Pulmonary contusions and critical care management in thoracic trauma.

Many victims of thoracic trauma require ICU care and mechanical ventilatory support. Pressure and volume-limited modes assist in the prevention of ventilator-associated lung injury. Ventilator-associated pneumonia is a significant cause of posttraumatic morbidity and mortality.

Family as a member of the trauma rounds: a strategy for maximized communication.

Introductions: In many hospital settings, the process of providing information to families of critically ill and injured patients can be frustrating for all concerned. Communication failure is the root of much dysfunction in health care and improvement would be well received. The Trauma Team chose to include family members in daily work rounds, allowing total access to team deliberations.

Maximizing reimbursement from trauma response fees (UB-92: 68X) - lessons learned from a hospital comparison.

Background: The trauma response fee (UB-92:68x) recently has been approved, to be used by hospitals to cover expenses resulting from continuous trauma team availability. These charges may be made by designated trauma centers for all defined trauma patients when notification has been received before arrival (eligible pt). This study compares two trauma centers' performance in collecting this fee help define methodologies that can enhance reimbursement.

Two major hospitals can share level I status in a rural community setting.

Background: Even though development of Level I trauma centers is thought to improve outcome of injury treatment, the political barriers in communities where two capable hospitals compete for designation can be formidable. This report documents the initial experience of a Level I trauma center developed in a two-hospital setting whereby each hospital hosted the trauma center on an alternating annual basis.

Methods: Preliminary efforts began with a community-based report on trauma care to which both hospitals and their associated school of medicine contributed.