Showing posts with label trauma. Show all posts
Showing posts with label trauma. Show all posts
Monday, 10 June 2019
Tuesday, 23 April 2019
Repeated Exposure to Media Coverage of Traumas Can Fuel Distress
Repeated exposure to media coverage of collective traumas, such as mass shootings or natural disasters, can fuel a cycle of distress, according to a new study. Read Psych Central article here
Tuesday, 27 November 2018
Childhood Trauma Linked to Later Psychotic Experiences
A new study from the U.K. has found greater evidence for a link between trauma in childhood and psychotic experiences by 18 years old. Click here to read PsychCentral article
Wednesday, 13 June 2018
Wednesday, 30 May 2018
Cognitive training reduces depression, rebuilds injured brain structure and connectivity after traumatic brain injury
New research shows that certain cognitive training exercises can help reduce depression and improve brain health in individuals years after they have suffered a traumatic brain injury. Read ScienceDaily post here
Monday, 5 February 2018
UHCW publication: Micro-CT for quantitative toolmark analysis of sharp force trauma to bone
The cutting edge - Micro-CT for quantitative toolmark analysis of sharp force trauma to bone.
Norman, D G; Watson, D G; Burnett, B; Fenne, P M; Williams, M A; et al.
Forensic science international 2018 February Vol. 283: 156-172.
Abstract
Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible. In Experiment 1 a mechanical stab rig and two knives were used to create 14 knife cut marks on dry pig ribs. The toolmarks were laser and micro-CT scanned to allow for quantitative measurements of numerous toolmark properties. The findings from Experiment 1 demonstrated that both knives produced statistically different cut mark widths, wall angle and shapes. Experiment 2 examined knife marks created on fleshed pig torsos with conditions designed to better simulate real-world stabbings. Eight knives were used to generate 64 incision cut marks that were also micro-CT scanned. Statistical exploration of these cut marks suggested that knife type, serrated or plain, can be predicted from cut mark width and wall angle. Preliminary results suggest that knives type can be predicted from cut mark width, and that knife edge thickness correlates with cut mark width. An additional 16 cut marks walls were imaged for striation marks using scanning electron microscopy with results suggesting that this approach might not be useful for knife mark analysis. Results also indicated that observer judgements of cut mark shape were more consistent when rated from micro-CT images than light microscopy images. The potential to combine micro-CT data, medical grade CT data and photographs to develop highly realistic virtual models for visualisation and 3D printing is also demonstrated. This is the first study to statistically explore simulated real-world knife marks imaged by micro-CT to demonstrate the potential of quantitative approaches in knife mark analysis. Findings and methods presented in this study are relevant to both forensic toolmark researchers as well as practitioners. Limitations of the experimental methodologies and imaging techniques are discussed, and further work is recommended.
Full text available at
Norman, D G; Watson, D G; Burnett, B; Fenne, P M; Williams, M A; et al.
Forensic science international 2018 February Vol. 283: 156-172.
Abstract
Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible. In Experiment 1 a mechanical stab rig and two knives were used to create 14 knife cut marks on dry pig ribs. The toolmarks were laser and micro-CT scanned to allow for quantitative measurements of numerous toolmark properties. The findings from Experiment 1 demonstrated that both knives produced statistically different cut mark widths, wall angle and shapes. Experiment 2 examined knife marks created on fleshed pig torsos with conditions designed to better simulate real-world stabbings. Eight knives were used to generate 64 incision cut marks that were also micro-CT scanned. Statistical exploration of these cut marks suggested that knife type, serrated or plain, can be predicted from cut mark width and wall angle. Preliminary results suggest that knives type can be predicted from cut mark width, and that knife edge thickness correlates with cut mark width. An additional 16 cut marks walls were imaged for striation marks using scanning electron microscopy with results suggesting that this approach might not be useful for knife mark analysis. Results also indicated that observer judgements of cut mark shape were more consistent when rated from micro-CT images than light microscopy images. The potential to combine micro-CT data, medical grade CT data and photographs to develop highly realistic virtual models for visualisation and 3D printing is also demonstrated. This is the first study to statistically explore simulated real-world knife marks imaged by micro-CT to demonstrate the potential of quantitative approaches in knife mark analysis. Findings and methods presented in this study are relevant to both forensic toolmark researchers as well as practitioners. Limitations of the experimental methodologies and imaging techniques are discussed, and further work is recommended.
Full text available at
Wednesday, 17 January 2018
NIHR Signal Two common operations to fix a broken tibia have similar outcomes
In people who had broken the lower part of their tibia (shin bone), fixation using a metal rod nailed to the inside the bone was compared with a locking plate screwed onto the surface of the bone. There was no difference in the quality of life, disability or pain at 12 months for people who had fractures of the lower tibia fixed using either technique.
NICE guidance recommends that surgery takes place within 24 hours of injury but does not mandate which type of surgery to perform. This NIHR UK-based trial was funded to find which treatment was better for lower tibial fractures.
From the NIHR Dissemination Centre
NICE guidance recommends that surgery takes place within 24 hours of injury but does not mandate which type of surgery to perform. This NIHR UK-based trial was funded to find which treatment was better for lower tibial fractures.
From the NIHR Dissemination Centre
Monday, 15 January 2018
Cranio-Cervical Trauma Eidemiology, Classification, Diagnosis and Management
J Spine Neurosurg 2017, 6:5. DOI: 10.4172/2325-9701.1000284
Objective: To provide an overview of current knowledge of the management of Cranio-Cervical (Occipito-cervical) injuries.
Conclusion: Cranio-cervical injuries constitute a significant proportion of high velocity trauma and can be missed. There is a need for high index of suspicion in such patients. Recent trends seem to favour surgical management of these injuries even in the elderly. Aim should be early surgical fixation wherever possible even in elderly patients, if there is no significant co-morbidity or contraindication for surgery.
UHCW Research: Amar Saxena
Objective: To provide an overview of current knowledge of the management of Cranio-Cervical (Occipito-cervical) injuries.
Conclusion: Cranio-cervical injuries constitute a significant proportion of high velocity trauma and can be missed. There is a need for high index of suspicion in such patients. Recent trends seem to favour surgical management of these injuries even in the elderly. Aim should be early surgical fixation wherever possible even in elderly patients, if there is no significant co-morbidity or contraindication for surgery.
UHCW Research: Amar Saxena
Monday, 8 January 2018
The cutting edge — Micro-CT for quantitative toolmark analysis of sharp force trauma to bone
Forensic Science International, Volume 283, Issue null, Pages 156-172
Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible.
UHCW Research: B. Burnett
Toolmark analysis involves examining marks created on an object to identify the likely tool responsible for creating those marks (e.g., a knife). Although a potentially powerful forensic tool, knife mark analysis is still in its infancy and the validation of imaging techniques as well as quantitative approaches is ongoing. This study builds on previous work by simulating real-world stabbings experimentally and statistically exploring quantitative toolmark properties, such as cut mark angle captured by micro-CT imaging, to predict the knife responsible.
UHCW Research: B. Burnett
Wednesday, 27 December 2017
A prospective, observational cohort study of patients presenting to an emergency department with acute shoulder trauma: the Manchester emergency shoulder (MESH) project
Fracture and dislocation of the shoulder are usually identifiable through the use of plain radiographs in an emergency department. However, other significant soft tissue injuries can be missed at initial presentation. This study used contrast enhanced magnetic resonance arthrography (MRA) to determine the pattern of underlying soft tissue injuries in patients with traumatic shoulder injury, loss of active range of motion, and normal plain radiography.
UHCW Research: Charles E. Hutchinson
Tuesday, 19 December 2017
Current Concepts in Elbow Trauma
Editorial in The Open Orthopaedics Journal vol 11, 2017
Elbow injuries are relatively common and have a significant socioeconomic impact, accounting for 10% of all injuries to the upper limb with almost one third of these being dislocations and approximately 10% being fractures. Furthermore, the elbow is the second most commonly dislocated joint in adults and the most commonly dislocated joint in the paediatric population with 40% of these injuries being associated with sport. Injuries patterns can range from simple low-energy dislocations up to high-energy complex fractures and fracture-dislocations.
Elbow injuries are relatively common and have a significant socioeconomic impact, accounting for 10% of all injuries to the upper limb with almost one third of these being dislocations and approximately 10% being fractures. Furthermore, the elbow is the second most commonly dislocated joint in adults and the most commonly dislocated joint in the paediatric population with 40% of these injuries being associated with sport. Injuries patterns can range from simple low-energy dislocations up to high-energy complex fractures and fracture-dislocations.
UHCW Research: Chetan S. Modi
Monday, 27 November 2017
Patient evaluation of trauma service
Emerg Med J. 2017 Dec;34(12):A890. doi: 10.1136/emermed-2017-207308.45.
Patient Experience of the Trauma System (PETS)Trauma care is highly organised, time critical medicine. Changes to patient management in trauma care are often the result of Random Control Trials, and expert opinion following rigorous evaluation of the evidence. Highly efficient, injury focused care is required to achieve the best outcomes for patients. One area that has not been researched so thoroughly however, is the patient experience of trauma care. As evidence already suggests that patients with high stress levels have poorer outcomes, we wanted to investigate the patient perception of the trauma system. We were particularly interested to find out if there were any areas where patient anxieties could be reduced or eliminated.
UHCW Research: C. Turner
Patient Experience of the Trauma System (PETS)Trauma care is highly organised, time critical medicine. Changes to patient management in trauma care are often the result of Random Control Trials, and expert opinion following rigorous evaluation of the evidence. Highly efficient, injury focused care is required to achieve the best outcomes for patients. One area that has not been researched so thoroughly however, is the patient experience of trauma care. As evidence already suggests that patients with high stress levels have poorer outcomes, we wanted to investigate the patient perception of the trauma system. We were particularly interested to find out if there were any areas where patient anxieties could be reduced or eliminated.
UHCW Research: C. Turner
Wednesday, 30 August 2017
Whole body computed tomography for trauma: friend or foe?
Whole body CT (WBCT) is now an accepted practice in the primary management of the major trauma patient, but there remains a notable absence of a universal clinical decision tool for patient selection in any country. In the UK, The Royal College of Radiologists advises that a polytrauma protocol Multi-Detector Computed Tomography (MDCT) is indicated when there is haemodynamic instability, the mechanism of injury or presentation suggests that there may be occult severe injuries that cannot be excluded by clinical examination or plain films, plain films or Focussed Assessment with Songraphy for Trauma (FAST) suggest significant injury or there is obvious severe injury on clinical assessment.1 The 2016 National Institute for Health and Care Excellence Major Trauma Guidelines also broadly recommended to use WBCT in patients with ‘blunt major trauma and suspected multiple injuries’.2
Trauma team leaders must use their clinical judgement to weigh up the potential benefits of detecting significant injury with diagnostic certainty, against the risk of radiation exposure, the use of potentially nephrotoxic intravenous contrast and the cost of blocking a valuable imaging resource.
When assessing risks of imaging, the standard WBCT is equivalent to 2100 chest radiographs or 11 years of background radiation in the UK. The overall lifetime risk of developing an invasive cancer is 1 in 3 for women and 1 in 2 for men, and for a 20-year-old female, a WBCT will create an estimated additional lifetime risk of cancer of 1 in 184 or a 99.45% chance of having no effect.3 Younger age, female sex, higher body mass index and cumulative scans create a higher risk. However, the true risk of radiation exposure is impossible to quantify. Studies reporting cancer risk include …
UHCW Research: Caroline Leech
Major trauma in older people: implications for anaesthesia and intensive care medicine
Editorial in Anaesthesia. DOI: 10.1111/anae.14027
The Trauma Audit and Research Network (TARN ) is the independent monitor of trauma care in England and Wales. It produces reports for participating hospitals three times a year, and has also produced national reports on major trauma in children [1, 2]. It is the trauma equivalent of the Intensive Care National Audit and Research Centre (ICNARC) for Intensive Care Medicine. The latest themed report has just been published and is entitled ‘Major trauma in older people’ [3]. This first report on trauma in older people from TARN was written by a multidisciplinary group of healthcare professionals and we were privileged to be the representatives from anaesthesia.
UHCW Research: D. Surendra Kumar
The Trauma Audit and Research Network (TARN ) is the independent monitor of trauma care in England and Wales. It produces reports for participating hospitals three times a year, and has also produced national reports on major trauma in children [1, 2]. It is the trauma equivalent of the Intensive Care National Audit and Research Centre (ICNARC) for Intensive Care Medicine. The latest themed report has just been published and is entitled ‘Major trauma in older people’ [3]. This first report on trauma in older people from TARN was written by a multidisciplinary group of healthcare professionals and we were privileged to be the representatives from anaesthesia.
UHCW Research: D. Surendra Kumar
Wednesday, 23 August 2017
Prehospital finger thoracostomy in patients with traumatic cardiac arrest
Tension pneumothorax is a cause of traumatic cardiac arrest that must be considered and rapidly treated if suspected. Finger thoracostomy can be performed quickly and with a low rate of complications. It appears acceptable for use as a method of chest decompression in the pre-hospital environment. Further research is required to evaluate its use by non-HEMS crews, with consideration to integrating ultrasound detection into the clinical decision making where feasible.
Tuesday, 22 August 2017
Specialised services quality dashboards
These dashboards are designed to provide assurance on the quality of care by collecting information about outcomes from healthcare providers. The dashboards are a key tool in monitoring the quality of services, enabling comparison between service providers and supporting improvements over time in the outcomes of services commissioned by NHS England.
Friday, 26 May 2017
HSJ Value in Healthcare Awards 2017: Emergency, Urgent & Trauma Care
In November 2014 Sherwood Forest Hospitals was the second to the bottom in the ED four-hour target performance in England. The ED department had been rated as ‘inadequate’ for safety in 2015 and the trust had 17 patients breach 12 hours during December 2014 and January 2015.
The trust recognised that this was not just a problem for ED to solve and so created the Emergency Flow Programme, which is organisation wide.
The trust recognised that this was not just a problem for ED to solve and so created the Emergency Flow Programme, which is organisation wide.
Coping after a traumatic event
RCPYSCH are signposting guidance on coping after a traumatic event in light of recent attacks.
Monday, 24 April 2017
Long-term outcome of traumatic brain injury patients managed at a major trauma centre in England.
British Journalof Neurosurgery. Conference: 2016 Autumn Meeting of the Society ofBritish Neurological Surgeons, SBNS 2016. United Kingdom. Conference Start:20160921. Conference End: 20160923. 30 (5) (pp 503), 2016. Date ofPublication: 2016.
UHCW is the second busiest Major Trauma Centre in England according to TARN (Trauma Audit and Research Network). Managing patients with traumatic brain injury (TBI) constitutes a significant proportion of the workload. The objective of our study was to document the management and the long term outcome of TBI patients admitted to UHCW.
UHCW Research Talibi S., Land T. , McCullagh, C. Dardis R. and Siddique S.
UHCW is the second busiest Major Trauma Centre in England according to TARN (Trauma Audit and Research Network). Managing patients with traumatic brain injury (TBI) constitutes a significant proportion of the workload. The objective of our study was to document the management and the long term outcome of TBI patients admitted to UHCW.
UHCW Research Talibi S., Land T. , McCullagh, C. Dardis R. and Siddique S.
Monday, 20 February 2017
Clinical guidance for the management of elderly major trauma patients
The Trauma Audit Research Network (TARN) reported that major trauma patients in England and Wales are becoming more elderly, and low level falls are now a leading cause of severe injury. However few clinical guidelines specifically focus on the needs of injured elderly patients admitted to major trauma networks.
In response, the London Major Trauma System has published new clinical guidance for use by major trauma centres and trauma units in conjunction with local guidance.
In response, the London Major Trauma System has published new clinical guidance for use by major trauma centres and trauma units in conjunction with local guidance.
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