The metabolic response to spinal cord injury.

The metabolic response to trauma, including neurotrauma in general, has been studied extensively, but the acute metabolic response to spinal cord injury (SCI) has not. Therefore, 12 patients with SCI are presented in whom intensive nutrition assessment and management were instituted immediately after injury. Nitrogen balance (NB), predicted energy expenditure (PEE), and actual energy expenditure (MEE) were calculated or measured in each patient.

Preoperative management of patients with major trauma injuries.

Traumatic injuries require rapid, efficient, and precise diagnose and immediate treatment. Patients with major trauma injuries place special demands on emergency department, OR, and intensive care unit health care providers. Cost-effective and time-efficient management of these patients results in improved patient care and optimal outcomes in this era of shrinking health care dollars.

Throughput analysis of trauma resuscitations with financial impact.

Objectives: In an era of diminishing reimbursement, efficient resource utilization is paramount. The effects of three parallel factors were tracked: (a) coordinated physician-hospital patient care, (b) increasing physician awareness of resources, and (c) in-house trauma attendings.

Design: Observational study.

The impact of selective laboratory evaluation on utilization of laboratory resources and patient care in a level-I trauma center.

Background: Routine laboratory evaluation of preoperative patients has not been shown to be cost effective when a detailed history and physical examination are performed. However, since such a detailed history is not possible in trauma patients, the time-honored approach has been for laboratory evaluation to be protocol driven. The cost-benefit ratio of this practice has never been evaluated.

Information retrieval patterns and needs among practicing general surgeons: a statewide experience.

Information retrieval has progressed from a reliance on traditional print sources to the modern era of computer databases and online networks. Surgeons, many from remote areas not served by professional medical libraries, must develop and maintain skills in information retrieval and management in both electronic and standard formats. One hundred thirty-three New Mexico general surgeons were surveyed to identify their information-seeking patterns in five areas: retrieval purposes, retrieval sources, barriers to access, techniques used, and continuing education needs.