The primary purpose of this narrative is to elucidate the numerous significant changes that occur at the intensive care unit (ICU) level as a medical center pursues becoming a Level I trauma center. Specifically, we will focus on the following important areas: (1) leadership and strategy issues behind the decision to move forward with becoming a trauma center; (2) preparation needed to take a highly functioning surgical ICU and align it for the inevitable changes that happen as trauma go-live occurs; (3) intensivist staffing changes; (4) roles for and training of advanced practice practitioners; (5) graduate medical education issues; (6) optimizing interactions with closely related services; (7) nursing, staffing, and training issues; (8) bed allocation issues; and (9) reconciling the advantages of a "unified adult critical care service" with the realities of the central relationship between trauma and surgical critical care.
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http://dx.doi.org/10.4103/JETS.JETS_9_17 | DOI Listing |
JAMA Netw Open
January 2025
Department of Surgery, University of Washington, Seattle.
Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.
Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.
Intensive Care Med
January 2025
Department of Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Eur J Trauma Emerg Surg
January 2025
Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Background: Traumatic brain injury (TBI) is considered a major cause of death globally, resulting from trauma. Decompressive craniectomy (DC) may improve functional outcomes in patients with TBI and its associated complications. This study was designed to determine safety and efficacy of DC in improving clinical outcomes in TBI patients compared to standard therapy.
View Article and Find Full Text PDFPsychol Trauma
January 2025
VA New England Mental Illness Research, Education and Clinical Center, VA Connecticut Health Care System.
Objective: To elucidate the relationship between impaired sleep duration and trauma/posttraumatic stress disorder (PTSD) net of sociodemographic, behavioral, and comorbid diagnostic factors.
Method: We investigated this relationship using the National Epidemiologic Survey on Alcohol and Related Conditions-III data set, analyzing a nationally representative sample of 36,309 adults. Our study identified three groups: those without trauma/PTSD, those with trauma but no PTSD, and those with PTSD.
J Trauma Acute Care Surg
January 2025
From the Division of Urology, Department of Surgery (S.K., J.B.M.), University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery (G.T.T.), Scripps Memorial Hospital La Jolla, La Jolla, California; Division of Urology, Department of Surgery (R.M.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology (J.A.G.), University of Washington, Harborview Medical Center, Seattle, Washington; Department of Surgery (C.C.), UC Health Medical Center of the Rockies, Loveland, Colorado; Department of Surgery (K.L.K.), University of California San Francisco Fresno, Fresno, California; Department of Surgery (M.C.), Case Western Reserve University, Cleveland, Ohio; Shock Trauma Center (R.A.K.), University of Maryland School of Medicine, Baltimore, Maryland; Division of Acute Care and Regional General Surgery (N.L.W., B.L.Z.), University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; and Scott Department of Urology (M.C.), Baylor College of Medicine, Houston, Texas.
The American Association for the Surgery of Trauma initially published the organ injury scaling for the kidney in 1989, which was subsequently updated in 2018. This current American Association for the Surgery of Trauma kidney organ injury scaling update incorporates the latest evidence in diagnosis and management of renal trauma and is based upon a multidisciplinary consensus. These changes reflect the near universal use of computed tomography for renal trauma evaluation and the widespread adoption of conservative management across all grades of renal trauma.
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