From Peril to Protection: an evaluation of regulations impacting eScooter injuries.

Background: The use of standing electric motorized scooters (eScooters) has skyrocketed since its first release in 2016. This quickly popularized form of transportation has been associated with significant injury and even death. These eScooter-related traumatic injuries led to local advocacy efforts, resulting in safety restrictions including speed limit geofencing, sidewalk restrictions, and limiting the number of eScooter providers in high-density population areas.

Wearable, noninvasive, pulsed shortwave (radiofrequency) therapy for postoperative analgesia: A randomized, double-masked, sham-controlled pilot study.

Background: Nonthermal, pulsed shortwave (radiofrequency) therapy (PSWT) is a nonpharmacologic, noninvasive modality that limited evidence suggests provides analgesia. Its potential favorable risk-benefit ratio stems from its lack of side effects and significant medical risks, applicability to any anatomic location, long treatment duration, and ease of application by simply affixing it with tape. Even with a relatively small treatment effect, PSWT might contribute to a multimodal analgesic regimen, similar to acetaminophen.

Ultrasound-guided Percutaneous Cryoneurolysis for the Treatment of Pain after Traumatic Rib Fracture: A Randomized, Active-controlled, Participant- and Observer-masked Study.

Background: Traumatic rib fractures are associated with pain lasting weeks to months and a decreased ability to inspire deeply or cough to clear secretions. Ultrasound-guided percutaneous cryoneurolysis involves reversibly ablating peripheral nerve(s) using exceptionally low temperature with a transdermal probe, resulting in a prolonged nerve block with a duration measured in months. The authors hypothesized that cryoneurolysis would improve analgesia and inspired volume after rib fracture.

Upper-Extremity Injuries in a Level 1 Trauma Center Following Border Wall Height Increase.

Purpose: From 2018-2019, the height of over 400 miles of southern border wall was raised to 30 feet. Our aim was to evaluate the impact of the increase in border wall height on upper-extremity injuries sustained via barrier fall.

Methods: A retrospective review of patients admitted with upper-extremity injuries sustained via border wall fall between January 2015 and December 2022 at a Level 1 trauma center serving the United States-Mexico border.

Mortality in a Clostridium sordellii Case Series.

Introduction: Clostridium sordellii (C sordellii) is a gram positive, anaerobic bacterium that causes severe, often fatal infections. Classically, C sordellii infection is described as a high mortality process for women of childbearing age. We examined C sordellii infections in our hospital to determine if there have been any changes in prevalence, treatment, or outcome.

In-Hospital Drug Use Affects a Broad Patient Population and the Health Care System.

Introduction: Patients who suffer from addiction sometimes take illicit substances while in the hospital (in-hospital drug use [IHDU]), which can lead to unnecessary work-up and preventable treatments when symptoms develop. The purpose of this study was to define the frequency and scope of this problem, who it affects, and its impact on the medical system.

Methods: We reviewed all incident reports from our large, urban level 1 trauma center that involved a patient being found with illicit substances in the hospital between January 2020 and January 2023.

Robotic availability, not payor status, determines access to robotic emergency general surgery hernia repair in California and Florida.

Background: Previous studies have demonstrated that access to robotic surgery is influenced by socioeconomic factors, including insurance status. The 2010 Affordable Care Act established an avenue for states to expand Medicaid coverage, which has increased access to surgical care for many conditions. We hypothesized that socioeconomic disparities in access to robotic repair of non-elective emergency general surgery (EGS) hernias are less prevalent in California, a Medicaid expansion state, compared to Florida, which has not adopted Medicaid expansion.

Friction Burns: Defining the Rub of Road Rash After Motorcycle Trauma.

There is a paucity of literature on friction burn epidemiology, injury characteristics, and management after trauma. This study aims to characterize friction burns resulting from motorcycle accidents, evaluate the role of specialized burn surgery teams, and assess the need for operative intervention. The trauma registry of a Level 1 Trauma Center was queried for all admissions after motorcycle accidents between January 2018 and December 2022.

Increased Traumatic Brain Injury Severity and Mortality in Undocumented Immigrants.

Background And Objectives: Health disparities related to traumatic brain injury (TBI) have focused on socioeconomic status, race, and ethnicity. We sought to characterize TBI patterns and outcomes based on undocumented status.

Methods: Patients who presented to University of California, San Diego Health Trauma Center with a TBI between 2019 and 2022 were identified and stratified based on undocumented status.

From across the globe - traumatic injuries are an international concern at the US-Mexico border wall.

Introduction: Socio-economic and political events of recent years have caused a significant increase in immigrants attempting to illegally cross the United States (US)-Mexico border. While a 30-foot border wall separates the US and Mexico, immigrants from around the world have used this location as their point of entry to the US. These border crossings have led to a dramatic increase in major trauma resulting in increased inpatient resource utilization and the need for comprehensive hospital services.

The Scalding Truth: Geospatial Analysis Identifies Communities at Risk for Pediatric Scald Burns.

Introduction: Pediatric scald burns account for 12% of all U.S. burn center admissions and are the most common type of burn in children.

Unmasking the Impact: Exploring the Role of Masks in Trauma-Informed Care Communication.

Introduction: The COVID pandemic has necessitated mask-wearing by inpatient providers; however, the impact of masks on the acute care surgeon-patient relationship is unknown. We hypothesized that mask-wearing, while necessary, has a negative impact by acting as a barrier to communication, empathy, and trust between patients and surgeons.

Methods: A cross-sectional study was performed by administering a written survey in English or Spanish to trauma, emergency general surgery, burn, and surgical critical care inpatients aged ≥18 y at a University Level 1 Trauma Center between January 2023 and June 2023.

Ethics in disaster, mass casualty care, and critical care.

The primary ethical principle guiding general medical practice is autonomy. However, in mass casualty (MASCAL) or disaster scenarios, the principles of beneficence and justice become of foremost concern. Despite multiple reviews, publications, and training courses available to prepare for a MASCAL incident, a minority of physicians and healthcare providers are abreast of these.

Percutaneous auricular neuromodulation (nerve stimulation) for the treatment of pain following cholecystectomy and hernia repair: a randomized, double-masked, sham-controlled pilot study.

Background: Percutaneous auricular nerve stimulation (neuromodulation) involves implanting electrodes around the ear and administering an electric current. A device is currently available within the USA cleared to treat symptoms from opioid withdrawal, and multiple reports suggest a possible postoperative analgesic effect. The current randomized controlled pilot study was undertaken to (1) determine the feasibility and optimize the protocol for a subsequent definitive clinical trial; and (2) estimate the treatment effect of auricular neuromodulation on postoperative pain and opioid consumption following two ambulatory surgical procedures.

A border health crisis at the United States-Mexico border: an urgent call to action.

In this Viewpoint, we provide an overview of the worsening trend of traumatic injuries across the United States-Mexico border after its recent fortification and height extension to 30-feet. We further characterize the international factors driving migration and the current U.S.

Disaster planning for a surgical surge: when mass trauma threatens to overwhelm your operating rooms.

Mass casualty events particularly those requiring multiple simultaneous operating rooms are of increasing concern. Existing literature predominantly focuses on mass casualty care in the emergency department. Hospital disaster plans should include a component focused on preparing for multiple simultaneous operations.

INTRACOLON COOLING INCREASES SURVIVAL RATE IN THE RAT MODEL OF LETHAL HEMORRHAGE.

Background: The objective of this study was to investigate whether transrectal intracolon (TRIC) cooling can prolong the survival duration in a rat hemorrhagic shock (HS) model. Methods: A lethal HS was induced by bleeding 47% of the total blood volume. A TRIC device was placed into the colon to maintain the intracolon temperature either at 37°C (TRIC37) or at 10°C (TRIC10) post-HS.

Sigh Ventilation in Patients With Trauma: The SiVent Randomized Clinical Trial.

Importance: Among patients receiving mechanical ventilation, tidal volumes with each breath are often constant or similar. This may lead to ventilator-induced lung injury by altering or depleting surfactant. The role of sigh breaths in reducing ventilator-induced lung injury among trauma patients at risk of poor outcomes is unknown.