Asunto(s)
Antiinflamatorios/uso terapéutico , Vértebras Cervicales/lesiones , Tratamiento de Urgencia/métodos , Fútbol Americano/lesiones , Metilprednisolona/uso terapéutico , Fármacos Neuroprotectores/uso terapéutico , Cuadriplejía/tratamiento farmacológico , Traumatismos de la Médula Espinal/tratamiento farmacológico , Fracturas de la Columna Vertebral/tratamiento farmacológico , Enfermedad Aguda , Adolescente , Adulto , Tratamiento de Urgencia/normas , Medicina Basada en la Evidencia , Humanos , Infusiones Intravenosas , Masculino , Selección de Paciente , Cuadriplejía/diagnóstico , Cuadriplejía/etiología , Traumatismos de la Médula Espinal/diagnóstico , Traumatismos de la Médula Espinal/etiología , Fracturas de la Columna Vertebral/diagnóstico , Fracturas de la Columna Vertebral/etiología , Resultado del TratamientoAsunto(s)
Antiinfecciosos/administración & dosificación , Cateterismo Venoso Central/instrumentación , Materiales Biocompatibles Revestidos , Infección Hospitalaria/prevención & control , Sepsis/prevención & control , Cateterismo Venoso Central/efectos adversos , Infección Hospitalaria/etiología , Humanos , Sepsis/etiologíaRESUMEN
INTRODUCTION: Emergency nurses routinely treat a wide variety of animal-related injuries, yet the trauma literature rarely addresses injuries associated with livestock. METHODS: The purpose of this retrospective, descriptive study was to examine the incidence, demographics, severity, and other factors associated with trauma related to livestock in persons admitted to one central texas trauma center during a 5-year period. Patients were classified by activity at the time of injury. The following 5 categories were identified: cowboy, rancher, dude, standing near, and unidentified. Groups were further analyzed by the type of animal involved in the injury, mechanism of injury, patient sex and age, body regions injured, indicators of severity, and county in which the injury occurred. RESULTS: One hundred thirty-six patients met the inclusion criteria. Of these patients, 24% were categorized as cowboys, 18% as ranchers, and 39% as dudes. Six percent were standing near the animal, and activity at the time of injury could not be adequately determined for 13% of patients. Typical demographics, mechanisms of injury, wounds, indicators of severity, and animals were found to be associated with each activity class. DISCUSSION: Horses were responsible for 75% of the traumas sustained by ranchers and 83% of the traumas sustained by dudes. Bulls were responsible for 94% of the cases involving cowboys. Simply standing near livestock was dangerous for 6% of the sample, including young children. Although helmets and steel-toed boots are currently unpopular, wearing them is a simple and important safety strategy.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Crianza de Animales Domésticos , Bovinos , Caballos , Ocupaciones/estadística & datos numéricos , Heridas y Lesiones/epidemiología , Heridas y Lesiones/etiología , Accidentes de Trabajo/clasificación , Adolescente , Adulto , Distribución por Edad , Anciano , Animales , Animales Domésticos , Niño , Preescolar , Femenino , Humanos , Incidencia , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Salud Laboral , Vigilancia de la Población , Ropa de Protección , Sistema de Registros , Características de la Residencia , Estudios Retrospectivos , Factores de Riesgo , Texas/epidemiología , Centros Traumatológicos , Heridas y Lesiones/clasificación , Heridas y Lesiones/prevención & controlAsunto(s)
Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Conducción de Automóvil/legislación & jurisprudencia , Enfermería de Urgencia/legislación & jurisprudencia , Servicio de Urgencia en Hospital/legislación & jurisprudencia , Notificación Obligatoria , Personal de Enfermería en Hospital/legislación & jurisprudencia , Consumo de Bebidas Alcohólicas/sangre , Confidencialidad/legislación & jurisprudencia , Derecho Penal/legislación & jurisprudencia , Revelación , Etanol/sangre , Humanos , Salud Pública/legislación & jurisprudencia , Estados UnidosRESUMEN
Intracranial aneurysmal hemorrhage is a common but devastating condition associated with significant morbidity and mortality. Epidemiologic studies have identified risk factors associated with this condition. Genetic factors involve family history and the presence of certain heritable connective tissue disorders such as Ehlers-Danlos syndrome, Marfan's syndrome, neurofibromatosis, and polycystic kidney disease. Acquired factors include traumatic brain injury, sepsis, smoking, and hypertension. Management of these patients consists of prevention, patient screening, and prophylactic aneurysm repair.
Asunto(s)
Aneurisma Intracraneal/epidemiología , Hemorragia Subaracnoidea/epidemiología , Lesiones Encefálicas/complicaciones , Síndrome de Ehlers-Danlos/complicaciones , Humanos , Hipertensión/complicaciones , Aneurisma Intracraneal/etiología , Aneurisma Intracraneal/prevención & control , Síndrome de Marfan/complicaciones , Tamizaje Masivo/métodos , Morbilidad , Neurofibromatosis/complicaciones , Riñón Poliquístico Autosómico Dominante/complicaciones , Prevención Primaria/métodos , Factores de Riesgo , Sepsis/complicaciones , Fumar/efectos adversos , Hemorragia Subaracnoidea/etiología , Hemorragia Subaracnoidea/prevención & control , Estados Unidos/epidemiologíaRESUMEN
In patients with early acute ischemic stroke (AIS), studies have shown improved recovery rates when thrombolytic therapy is appropriately initiated. However, in clinical practice, there are several barriers to rapid patient evaluation and drug administration. To facilitate the management of this population, an AIS clinical pathway, Emergi-path, was developed. Initiated at the time of the patients' arrival to the emergency department, Emergi-path provides a step-by-step guide for early care of AIS patients. A citywide stroke team plays an integral role in this process by responding to stroke codes. Implementation of an AIS pathway and activation of an organized team of stroke specialists can facilitate rapid evaluation and treatment of this high-risk population.
Asunto(s)
Infarto Cerebral/enfermería , Vías Clínicas , Servicio de Urgencia en Hospital , Grupo de Atención al Paciente , Anciano , Infarto Cerebral/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Evaluación en Enfermería , Diagnóstico de EnfermeríaRESUMEN
INTRODUCTION: Hot-loading is a common practice among rotor-wing air medical programs that respond to scene calls. Drawbacks include noise, flying debris, and risk of serious injury. The purpose of this study was to identify the frequency, ground time, and short-term outcomes of hot-loaded patients flown by the STAR Flight program. METHODS: A 1-year retrospective records review identified all hot-loaded patients. Results were analyzed by call nature, number of patients, and type of aircraft. RESULTS: In 1996 STAR Flight transported 1184 individuals from the scene of illness or injury; 269 (23%) were hot-loaded. Overall, hot-load ground times averaged 7.0 minutes. The shortest mean time, 6.6 minutes, was for single trauma patients. Medicine patients averaged 7.3 minutes, and multipatient transports required 10.3 minutes. Mean scene times for those flown in the Bell 412 and 206 were 6.9 and 7.4 minutes, respectively. Thirty percent of hot-loaded patients were considered critical. CONCLUSION: Hot-loading rarely was accomplished in less than the helicopter shutdown/startup time. Multipatient hot-loads always exceeded shutdown/restart intervals. Medicine and Bell 206 transports required the longest mean ground times. Most of STAR Flight's hot-loaded patients were not critically ill or injured.
Asunto(s)
Ambulancias Aéreas/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud , Estudios de Tiempo y Movimiento , Transporte de Pacientes/métodos , Estudios de Evaluación como Asunto , Humanos , Estudios Retrospectivos , Medición de Riesgo , TexasRESUMEN
INTRODUCTION: This study was designed to define 1 trauma center's drunk driver patient population, determine the incidence of alcohol intoxication in motorists admitted to the hospital following a collision, and ascertain the frequency of the Driving Under the Influence (DUI) charges filed against this population. METHODS: Hospitalized motorists were divided into 2 groups--those who did and did not have blood alcohol levels measured--then further classified into 3 subsets based on serum ethanol values. A 2-year retrospective trauma registry review established patient demographics, outcomes, hospital costs, blood alcohol levels, and concomitant drug use. Local police records were accessed to determine the number of patients cited for DUI. RESULTS: Eighty percent of those intoxicated were men. On the average, drunk drivers were 1.7 years younger than were sober patients. Minimally to moderately intoxicated motorists had the highest overall injury severity scores and hospital costs and were the most likely to concomitantly abuse illegal drugs. Patients who did not have ethanol levels measured had the highest mortality rate. DISCUSSION: Overall, 60% of admitted injured drivers who were tested had positive results for 1 or more substances known to impair driving ability, yet only 16% of those with a blood alcohol level of > or = 100 mg/dL were charged with DUI. This finding supports previously published data suggesting that injury and transport to a hospital protect the alcohol-impaired driver from legal consequences.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Heridas y Lesiones/epidemiología , Heridas y Lesiones/etiología , Accidentes de Tránsito/legislación & jurisprudencia , Adulto , Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Femenino , Humanos , Incidencia , Masculino , Admisión del Paciente/estadística & datos numéricos , Estudios Retrospectivos , Texas/epidemiología , Centros TraumatológicosAsunto(s)
Laringe/lesiones , Tráquea/lesiones , Accidentes de Tránsito , Adolescente , Adulto , Cuidados Críticos , Femenino , Humanos , Incidencia , RoturaRESUMEN
Nurse educators have used various teaching strategies to comply with annual infection control and safety review requirements. In this study, the author investigated a computer-assisted instructional program that allows individualized education on the nursing unit during regular work hours. Significant time and cost savings to the institution were realized, and user satisfaction and compliance were high.