma centers for all defined trauma patients when notification has been received before arrival (eligible pt). This study compares two trauma centers' performance in collecting this fee help define methodologies that can enhance reimbursement.

Complete occlusion after blunt injury to the abdominal aorta.

Background: Injury to the abdominal aorta after blunt trauma is uncommon. When this injury results in complete vessel occlusion, the presentation is dramatic. Timely intervention is essential.