Trauma Quality Improvement Program: A Retrospective Analysis from A Middle Eastern National Trauma Center.

Background: The Trauma Quality Improvement Program (American College of Surgery (ACS-TQIP)) uses the existing infrastructure of the Committee on Trauma programs and provides feedback to participating hospitals on risk-adjusted outcomes. This study aimed to analyze and compare the performance of the Level I Hamad Trauma Centre (HTC) with other TQIP participating centers by comparing TQIP aggregate database reports. The primary goal was to pinpoint the variations in adult trauma outcomes and quality measures, identify areas that need improvement, and leverage existing resources to facilitate quality improvement.

Traumatic lung laceration secondary to avulsed lung adhesion - A case report.

Background: Pulmonary lacerations caused by an avulsion force on an adhesion between the lung and chest wall following blunt thoracic injury are very rare. They may result in pneumothorax and/or hemothorax and may not be immediately apparent clinically or radiologically.

Case Presentation: We present the case of a healthy 34-year-old male who sustained blunt thoracic injury.

Spontaneous tension pneumothorax as a complication of Coronavirus disease 2019: Case report and literature review.

Primary spontaneous tension pneumothorax (STP) is a rare and life-threatening condition. We report a case of COVID-19-pneumonia patient who developed STP as a complication. He had a prolonged hospital stay and was ultimately discharged asymptomatic.

Impact of Extracorporeal Membrane Oxygenation Service on Burnout Development in Eight Intensive Care Units. A National Cross-Sectional Study.

Objectives: This study aimed at investigating the effects of an extracorporeal membrane oxygenation (ECMO) service on Burnout syndrome (BOS) development in the intensive care unit (ICU).

Design: The authors conducted a cross-sectional descriptive study.

Settings: Eight ICUs within 5 tertiary hospitals in 1 country.

Beta blocker use in traumatic brain injury based on the high-sensitive troponin status (BBTBBT): methodology and protocol implementation of a double-blind randomized controlled clinical trial.

Background: Beta-adrenergic receptor blockers (BB) play an important role in the protection of organs that are susceptible for secondary injury due to stress-induced adrenergic surge. However, the use of BB in traumatic brain injury (TBI) patients is not yet the standard of care which necessitates clear scientific evidence to be used. The BBTBBT study aims to determine whether early administration of propranolol based on the high-sensitive troponin T(HsTnT) status will improve the outcome of TBI patients.

Utility of extracorporeal membrane oxygenation (ECMO) in the management of traumatic tracheobronchial injuries: case series.

Tracheobronchial injury is a rare, but potentially life-threatening condition, and in most cases requires urgent treatment to restore normal respiratory physiology. Over the past decades, extracorporeal membrane oxygenation (ECMO) has evolved as an important adjunct in airway surgery. We presented three cases of traumatic tracheobronchial injury managed with ECMO support at a level-1 trauma center and emphasized the benefits of anticipation and early institution of ECMO support perioperatively, in these high-risk cases.

Trauma intensive care unit (TICU) at Hamad General Hospital.

Trauma is a leading cause of mortality and morbidity worldwide, and thus represents a great global health challenge. The World Health Organization (WHO) estimated that 9% of deaths in the world are the result of trauma. In addition, approximately 100 million people are temporarily or permanently disabled every year.

Self-Extubation in Patients with Traumatic Head Injury: Determinants, Complications, and Outcomes.

Background: Self-extubation is a common clinical problem associated with mechanical ventilation in trauma patients worldwide.

Objectives: This study aimed to evaluate the predisposing factors, complications, and outcomes of self-extubation in patients with head injury.

Methods: This was a retrospective cohort study.

The Role of Transcranial Doppler in Traumatic Brain Injury: A Systemic Review and Meta-Analysis.

To evaluate whether transcranial Doppler (TCD) monitoring plays a role as a prognostic indicator, by being both a diagnostic as well as a monitoring tool for increased intracranial pressure and cerebral vasospasm (VSP), in traumatic brain injury (TBI). Electronic databases and gray literature (unpublished articles) were searched under different MeSH terms from 1990 to the present. Randomized control trials, case-control studies, and prospective cohort studies on TCD in TBI (>18 years old).

Pancreaticoatmospheric fistula following severe acute necrotising pancreatitis.

Severe acute necrotising pancreatitis is associated with numerous local and systemic complications. Abdominal compartment syndrome requiring urgent decompressive laparotomy is a potential complication of this disease process and is associated with increased morbidity and mortality. We describe the case of a pancreaticoatmospheric fistula following decompressive laparotomy in a patient with severe acute necrotising pancreatitis.

A descriptive study of bicycle helmet use in Montreal, 2011.

Objective: The purpose of this study was to describe bicycle helmet use among Montreal cyclists as a step towards injury prevention programming.

Methods: Using a cross-sectional study design, cyclists were observed during 60-minute periods at 22 locations on the island of Montreal. There were 1-3 observation periods per location.

Successful resection of a large incidentally found primary mediastinal liposarcoma.

Primary liposarcoma of the mediastinum is an uncommon tumour. We report a case of a 45-year-old female who was found incidentally to have a large anterior mediastinal mass. Complete removal of the tumour was accomplished successfully.

Update on managing diaphragmatic rupture in blunt trauma: a review of 208 consecutive cases.

Background: Blunt diaphragmatic rupture (BDR) is a rare event and represents a diagnostic challenge. The purpose of our study was to review our experience with BDR at the Sunnybrook Health Sciences Centre (Sunnybrook), the largest trauma centre in Canada, and to highlight recent changes in the diagnosis and management of the condition.

Methods: We retrospectively reviewed the cases of patients with BDR who were admitted to Sunnybrook between January 1986 and December 2003 using our trauma registry.

Extravasation of intravenous computed tomography scan contrast in blunt abdominal and pelvic trauma.

Background: Intravenous contrast extravasation (CE) on computed tomography (CT) scan in blunt abdominal trauma is generally regarded as an indication for the need for invasive intervention (either angiography or laparotomy). More recently, improvements in CT scan technology have increased the sensitivity in detecting CE, and, thus, we postulate that not all patients with this finding require intervention.

Methods: This study is a retrospective review of all patients who underwent a CT scan for blunt abdominal trauma between January 1999 and September 2003.

Surgically important bowel and/or mesenteric injury in blunt trauma: accuracy of multidetector CT for evaluation.

Purpose: To determine the accuracy of multidetector computed tomography (CT) in the detection of surgically important blunt bowel and/or mesenteric injury, to identify and describe the most reliable CT features of bowel and/or mesenteric injury, and to evaluate the performance of readers with different levels of expertise.

Materials And Methods: Institutional review board approval was obtained for this retrospective case-control study of 96 subjects with laparotomy-confirmed findings: 54 consecutive patients with bowel and/or mesenteric injury (surgically important and unimportant) (32 male patients, 22 female patients; mean age, 40.4 years +/- 17.

Association between alcohol and mortality in patients with severe traumatic head injury.

Hypothesis: Admission blood alcohol concentration (BAC) is associated with in-hospital death in patients with severe brain injury from blunt head trauma.

Design: Retrospective cohort study.

Setting: Academic level I trauma center in Toronto, Ontario.

Evaluation of bowel and mesenteric blunt trauma with multidetector CT.

Bowel and mesenteric injuries are detected in 5% of blunt abdominal trauma patients at laparotomy. Computed tomography (CT) has been shown to be accurate for the diagnosis of bowel and mesenteric injuries and is the diagnostic test of choice in the evaluation of blunt abdominal trauma in hemodynamically stable patients. Specific CT findings of bowel and mesenteric injuries include bowel wall defect, intraperitoneal and mesenteric air, intraperitoneal extraluminal contrast material, extravasation of contrast material from mesenteric vessels, and evidence of bowel infarct.

Do trauma patients with a Glasgow Coma Scale score of 3 and bilateral fixed and dilated pupils have any chance of survival?

Background: Low Glasgow Coma Scale score (GCS) and pupillary status predict poor outcomes in head injury (HI) patients. We compared the mortality of GCS 3 patients having bilateral fixed and dilated pupils (BFDP) with GCS 3 patients having reactive pupils (RP). We then determined if trauma system or patient factors were responsible for the difference in mortality.

The emerging role of recombinant activated Factor VII (rFVIIa) in the treatment of blunt traumatic haemorrhage.

Recombinant activated Factor VII (rFVIIa; eptacog alpha [activated], NovoSeven) is currently used for the management of a subgroup of haemophilia patients with inhibitors to Factors VIII or IX, and is under investigation as an adjuvant therapy for critical bleeding from other causes, including trauma. rFVIIa has a mode of action founded on physiological coagulation processes, and causes localised haemostasis at injury sites, both spontaneous and traumatic, with the capacity to correct the systemic coagulopathy associated with massive blood loss and its management. This review charts the development of rFVIIa as a new and potent adjuvant therapy for severe bleeding and coagulopathy caused by blunt trauma, where it is reported to produce rapid and significant haemostasis, reducing transfusion requirements and improving clinical outcome.