Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy.

Background: Needle thoracostomy is a potentially life-saving intervention for tension pneumothorax but may be overused, potentially leading to unnecessary morbidity.

Objective: To review prehospital needle thoracostomy indications, effectiveness, and adverse outcomes.

Methods: A retrospective cohort study was conducted based on registry data for a United States Midwestern Level I trauma center for a 7.

Trauma Response for Elderly Anticoagulated Patients: An Initiative to Reduce Trauma Resource Utilization in the Emergency Department.

Background: Trauma centers are challenged to have appropriate criteria to identify injured patients needing a trauma activation; one population that is difficult to triage is injured elderly patients taking anticoagulation or antiplatelet (ACAP) medications with suspected head injury.

Objective: The study purpose was to evaluate a hospital initiative to improve the trauma triage response for this population.

Methods: A retrospective study at a Level I trauma center evaluated revised trauma response criteria.

Effect of Pain Management Electronic Order Sets on Opioid Use in Adult Rib Fracture Patients.

Background: Inpatient pain management order sets are an important and necessary tool for standardizing and enhancing pain management for patients with traumatic injury. The purpose of this study was to assess the impact of revised inpatient pain management electronic order sets on opioid usage for patients with significant chest wall trauma.

Methods: A retrospective pre-post study was conducted for adult patients with 3 or more rib fractures admitted to the hospital at a Level 1 trauma center.

Hemorrhage Control Training: Preparing Adolescents to Act at Home, at School, or in Public.

Objectives: Uncontrolled bleeding is the leading cause of preventable death after a traumatic event, and early intervention to control bleeding improves opportunities for survival. It is imperative to prepare for local and national disasters by increasing public knowledge on how to control bleeding, and this preparation should extend to both adults and children. The purpose of this study is to describe a training effort to teach basic hemorrhage control techniques to early adolescent children.

Anticoagulated Trauma Patients: A Level I Trauma Center's Response to a Growing Geriatric Population.

Background: Injured older adults often receive delayed care in the emergency department (ED) because they do not meet criteria for trauma team activation (TTA). This is particularly dangerous for the increasing number of patients taking anticoagulant or antiplatelet (AC/AP) medication at the time of injury.

Objectives: The present study examined improvements in processes of care and triage accuracy when TTA criteria include an escalated response for older anticoagulated patients.

Is pain really undertreated? Challenges of addressing pain in trauma patients during prehospital transport and trauma resuscitation.

Background: Prior research has documented the inadequacy of pain management for trauma patients in the emergency department (ED), with rates of pain assessment and opioid administration averaging about 50%. Such rates, however, may be misleading and do not adequately capture the complexity of pain management practices in a trauma population. The goal of the study was to determine if pain was undertreated at the study hospital or if patient acuity explained the timing and occurrence of pain treatment in the prehospital setting and the ED.