Trauma Surgeon-Led and Funded Injury Prevention Program Decreases Number of All-Terrain Vehicle-Related Admissions.

Background: All-terrain vehicle (ATV) laws regarding helmet use, alcohol involvement, and roadway riding are poorly enforced or largely ignored. We hypothesized that direct surgeon funding and leadership in injury prevention would decrease ATV crashes. To focus prevention efforts, we reviewed a rural level 1 trauma center 11-year experience with ATV crashes comparing helmeted and unhelmeted rider outcomes.

Midlevel Providers Focusing on Geriatrics Improve Care and Outcomes of Fall-Related Injuries Among the Elderly.

Background: A rural level 1 trauma center underwent a consolidation to level III status in a new trauma network system. A dedicated group of midlevel practitioners emphasizing early mobilization, a geriatric care model, and fall prevention replaced surgical residents in the level 3 center. We hypothesized that outcomes of elderly fall-related injuries may be enhanced with midlevel providers using a geriatric-focused care model.

Trauma Surgeon-Led and Funded Injury Prevention Program Decreases Admission for Motorcycle Crash Injuries.

Background: Unhelmeted motorcyclists injured in states with lax or poorly enforced helmet safety laws are frequently seen in rural trauma centers. A trauma surgeon started a comprehensive injury prevention and research fund with outreach to a three-state trauma center catchment area promoting injury prevention at area high schools and local communities. We hypothesized that unhelmeted riders would have more severe head injuries and fatalities than helmeted riders.

Helmets Matter: Kentucky All-Terrain Vehicle Crashes Seen at a Tennessee Trauma Center.

All-terrain vehicle (ATV) safety laws, including helmet use, vary by state and are sporadically enforced. Kentucky state laws require safety helmets only for younger riders. We hypothesized that ATV riders injured in Kentucky and seen at a Tennessee trauma center would more likely be unhelmeted, have more severe head injuries, and have higher mortality rates than those injured in Virginia or Tennessee.

Helmets Matter: Kentucky Motorcycle Crash Victims Seen at a Tennessee Trauma Center.

Objectives: Motorcycle helmet laws vary by state, with Kentucky requiring helmets only for younger riders. We hypothesized that motorcyclists injured in Kentucky and seen at a Tennessee trauma center would be more likely to be unhelmeted, have more severe head injuries, and sustain more fatal injuries than those injured in Tennessee or Virginia.

Methods: A Trauma Registry review of 729 injured motorcyclists from January 2005 through June 2015 examined state location of crash, demographics, helmet use, and clinical outcomes.

Airway pressure release ventilation in morbidly obese surgical patients with acute lung injury and acute respiratory distress syndrome.

Morbidly obese patients with body mass index greater than 40 kg/m(2) and respiratory failure requiring critical care services are increasingly seen in trauma and acute care surgical centers. Baseline respiratory pathophysiology including decreased pulmonary compliance with dependent atelectasis and abnormal ventilation-perfusion relationships predisposes these patients to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS) as well as prolonged stays in the intensive care unit. Airway pressure release ventilation (APRV) is an increasingly used alternative mode for salvage therapy in patients with hypoxemic respiratory failure that also provides lung protection from ventilator-induced lung injury.

Full-time orthopedic traumatologists enhance rural trauma center pelvic fracture outcomes and financials.

We hypothesized that full-time orthopedic traumatologists would increase interfacility transfer patients with pelvic ring injuries at a trauma center seeking American College of Surgeons Level I verification. A trauma registry query identified 790 patients with pelvic ring injuries admitted to a trauma service over 10 years. The study groups included 173 patients 3 years before and 405 patients 3 years after recruitment of two full-time orthopedic traumatologists.

Necrotizing fasciitis due to an infected urachal cyst in an adult.

Urachal cyst complications requiring surgical intervention are rarely seen in adults, because the urachus is normally obliterated in infancy. Necrotizing fasciitis due to an infected urachal cyst in an adult female has not been reported. We describe the case of a fifty-year-old female who required aggressive surgical management of abdominal wall necrotizing soft tissue infection from an infected urachal cyst.

Bilateral carotid stenting after a motor vehicle crash.

Extracranial carotid artery dissection after blunt trauma may manifest as arterial stenosis or occlusion or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but, because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. A small subset of patients with blunt carotid dissection, or pseudoaneurysms, have bilateral injuries which may be high risk for occlusion and ischemic stroke.

300 all-terrain vehicle crashes: an East Tennessee trauma center's experience.

Background: All-terrain vehicle (ATV) riding is a popular recreation in the mountainous areas of Southeastern Kentucky, Southwest Virginia and East Tennessee. We hypothesized that admissions for serious injuries have increased among ATV riders. A retrospective data review from a Level 1 trauma center trauma registry presents injury characteristics and outcomes, comparing patients in earlier and later time periods.