Journal of Trauma Nursing最新文献

英文中文

Optimizing Trauma Activation Criteria for a Rural Trauma Center. 优化农村创伤中心的创伤启动标准。

IF 1 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000809

Erin Klarr,Heather Xenia Rhodes-Lyons,Rachel Symons

BACKGROUNDThere is a need for activation criteria that reflect the different factors affecting rural trauma patients.OBJECTIVETo develop effective activation criteria for a rural trauma center among adults, incorporating variables specific to the geography, mechanisms of injury, and population served.METHODSThis is a single-center, retrospective cohort study conducted from (23 years) January 1, 2000, to July 31, 2023. The data collected patient demographics, injury details, morbidity, and preexisting comorbidity. This research included all adult (≥15 years) true Level I trauma activations defined as an injury severity score > 25 and met the need for trauma intervention criteria. The patients were grouped into adult and elderly categories. The analysis utilized a logistic regression model with the outcome of a true Level I trauma activation.RESULTSA total of 19,480 patients were included in the sample; 2,858 (14.6%) met the Level I activation criteria. Elderly Level I activation included assault, pedestrian struck, multiple pelvic fractures, traumatic pneumo/hemothorax, mediastinal fracture, sternum fracture, and flail rib fracture.CONCLUSIONUsing the findings of the logistic regression model, this center has made more robust activation guidelines adapted to its rural population.

背景需要制定能反映影响农村创伤患者的不同因素的启动标准。目的为农村创伤中心制定有效的成人启动标准，并纳入地理位置、受伤机制和服务人群的特定变量。方法这是一项单中心回顾性队列研究，研究时间为 2000 年 1 月 1 日至 2023 年 7 月 31 日（23 年）。数据收集了患者的人口统计学特征、受伤详情、发病率和既往合并症。这项研究包括所有成人（≥15 岁）真正的一级创伤激活，即受伤严重程度评分大于 25 分，并符合创伤干预需求标准。患者被分为成人组和老年组。结果共有 19,480 名患者被纳入样本；2,858 人（14.6%）符合 I 级创伤激活标准。老年 I 级启动包括袭击、行人撞击、多发性骨盆骨折、创伤性气胸/血胸、纵隔骨折、胸骨骨折和肋骨骨折。

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引用次数: 0

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Field Setting: A Case Report From China. 在野外环境中进行主动脉血管内球囊闭塞复苏术（REBOA）：中国病例报告。

IF 1 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000803

Xixi Li,Nan Xie,Tong Zhou,Bo Yang

BACKGROUNDThe widespread use of agricultural machinery in China has increased the incidence of agricultural machinery-related injuries, posing challenges to on-site medical rescue. This study explores resuscitative endovascular balloon occlusion of the aorta (REBOA) as a life-saving intervention for a patient with severe trauma from agricultural machinery.CASEPRESENTATIONThis study reviews the emergency medical response for a 70-year-old male who suffered machinery entanglement injuries in an agricultural field in western China. The intervention involved a tiered multidisciplinary medical response, including the implementation of REBOA.CONCLUSIONThis case demonstrates the successful use of REBOA in the prehospital setting in China. While prehospital REBOA use is rare, it is increasingly reported in both military and civilian contexts in austere environments in different countries. Further research is required to validate the feasibility and efficacy of REBOA as a prehospital resuscitation strategy.

背景中国农业机械的广泛使用增加了农业机械相关损伤的发生率，给现场医疗救援带来了挑战。本研究探讨了主动脉血管内球囊闭塞复苏术（REBOA）作为一种挽救生命的干预措施，用于救治一名因农业机械造成严重创伤的患者。干预措施涉及多学科分级医疗响应，包括实施 REBOA。结论本病例展示了 REBOA 在中国院前环境中的成功应用。虽然院前 REBOA 的使用并不多见，但在不同国家的艰苦环境中，其在军事和民用环境中的应用报道却越来越多。要验证 REBOA 作为院前复苏策略的可行性和有效性，还需要进一步的研究。

引用次数: 0

Differences in Injury Patterns and Delays in Care-Seeking Behaviors in the Anabaptist Population. 再洗礼派人群的受伤模式和延迟就医行为的差异。

IF 1 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000807

Marsha Salzwedel,Heather Xenia Rhodes-Lyons,Elizabeth Kracht

BACKGROUNDThe lifestyle differences of Anabaptists and their views on health care may yield different injury patterns than standard populations and require a customized approach to injury prevention and health care delivery.OBJECTIVETo identify differences in injury patterns and delays in care-seeking behaviors among the Anabaptists in Wisconsin.METHODSThis single-center retrospective cohort study was conducted from (23 years) January 1, 2000, to December 31, 2023. Local Trauma Registry data collected patient demographics, injury details, morbidity outcomes, in-hospital mortality, and preexisting comorbidity. Anabaptist trauma patients were isolated by confirmed identification in the Trauma Registry. The analysis utilized both descriptive statistics and a logistic regression model with the outcome of Anabaptist.RESULTSA total of 14,431 patients were included in the analysis; 81 (0.4%) were confirmed as Anabaptist. The Anabaptist population showed a higher likelihood of helicopter transportation (odds ratio [OR] 4.64, p < .01) and an activation of Pediatric Level I (OR 4.07, p < .01). As the emergency department shock index increased by one unit, the odds of being Anabaptist increased by 9.87 (p < .01). The injury mechanisms that were associated with the Anabaptist population included buggy collisions (OR 312.58, p < .01), caught or crushed (OR 5.21, p = .01), machinery (OR 5.38, p < .01), near drowning (OR 14.09, p < .01), scooter (OR 13.93, p = .04), and woodworking (OR 12.81, p = .01).CONCLUSIONSThis study identified differences in injury patterns and delays in care-seeking behaviors in the Anabaptist population.

背景再洗礼派教徒的生活方式差异及其对医疗保健的看法可能会导致他们的受伤模式与普通人群不同，因此需要采用定制的方法来预防受伤和提供医疗保健服务。方法这项单中心回顾性队列研究的时间跨度为 2000 年 1 月 1 日至 2023 年 12 月 31 日（23 年）。当地创伤登记处的数据收集了患者的人口统计学特征、受伤细节、发病结果、院内死亡率和原有合并症。再洗礼派创伤患者是通过在创伤登记处的确认身份而被分离出来的。结果共有 14,431 名患者被纳入分析，其中 81 人（0.4%）被确认为再洗礼派。重洗派患者使用直升机转运的可能性更高（比值比 [OR] 4.64，p < .01），儿科 I 级的启动率更高（比值比 4.07，p < .01）。当急诊科休克指数增加一个单位时，成为再洗礼派的几率增加了 9.87（P < .01）。与再洗礼派人群相关的受伤机制包括：马车碰撞（OR 312.58，p < .01）、夹伤或压伤（OR 5.21，p = .01）、机械伤害（OR 5.38，p < .01）、溺水（OR 14.结论本研究确定了再洗礼派人群在受伤模式和延迟寻求护理行为方面的差异。

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引用次数: 0

Needlessly Treated: Evaluation of Prehospital Needle Thoracostomy. 不必要的治疗：评估院前针刺胸腔造口术。

IF 1 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-09-06 DOI: 10.1097/jtn.0000000000000812

引用次数: 0

Lessons in Running and Nursing. 跑步和护理课程

IF 0.7 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI: 10.1097/JTN.0000000000000806

LeAnne Young

引用次数: 0

Just-in-Time Video Using QR Codes: An Approach to Pediatric Trauma Nursing Education. 使用 QR 码的即时视频：儿科创伤护理教育方法。

IF 0.7 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI: 10.1097/JTN.0000000000000800

Nicholas Fraser Mudry, Linda Nancy Roney

Background: High acuity trauma and patients in cardiopulmonary arrest are not frequently seen in all pediatric Level I trauma centers. Yet, nurses are required to manage these patients in fast-paced, high-pressure environments.

Objective: This project aims to develop and evaluate an education program for high-risk, low-volume equipment and skills in the pediatric emergency department setting.

Methods: This is a pre- and post-quality improvement study conducted in a Northeastern United States pediatric Level I trauma center. Emergency department nurses were invited to view videos detailing high-risk, low-volume equipment use. For the convenience of access, Quick Response (QR) codes linked to the videos were placed on each piece of equipment reviewed. General self-efficacy and levels of self-efficacy in using the equipment were assessed before the intervention and again after 4 weeks from January to February 2023.

Results: A total of 43 pediatric emergency nurses participated in the education. The mean aggregate general self-efficacy score was 32.93. Mean scores in all areas (Level 1 rapid infuser, fluid warmer, blood administration, and securing an endotracheal tube) improved after the intervention.

Conclusions: Easily accessible, brief refresher videos linked to QR codes in the pediatric emergency department can help empower nurses who need to use high-risk, low-volume equipment.

背景：在所有儿科一级创伤中心，高危重创伤和心肺骤停患者并不常见。然而，护士需要在快节奏、高压力的环境中管理这些病人：本项目旨在开发和评估儿科急诊室环境中的高风险、低容量设备和技能教育项目：这是一项在美国东北部儿科一级创伤中心进行的前后质量改进研究。急诊科护士应邀观看了详细介绍高风险、低容量设备使用的视频。为方便观看，在每件被审查的设备上都放置了与视频链接的快速反应（QR）代码。在干预前对一般自我效能和使用设备的自我效能水平进行了评估，并在 2023 年 1 月至 2 月的 4 周后再次进行了评估：共有 43 名儿科急诊护士参加了教育活动。总体自我效能感的平均总分为 32.93 分。干预后，所有领域（1 级快速输液器、液体加温器、输血和固定气管插管）的平均得分都有所提高：结论：在儿科急诊室播放与 QR 码相连的简短复习视频有助于提高需要使用高风险、低容量设备的护士的能力。

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引用次数: 0

Factors Influencing Time to Definitive Care in Hip Fracture Patients ina Rural Health System. 影响农村医疗系统髋部骨折患者接受最终治疗时间的因素。

IF 0.7 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI: 10.1097/JTN.0000000000000804

引用次数: 0

Advanced Trauma Care for Nurses New International Collaboration: ATCN Sister Sites Program. 护士高级创伤护理新国际合作：ATCN 姐妹站点计划。

IF 0.7 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI: 10.1097/JTN.0000000000000795

Michael A Glenn

引用次数: 0

Development of a Standardized Nursing Handoff With Tablet Technology: A Quality Improvement Initiative. 利用平板电脑技术开发标准化护理交接：质量改进计划。

IF 0.7 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI: 10.1097/JTN.0000000000000801

Briana R Miller, Kimberly A Maye, Frances D Charlton

Background: Nursing handoff of complete and accurate information is critical for patient safety yet is often difficult to achieve with consistency between nursing departments.

Objective: This quality improvement project aims to describe the development and piloting of a standardized handoff tool for administration by computer tablet for nursing report.

Methods: This descriptive quality improvement initiative was conducted in an 885-bed Level I trauma center in the Southeast Region of the United States. The study was completed in three phases. First, emergency department and trauma intensive care unit nurses were surveyed to determine handoff barriers and best practices. Second, the survey information was used to develop a standardized handoff tool incorporating tablet technology. Third, staff pilot testing was performed, followed by a final survey to ascertain staff feedback on the tool.

Results: A total of n = 120 nurses completed the surveys, and pilot testing was conducted on n = 177 patient handoffs. Ninety-five percent of nurses expressed satisfaction with the tool and 65% with the tablet.

Conclusion: This study supported using a standardized handoff tool between the emergency department and trauma intensive care unit and substantiated the benefits of using a tablet for face-to-face communication.

背景：完整准确的护理信息交接对患者安全至关重要，但护理部门之间往往难以实现信息交接的一致性：本质量改进项目旨在介绍标准化交接工具的开发和试用情况，该工具可通过电脑平板管理，用于护理报告：这项描述性质量改进项目在美国东南部地区一家拥有 885 张床位的一级创伤中心进行。研究分三个阶段完成。首先，对急诊科和创伤重症监护室的护士进行调查，以确定交接障碍和最佳实践。其次，利用调查信息开发了一种结合平板电脑技术的标准化交接工具。第三，对员工进行试点测试，然后进行最终调查，以确定员工对该工具的反馈意见：共有 n = 120 名护士完成了调查，并在 n = 177 次病人交接中进行了试点测试。95%的护士对该工具表示满意，65%的护士对平板电脑表示满意：这项研究支持在急诊科和创伤重症监护室之间使用标准化交接工具，并证实了使用平板电脑进行面对面交流的好处。

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引用次数: 0

Out of Many. 从芸芸众生中脱颖而出

IF 0.7 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing

Pub Date : 2024-07-01 Epub Date: 2024-07-04 DOI: 10.1097/JTN.0000000000000794

LeAnne Sitari Young

引用次数: 0

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