Don't break the bank: Description of survivors in high-volume transfusion and utility of transfusion in trauma.

Introduction: In response to blood shortages, providers face pressure to conserve blood. No metrics exist to calculate transfusion utility. We describe characteristics of survivors after high-volume resuscitation and evaluate transfusion utility in low-volume and high-volume resuscitation.

Lost and found: a unique foregut gastrointestinal bullet embolism.

Bullet embolism is a rare phenomenon where a bullet migrates from its original point of entry to a distant site within the body. This brief report describes a case of a bullet embolism entering the gastrointestinal (GI) tract through the posterior oropharynx. The patient initially presented with a gunshot wound to the left scapula, and the bullet was later identified in the GI tract.

Retained bullets: to remove or not to remove? Lessons from two clinical scenarios with intracardiac bullet embolization.

Firearm-related injuries in the USA are increasing, with over 105,000 cases annually. Gunshot wounds (GSWs), especially those involving retained bullets, present complex challenges due to bullet trajectories and embolization risks. This study reviews two cases of bullet emboli, focusing on bullet localization strategies and timing of removal.

Case report: Selective operative management of zone 3 carotid artery transection.

Introduction: Penetrating carotid artery injury is rare and particularly uncommon in zone 3 of the vessel. Due to anatomical challenges to open operative management in zone 3, there are minimal treatment recommendations for this highly morbid condition. The urgency associated with understanding proper management of this traumatic injury is further supported by the nearly 100 % rate of fatality in untreated penetrating carotid artery injuries.

The Use of Art to Develop Holistic Nurses and Clinical Judgment: An Educational Intervention.

Artwork can be used to practice the development of holistic care for nursing students. This activity was designed for senior nursing students to develop their holistic nursing skills through a series of in-class activities while viewing Frida Kahlo's . This study's aim was to design an educational experience to develop a more holistic approach to caring for patients for nursing students.

Faculty Behaviors and Beliefs About Teaching Gun Violence Prevention in Undergraduate Nursing Programs.

Background: Gun violence is a public health crisis, but nurses report receiving little education related to gun violence prevention (GVP).

Purpose: This study aimed to describe undergraduate nursing faculty teaching behaviors and perceptions related to GVP and explore factors associated with teaching it.

Methods: A cross-sectional survey design was used.

Faculty Development Needs and Approaches to Support Course Examination Development in Nursing Programs: An Integrative Review.

Background: Many nursing faculty lack formal training in item writing and test construction.

Purpose: This integrative review synthesizes the evidence to gain a comprehensive understanding of the developmental needs and interventions employed to help nursing faculty gain skills to develop course examinations.

Methods: Original research and non-research reports published since 2012 were included.

Optimal Management of Traumatic Abdominal Wall Hernias Remains Unclear.

High-energy, blunt force trauma to the abdomen results in an abdominal wall injury (AWI) in up to 9% of patients. In 1% of blunt abdominal trauma, they result in a traumatic abdominal wall hernia (TAWH). Optimal management of these injuries remains unclear.

The transformative palette: the use of art and Visual Thinking Strategies in nursing.

Visual Thinking Strategies is a teaching technique initially studied in primary education but recently has been used to teach nursing students and other healthcare professionals. VTS has been found to help participants think and see differently, explore learning in safe environments, and develop ethical competencies. Experiences with VTS can create rich discussions and present opportunities for nurses to talk about issues and concerns that may not always present in the classroom.

Early Repair of Rib Fractures Is Associated with Superior Length of Stay and Total Hospital Cost: A Propensity Matched Analysis of the National Inpatient Sample.

Previous studies have suggested that early scheduling of the surgical stabilization of rib fractures (SSRF) is associated with superior outcomes. It is unclear if these data are reproducible at other institutions. We hypothesized that early SSRF would be associated with decreased morbidity, length of stay, and total charges.

Ultra Long-term Follow-up of the Autologous Pubovaginal Sling for Stress Incontinence: Results at 23 Years.

Objective: To examine the efficacy, safety, and long-term durability of the autologous pubovaginal sling for stress incontinence over a 29-year period.

Methods: A total of 192 consecutive female patients with stress urinary incontinence who underwent autologous pubovaginal sling from 1993 through 1999 were analyzed over a 29-year period. Intermediate and ultra long-term follow-up were obtained at a mean of 4 and 23 years, respectively.

Energetics of high temperature degradation of fentanyl into primary and secondary products.

Fentanyl is a synthetic opioid used for managing chronic pain. Due to its higher potency (50-100×) than morphine, fentanyl is also an abused drug. A sensor that could detect illicit fentanyl by identifying its thermally degraded fragments would be helpful to law enforcement.

Benefit of balance? Odds of survival by unit transfused: Retrospective analysis of the ACS-TQIP database.

Background: The critical blood shortage in January 2022 threatened the availability of blood. Utility of transfusion per unit was reported in a previous study, revealing patients receiving balanced transfusion are more likely to die after 16 units of packed red blood cells. We aimed to validate this study using a larger database.

Value Assessment of Oncology Pharmacist Interventions.

A review of the published literature confirms the challenge in quantifying the value of oncology pharmacists. This editorial expands on a 2020 study by Meleis and colleagues published in the and seeks to correlate pharmacist interventions to cost-saving and cost-avoidance measures to show the value of ambulatory oncology clinical pharmacists in patient care. A total of 4,686 interventions were reviewed.

Comparison of differing dose levels of methotrexate for patients with primary central nervous system lymphoma.

Introduction: It has long been established that high-dose methotrexate is an essential part of therapy for primary central nervous system lymphoma. When regimens utilizing high-dose methotrexate were first studied, a dose of 8 g/m was used. More recently, reduced dosing strategies have been studied and adopted in attempts to reduce rates of adverse events.

Surgical subspecialization is associated with higher rate of rib fracture stabilization: a retrospective database analysis.

Background: Surgical stabilization of rib fractures (SSRF) is performed on only a small subset of patients who meet guideline-recommended indications for surgery. Although previous studies show that provider specialization was associated with SSRF procedural competency, little is known about the impact of provider specialization on SSRF performance frequency. We hypothesize that provider specialization would impact performance of SSRF.

Contemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale.

Introduction: The American Association for the Surgery of Trauma Colon Organ Injury Scale (OIS) was updated in 2020 to include a separate OIS for penetrating colon injuries and included imaging criteria. In this multicenter study, we describe the contemporary management and outcomes of penetrating colon injuries and hypothesize that the 2020 OIS system correlates with operative management, complications, and outcomes.

Methods: This was a retrospective study of patients presenting to 12 Level 1 trauma centers between 2016 and 2020 with penetrating colon injuries and Abbreviated Injury Scale score of <3 in other body regions.

When is enough enough? Odds of survival by unit transfused.

Background: Balanced transfusion is lifesaving for hemorrhagic shock. The American Red Cross critical blood shortage in 2022 threatened the immediate availability of blood. To eliminate waste, we reviewed the utility of transfusions per unit to define expected mortality at various levels of balanced transfusion.

Age as a Barrier to Surgical Stabilization of Rib Fractures in Patients with Flail Chest.

Introduction: Although randomized trials demonstrate a benefit to surgical stabilization of rib fractures (SSRF), SSRF is rarely performed. We hypothesized older patients were less likely to receive SSRF nationally.

Methods: The 2016 National Inpatient Sample was used to identify adults with flail chest.

Multi-System Inflammatory Syndrome Presenting as Non-Specific Colitis: A Medical Diagnosis with a Surgical Presentation.

A 20-year-old woman with previous COVID-19 diagnosis presented with abdominal pain and colitis on CT scan. She was admitted in septic shock, with etiology of colitis unclear. After resuscitation, antibiotics, and steroids, she clinically deteriorated.

Traffic stops do not prevent traffic deaths.

Objectives: Amid growing calls for police reform, it is imperative to reassess whether police actions designed to improve public safety are associated with injury prevention. This study aims to examine the relationship between the police traffic stops (PTSs) and motor vehicle crash (MVC) deaths at the state level. We hypothesize that increased PTSs would be associated with reduced MVC deaths.

The financial burden of rib fractures: National estimates 2007 to 2016.

Background: The aim of this study is to define the cost of rib fracture hospitalization by single, multiple, and flail type using a nationally representative sample.

Methods: The national inpatient sample (NIS) was used to identify patients with a primary diagnosis of rib fracture hospitalization 2007-2016. International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes were used to characterize patients as having single, multiple, or flail chest rib fractures.