Deborah M. Stein
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View article: Effect of Aspirin Versus Low-Molecular-Weight Heparin for Thromboprophylaxis in High-Risk and Fracture Location Subpopulations: A Secondary Analysis of the PREVENT CLOT Trial
Effect of Aspirin Versus Low-Molecular-Weight Heparin for Thromboprophylaxis in High-Risk and Fracture Location Subpopulations: A Secondary Analysis of the PREVENT CLOT Trial Open
OBJECTIVES: To compare the effectiveness and safety of aspirin versus low-molecular-weight heparin (LMWH) for thromboprophylaxis in 11 high-risk or fracture location subpopulations. METHODS: Design: A post hoc secondary analysis of the pub…
View article: Leadership in trauma and acute care surgery: insights on influence
Leadership in trauma and acute care surgery: insights on influence Open
When we think about leadership in trauma and acute care surgery, we are often reminded of the direct impact we can have beyond immediate patient care. Leadership is not just about making decisions; it’s about fostering growth within our in…
View article: Usability and Feasibility of a Mobile Application for Real-Time Trauma Care Guidance: Considerations for User Adoption
Usability and Feasibility of a Mobile Application for Real-Time Trauma Care Guidance: Considerations for User Adoption Open
Introduction Inadequate access to setting-relevant clinical guidance influences the implementation of evidence-based clinical practices in trauma care settings. This guidance is not optimally effective if it cannot be disseminated in setti…
View article: Penetrating Laryngeal Trauma: Management of Severe Injuries Without Open Reduction Internal Fixation
Penetrating Laryngeal Trauma: Management of Severe Injuries Without Open Reduction Internal Fixation Open
Objective Thyroid and cricoid cartilage fractures that are displaced or have multiple fracture lines are traditionally managed with open reduction and internal fixation (ORIF). In practice, patients with penetrating laryngeal trauma may ha…
View article: Can PowerPoint Save Lives? Assessment of Equity and Reach of Traditional Dissemination Channels in Geriatric Trauma Education—A Mixed-Methods Study using Digital Analytics
Can PowerPoint Save Lives? Assessment of Equity and Reach of Traditional Dissemination Channels in Geriatric Trauma Education—A Mixed-Methods Study using Digital Analytics Open
Background Creation of resources for evidence-based clinical guidance does not necessarily improve patient outcomes without deliberate dissemination and implementation. We sought to better understand the effectiveness of pre-recorded didac…
View article: Handoffs and transitions of care in the intensive care unit: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document
Handoffs and transitions of care in the intensive care unit: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document Open
Objectives The American Association for the Surgery of Trauma (AAST) Critical Care Committee chose handoffs and transitions of care in the intensive care unit (ICU) as a clinically relevant topic for review. This clinical consensus documen…
View article: Community of trauma care partnering with stakeholders to improve injury outcomes: survey analysis and panel development
Community of trauma care partnering with stakeholders to improve injury outcomes: survey analysis and panel development Open
Background In June 2021, the Injury Research Engagement Project (I-REP) was established. In 2022, we preformed focus group analysis with patients/caregiver and researchers that resulted in themes in preferences, motivations, and best pract…
View article: Equitable and effective clinical guidance development and dissemination: trauma aims to lead the way
Equitable and effective clinical guidance development and dissemination: trauma aims to lead the way Open
Thirty-four per cent of deaths among Americans aged 1–46 are due to injury, and many of these deaths could be prevented if all hospitals performed as well as the highest-performing hospitals. The Institute of Medicine and the National Acad…
View article: Main versus segmental hepatic artery angioembolization in patients with traumatic liver injuries: A Western Trauma Association multicenter study
Main versus segmental hepatic artery angioembolization in patients with traumatic liver injuries: A Western Trauma Association multicenter study Open
Main hepatic artery angioembolization is associated with increased rates of liver-related complications, multiple liver-related complications, and readmission within 30 days compared with segmental hepatic artery angioembolization. Thus, m…
View article: Venous thromboembolism prophylaxis prescribing patterns for patients with orthopedic trauma: a clinical vignette survey
Venous thromboembolism prophylaxis prescribing patterns for patients with orthopedic trauma: a clinical vignette survey Open
Background A recent clinical trial suggested aspirin is a viable alternative to enoxaparin for venous thromboembolism (VTE) prophylaxis in patients after orthopedic trauma. The initial impact of these findings on VTE prophylaxis prescribin…
View article: Best Case/Worst Case-ICU: protocol for a multisite, stepped-wedge, randomised clinical trial of scenario planning to improve communication in the ICU in US trauma centres for older adults with serious injury
Best Case/Worst Case-ICU: protocol for a multisite, stepped-wedge, randomised clinical trial of scenario planning to improve communication in the ICU in US trauma centres for older adults with serious injury Open
Introduction Poor communication about serious injury in older adults can lead to treatment that is inconsistent with patient preferences, create conflict and strain healthcare resources. We developed a communication intervention called Bes…
View article: Fever and infections in surgical intensive care: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document
Fever and infections in surgical intensive care: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document Open
The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the tw…
View article: Surgical and procedural antibiotic prophylaxis in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document
Surgical and procedural antibiotic prophylaxis in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document Open
The use of prophylactic measures, including perioperative antibiotics, for the prevention of surgical site infections is a standard of care across surgical specialties. Unfortunately, the routine guidelines used for routine procedures do n…
View article: Venous thromboembolism testing practices after orthopaedic trauma: prophylaxis regimen does not influence testing patterns
Venous thromboembolism testing practices after orthopaedic trauma: prophylaxis regimen does not influence testing patterns Open
Objectives: To determine venous thromboembolism (VTE) testing patterns in an orthopaedic trauma population and to evaluate for differences in VTE surveillance by prophylaxis regimen through a secondary analysis of the ADAPT trial. Design: …
View article: SP39. Traumatic Brain Injury In Patients With Frontal Sinus Fractures
SP39. Traumatic Brain Injury In Patients With Frontal Sinus Fractures Open
Purpose: Traumatic brain injury (TBI) is an insult to the brain from an external mechanical force that may lead to short or long-term impairment. TBI has been reported in up to 83% of craniofacial fractures involving the frontal sinus. How…
View article: High-grade liver injuries with contrast extravasation managed initially with interventional radiology versus observation: A secondary analysis of a WTA multicenter study
High-grade liver injuries with contrast extravasation managed initially with interventional radiology versus observation: A secondary analysis of a WTA multicenter study Open
Over 60% of patients were managed with IR initially. IR patients had an increased rate of operation yet similar rates of LRCs and mortality, suggesting initial OBS reasonable in appropriately selected HGLI + Extrav patients.
View article: Effect of Aspirin Versus Low-Molecular-Weight Heparin Thromboprophylaxis on Medication Satisfaction and Out-of-Pocket Costs
Effect of Aspirin Versus Low-Molecular-Weight Heparin Thromboprophylaxis on Medication Satisfaction and Out-of-Pocket Costs Open
Background: Current guidelines recommend low-molecular-weight heparin for thromboprophylaxis after orthopaedic trauma. However, recent evidence suggests that aspirin is similar in efficacy and safety. To understand patients’ experiences wi…
View article: Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis
Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis Open
Introduction Engaging trauma survivors/caregivers results in research findings that are more relevant to patients’ needs and priorities. Although their perspectives increase research significance, there is a lack of understanding about how…
View article: Advanced and alternative research methods for the acute care surgeon scientist
Advanced and alternative research methods for the acute care surgeon scientist Open
Clinical research has evolved significantly over the last few decades to include many advanced and alternative study designs to answer unique questions. Recognizing a potential knowledge gap, the AAST Associate Member Council and Education…
View article: Actual vs Expected Survival With the Use of the Molecular Adsorbent Recirculating System for Acute Liver Failure
Actual vs Expected Survival With the Use of the Molecular Adsorbent Recirculating System for Acute Liver Failure Open
BackgroundAcute liver failure (ALF) has a mortality rate of approximately 50%. Thus, it is evident that improvements in treatment of ALF are necessary. The Molecular Adsorbent Recirculating System (MARS; Baxter), an extracorporeal liver su…
View article: Sigh Ventilation in Patients With Trauma
Sigh Ventilation in Patients With Trauma Open
Importance Among patients receiving mechanical ventilation, tidal volumes with each breath are often constant or similar. This may lead to ventilator-induced lung injury by altering or depleting surfactant. The role of sigh breaths in redu…
View article: Venovenous extracorporeal membrane oxygenation in patients with traumatic brain injuries and severe respiratory failure: A single-center retrospective analysis
Venovenous extracorporeal membrane oxygenation in patients with traumatic brain injuries and severe respiratory failure: A single-center retrospective analysis Open
BACKGROUND Venovenous extracorporeal membrane oxygenation (VV ECMO) can support trauma patients with severe respiratory failure. Use in traumatic brain injury (TBI) may raise concerns of worsening complications from intracranial bleeding. …
View article: American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma: Clinical protocol for damage-control resuscitation for the adult trauma patient
American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma: Clinical protocol for damage-control resuscitation for the adult trauma patient Open
Damage-control resuscitation in the care of critically injured trauma patients aims to limit blood loss and prevent and treat coagulopathy by combining early definitive hemorrhage control, hypotensive resuscitation, and early and balanced …
View article: Establishing a core outcome set for blunt cerebrovascular injury: an EAST modified Delphi method consensus study
Establishing a core outcome set for blunt cerebrovascular injury: an EAST modified Delphi method consensus study Open
Objectives Our understanding of blunt cerebrovascular injury (BCVI) has changed significantly in recent decades, resulting in a heterogeneous description of diagnosis, treatment, and outcomes in the literature which is not suitable for dat…
View article: Early veno-venous extracorporeal membrane oxygenation is an effective strategy for traumatically injured patients presenting with refractory respiratory failure
Early veno-venous extracorporeal membrane oxygenation is an effective strategy for traumatically injured patients presenting with refractory respiratory failure Open
BACKGROUND Venovenous extracorporeal membrane oxygenation (VV ECMO) is used for respiratory failure when standard therapy fails. Optimal trauma care requires patients be stable enough to undergo procedures. Early VV ECMO (EVV) to stabilize…