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Mashup Score: 53Homepage | Trauma Surgery & Acute Care Open - 2 day(s) ago
TSACO is an open access journal publishing high-quality epidemiological, educational, and socioeconomic research on trauma surgery and critical care.
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Mashup Score: 104Sol Levinson & Bros., Inc. Funeral Home - 10 day(s) ago
For over 125 years, Sol Levinson & Bros. has been providing exceptional funeral care to the Jewish community in Baltimore, Howard County and surrounding areas from generation to generation through compassion, education, and personalization.
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Mashup Score: 18Victory out of tragedy: organ donation - 11 day(s) ago
Major improvements in trauma care during the last decade have improved survival rates in the severely injured. The unintended consequence is the presentation of patients with non-survivable injuries in a time frame in which intervention is considered and often employed due to prognostic uncertainty. In light of this, discerning survivability in these patients remains increasingly problematic. Evidence-based cut-points of futility can guide early decisions for discontinuing aggressive treatment and use of precious resources in severely injured patients arriving in extremis.
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Mashup Score: 34
The last two decades have seen increased efforts at early identification of those likely to require life-saving interventions such as rapid response teams, massive transfusion delivery, extracorporeal membrane oxygenation, and emergent surgical procedures.1–3 However, it was not until recently that this same level of interest was directed at limiting early interventions in severely injured patients where such efforts might be futile. Not surprisingly, it was the COVID-19 pandemic and its disruption of vital supply chains that brought this to the forefront. During the early months of the COVID-19 pandemic, a 50% reduction in blood donations was offset by a significant drop in demand for products due to restrictions on elective surgery.4 However, as society and its institutions began reopening, with surgical schedules returning to ‘normal’ and trauma volumes rebounding, the supply of blood required was unable to keep up. Adding to this was an increase in trauma, particularly penetrating
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Mashup Score: 20You’ve Been Served, Now What? Malpractice tips and prevention for the acute care surgeon - 11 day(s) ago
Trauma and acute care surgeons commonly perform high acuity and emergent interventions on critically ill or injured patients. This often entails making life or death decisions rapidly and with incomplete and imperfect information, and in patients who may have a variety of comorbidities that contribute to the risk of adverse outcomes. In cases where there are real or perceived breaches of care, a medical malpractice claim may result. In the USA, approximately one-third to one-half of all physicians will be named in medical litigation at least once in their career. Among the various specialties, surgery remains among the highest risk for malpractice litigation, at an average of 10.6 defendants per 100 surgeons. These events can be extremely stressful, demoralizing, or even devastating to the career and well-being of the involved physicians. This can be made better or worse by the individual response and actions of the surgeon on notification of a real or potential claim, and the primary
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Mashup Score: 6
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) provides a new tool in selected patients for the management of non-compressible torso hemorrhage.1–3 Recent improvements in technology have facilitated more rapid placement through smaller femoral access sheaths, which may reduce access-related complications.4 However, high grade evidence to guide REBOA use is limited, and there is a substantial complication risk should this approach be used inappropriately.5 To address the current state of implementation of this new therapeutic strategy, the American College of Surgeons Committee on Trauma (ACS COT) has worked in collaboration with the American College of Emergency Physicians to issue this joint policy statement which addresses the current practice relevant to patient indications, potential complications, implementation, patient management, and training of providers. We urge trauma centers to consider these factors in the adoption of this approach.
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Mashup Score: 6Early and late complications of bariatric operation - 12 day(s) ago
Weight loss surgery is one of the fastest growing segments of the surgical discipline. As with all medical procedures, postoperative complications will occur. Acute care surgeons need to be familiar with the common problems and their management. Although general surgical principles generally apply, diagnoses specific to the various bariatric operations must be considered. There are anatomic considerations which alter management priorities and options for these patients in many instances. These problems present both early or late in the postoperative course. Bariatric operations, in many instances, result in permanent alteration of a patient’s anatomy, which can lead to complications at any time during the course of a patient’s life. Acute care surgeons diagnosing surgical emergencies in postbariatric operation patients must be familiar with the type of surgery performed, as well as the common postbariatric surgical emergencies. In addition, surgeons must not overlook the common causes
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Mashup Score: 41
Damage control surgery has evolved during the past 40 years. The initial cases and studies were performed at level 1 trauma centers but has now shifted to damage control at smaller hospitals. This buys time for definitive care at higher-level centers. There is a role for damage control surgery in both general surgery and trauma patients at community trauma centers. The successful implementation and completion of damage control surgery require thorough planning and a full understanding of resource limitation. Additional training or practice for infrequently performed procedures may be necessary. A systems-based approach with postoperative transfer to a higher level of care is acceptable and expected.
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Mashup Score: 38
A patient in his 40s presented to the emergency department with a 1-day history of severe right lower extremity pain, numbness and dark urine. Prior to presentation, he admitted to using alcohol and cocaine and became unconscious and immobilized for a prolonged time. Vitals and labs including complete blood count and Basic Metabolic Panel (BMP) were normal. Creatine kinase level was elevated (296 000). On physical examination, tense, exquisitely tender compartments were present along the right lower extremity from the proximal hip to the lower calf. Motor function was decreased. Pulses were intact. He was taken emergently for right gluteal, thigh and leg fasciotomy and treated for rhabdomyolysis with hydration and eventual hemodialysis. Continued evaluation of multiple open wounds ensued with difficulties encountered with delayed primary closure given significant muscle edema (figure 1). Figure 1 Decompressive fasciotomy wound of lateral leg. 1. Continue with serial evaluations in the
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Mashup Score: 6
The ACTS Predoctoral Scholar Award recognizes achievement in translational research at the pre-doctoral level. Emphasis is on transformational scientific pot…
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Paying homage to @traumadoctors President @reillyp648 and President-Elect @Stewartr84 on behalf of #TSACO @TSACO_AAST https://t.co/MXOvhvXyLr https://t.co/iFsPE0EjbP