Admission hyperglycemia is associated with different outcomes after blunt versus penetrating trauma.

Background: Stress-induced hyperglycemia is associated with worse outcomes after trauma; however, the effect of mechanism of injury has not been studied. To fill this gap, we tested the hypothesis that blunt and penetrating trauma evoke different glycemic responses which are associated with different outcomes.

Materials And Methods: A retrospective cohort study comparing adults with blunt (n = 835) or penetrating trauma (n = 858) and admission glucose levels ≥ 106 mg/dL, ≥150 mg/dL, and ≥200 mg/dL at a level 1 trauma center from 02, 2011 to 08, 2013.

Admission Hyperglycemia Predicts Infectious Complications After Burns.

Inflammation and hypermetabolism post burn predisposes to hyperglycemia and insulin resistance. The authors hypothesize that admission hyperglycemia predicts infectious outcomes. A retrospective review of all patients greater than 20 years of age admitted for initial burn management from January 2008 to December 2013 was conducted.

Evaluation of Miniature Wireless Vital Signs Monitor in a Trauma Intensive Care Unit.

A previous study demonstrated basic proof of principle of the value of a miniature wireless vital signs monitor (MWVSM, MiniMedic, Athena GTX, Des Moines, Iowa) for battlefield triage However, there were unanswered questions related to sensor reliability and uncontrolled conditions in the prehospital environment. This study determined whether MWVSM sensors track vital signs and allow for appropriate triage compared to a gold standard bedside monitor in trauma patients. This was a prospective study in 59 trauma intensive care unit patients.

Scald Burns From Hair Braiding.

Only one previous case report has described scald burns secondary to hair braiding in pediatric patients. The present case study is the largest to date of scald burns as a result of hair braiding in children and adults. Charts of all 1609 female patients seen at a single burn center from 2008 to 2014 were retrospectively reviewed to identify patients with scald burns attributed to hair braiding.

Association Between American Board of Surgery In-Training Examination Scores and Resident Performance.

Importance: The American Board of Surgery In-Training Examination (ABSITE) is designed to measure progress, applied medical knowledge, and clinical management; results may determine promotion and fellowship candidacy for general surgery residents. Evaluations are mandated by the Accreditation Council for Graduate Medical Education but are administered at the discretion of individual institutions and are not standardized. It is unclear whether the ABSITE and evaluations form a reasonable assessment of resident performance.

Injury patterns and outcomes following pediatric bicycle accidents.

Objectives: Other than automobiles, bicycles are connected to more pediatric injuries than any other consumer product. Whereas characterization of injury patterns following motor vehicle accidents has led to safety initiatives and treatment guidelines, knowledge related to bicyclist injuries is lacking. Our purpose is to identify major injury patterns and outcomes associated with pediatric bicycle accidents.

Decreased mortality after prehospital interventions in severely injured trauma patients.

Background: We test the hypothesis that prehospital interventions (PHIs) performed by skilled emergency medical service providers during ground or air transport adversely affect outcome in severely injured trauma patients.

Methods: Consecutive trauma activations (March 2012 to June 2013) transported from the scene by air or ground emergency medical service providers were reviewed. PHI was defined as intubation, needle decompression, tourniquet, cricothyroidotomy, or advanced cardiac life support.

Coagulation Profile Changes Due to Thromboprophylaxis and Platelets in Trauma Patients at High-Risk for Venous Thromboembolism.

We hypothesize there are coagulation profile changes associated both with initiation of thromboporphylaxis (TPX) and with change in platelet levels in trauma patients at high-risk for venous thromboembolism (VTE). A total of 1203 trauma intensive care unit patients were screened with a VTE risk assessment profile. In all, 302 high-risk patients (risk assessment profile score ≥ 10) were consented for weekly thromboelastography.

Latissimus dorsi flap versus pedicled transverse rectus abdominis myocutaneous breast reconstruction: outcomes.

Background: Pedicled breast reconstruction is a mainstay treatment for plastic surgeons. Although indications vary for each breast reconstruction technique, there exist some overlapping characteristics that may determine a successful outcome. We aimed to determine the impact flap selection has on postoperative outcomes and resource utilization.

Does obesity affect outcomes of adult burn patients?

Background: Obesity negatively affects outcomes after trauma and surgery; results after burns are more limited and controversial. The purpose of this study was to determine the effect of obesity on clinical and economic outcomes after thermal injury.

Methods: The National Inpatient Sample was queried for adults from 2005-2009 with International Classification of Diseases-9 codes for burn injury.

Resource utilization patterns of pediatric esophageal foreign bodies.

Background: Ingested foreign bodies are a frequent presentation in pediatric emergency departments. Although some pass spontaneously through the gastrointestinal tract, the majority of esophageal-ingested foreign bodies (EFB) require removal.

Materials And Methods: Kids' Inpatient Database (1997-2009) was used to identify children (aged <20 y) with EFB (International Classification of Diseases, Ninth Revision, Clinical Modification code 935.

Prehospital care and transportation of pediatric trauma patients.

Background: Despite advances in prehospital emergency medical services (EMS), most advocate "scoop-and-run" over "stay-and-play." However, there are almost no studies in children. We hypothesize that the transportation of mortally injured children is delayed and that the performance of prehospital interventions (PHIs) themselves delay transportation and worsen outcomes in pediatric trauma patients.

Pediatric vascular injury: experience of a level 1 trauma center.

Background: Our purpose was to analyze modern major vascular injury (MVI) patterns in pediatric trauma, interventions performed, and outcomes at a level 1 trauma center.

Materials And Methods: From January 2000-December 2012, all pediatric admissions (≤17 y) were reviewed.

Results: Of 1928 pediatric admissions, 103 (5.

Spontaneous pneumomediastinum, pneumopericardium and epidural pneumatosis: insights on clinical management.

Spontaneous pneumomediastinum is a benign condition that has been reported, however the association with epidural pneumatosis is much less common. A 27-year-old male presented with concomitant air in the epidural space, mediastinum and pericardium after illicit drug use and engagement in sexual activity. The patient was hemodynamically stable.