Publications by authors named "Tala Dandan"
Pain management on a trauma service: a crisis reveals opportunities.
Sabina Schaffer Dunya Bayat Walter L Biffl Jeffrey Smith Kathryn B Schaffer Tala H Dandan Imad S Dandan
Trauma Surg Acute Care Open
March 2022
Objectives: The opioid crisis has forced an examination of opioid prescribing and usage patterns. Multimodal pain management and limited, procedure-specific prescribing guidelines have been proposed in general surgery but are less well studied in trauma, where multisystem injuries and multispecialty caregivers are the norm. We hypothesized that opioid requirements would differ by primary type of injury and by age, and we sought to identify factors affecting opioid prescribing at discharge (DC).
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- The study investigates whether early treatment with tissue plasminogen activator (tPA) combined with heparin can improve lung function in patients suffering from severe respiratory failure due to COVID-19.
- Conducted between May 2020 and March 2021, the research involved two phases with a total of 50 participants who were randomized into treatment or control groups.
- Results indicated that patients receiving the tPA bolus showed significant improvements in their lung function, measured by the Pao to Fio ratio, without any severe bleeding incidents occurring in either treatment group.
Article Synopsis
- The study introduced a 'pit stop' evaluation in a low-tier trauma triage protocol, aiming to speed up patient assessment and reduce costs in the emergency department (ED).
- A retrospective analysis showed that while the time to physician evaluation remained similar, the time to CT scan significantly decreased, indicating improved efficiency for trauma patients not meeting activation criteria.
- The implementation was deemed safe, with the majority of patients released from the ED without needing a full trauma activation, and it successfully minimized overtriage without overburdening trauma resources.
Article Synopsis
- Trauma systems need to adapt to changing populations to provide adequate care for severely injured individuals, particularly focusing on vulnerable groups like the elderly and homeless.
- A study of trauma patients over five years at a Level II trauma center in Southern California found that 30% were elderly, 3% were homeless, and other categories made up the rest, with significant differences in how these groups were triaged and treated.
- Both homeless and geriatric patients faced higher complications and longer hospital stays compared to other patients, highlighting the need for better case management and resources to handle their complex health issues and discharge planning challenges.