Joshua B. Brown
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View article: Drowning in the silver tsunami: Geriatric patient proportion impact on trauma outcomes
Drowning in the silver tsunami: Geriatric patient proportion impact on trauma outcomes Open
View article: A Machine Learning Trauma Triage Model for Critical Care Transport
A Machine Learning Trauma Triage Model for Critical Care Transport Open
Importance Under austere prehospital conditions, rapid classification of injured patients for intervention or transport is essential for providing lifesaving care. Discerning which patients need care most urgently further allows for optima…
View article: Analysis of time to death for children with life‐threatening hemorrhage from traumatic, surgical, and medical etiologies
Analysis of time to death for children with life‐threatening hemorrhage from traumatic, surgical, and medical etiologies Open
Introduction Life‐threatening hemorrhage (LTH) is a significant cause of mortality in pediatrics. Timing of mortality in children with LTH is important for future trials. Methods In a secondary analysis of the prospective observational mas…
View article: Predictive model for optimizing prehospital transfusions in an urban <scp>EMS</scp> system
Predictive model for optimizing prehospital transfusions in an urban <span>EMS</span> system Open
Background Prehospital transfusions might provide a survival benefit for injured patients. Because blood products are a scarce resource, their optimal deployment requires careful consideration. A computer model was built to explore differe…
View article: Adverse Prehospital Events and Outcomes After Traumatic Brain Injury
Adverse Prehospital Events and Outcomes After Traumatic Brain Injury Open
Importance While national guidelines recommend avoidance of hypoxia, hypotension, and hypocarbia in the prehospital care of traumatic brain injury (TBI), limited data validate the association of these adverse physiologic events with TBI ou…
View article: Early achievement of hemostasis defined by transfusion velocity: A possible mechanism for whole blood survival benefit
Early achievement of hemostasis defined by transfusion velocity: A possible mechanism for whole blood survival benefit Open
INTRODUCTION Whole blood resuscitation is associated with survival benefits in observational cohort studies. The mechanisms responsible for outcome benefits have not been adequately determined. We sought to characterize the achievement of …
View article: Early Cold-stored Platelet Transfusion following Traumatic Brain Injury
Early Cold-stored Platelet Transfusion following Traumatic Brain Injury Open
Objective: To determine the feasibility, efficacy, and safety of cold storage compared with room temperature (RT) platelet transfusion in patients with traumatic brain injury (TBI). Background: Data demonstrating the safety and efficacy of…
View article: High-grade liver injury: outcomes with a trauma surgery–liver surgery collaborative approach
High-grade liver injury: outcomes with a trauma surgery–liver surgery collaborative approach Open
Background Operative mortality for high-grade liver injury (HGLI) remains 42% to 66%, with near-universal mortality after retrohepatic caval injury. The objective of this study was to evaluate mortality and complications of operative and n…
View article: External evaluation of Brain Injury Guideline (BIG) low risk criteria for traumatic brain injury
External evaluation of Brain Injury Guideline (BIG) low risk criteria for traumatic brain injury Open
BIG1 criteria identified a low-risk subset of patients with TBI with ICH. However, an upper 95 % CI of 1.9 % does not exclude the risk of neurologic deterioration being <1 %. Validation of these criteria in larger cohorts is warranted.
View article: Association between timing of operative interventions and mortality in emergency general surgery
Association between timing of operative interventions and mortality in emergency general surgery Open
Background Emergency general surgery (EGS) often demands timely interventions, yet data for triage and timing are limited. This study explores the relationship between hospital arrival-to-operation time and mortality in EGS patients. Study…
View article: Identifying trigger cues for hospital blood transfusions based on ensemble of machine learning methods
Identifying trigger cues for hospital blood transfusions based on ensemble of machine learning methods Open
View article: The effect of staged versus rapid immersion on the cardio-respiratory components of the cold-shock response
The effect of staged versus rapid immersion on the cardio-respiratory components of the cold-shock response Open
Drowning is one of the leading causes of accidental death. Sudden cold-water immersion (CWI) leads to the stimulation of cutaneous cold receptors causing the cold-shock response (CSR) which includes a gasp, hyperventilation, and tachycardi…
View article: Characterization of adverse events in injured patients at risk of hemorrhagic shock: a secondary analysis of three harmonized prehospital randomized clinical trials
Characterization of adverse events in injured patients at risk of hemorrhagic shock: a secondary analysis of three harmonized prehospital randomized clinical trials Open
Background The reporting of adverse events (AEs) is required and well defined in the execution of clinical trials, but is poorly characterized particularly in prehospital trials focusing on traumatic injury. In the setting of prehospital t…
View article: Early GFAP and UCH-L1 point-of-care biomarker measurements for the prediction of traumatic brain injury and progression in patients with polytrauma and hemorrhagic shock
Early GFAP and UCH-L1 point-of-care biomarker measurements for the prediction of traumatic brain injury and progression in patients with polytrauma and hemorrhagic shock Open
OBJECTIVE Traumatic brain injury (TBI) and hemorrhage are responsible for the largest proportion of all trauma-related deaths. In polytrauma patients at risk of hemorrhage and TBI, the diagnosis, prognosis, and management of TBI remain poo…
View article: Prehospital tranexamic acid is associated with a survival benefit without an increase in complications: Results of two harmonized randomized clinical trials
Prehospital tranexamic acid is associated with a survival benefit without an increase in complications: Results of two harmonized randomized clinical trials Open
INTRODUCTION Recent randomized clinical trials have demonstrated that prehospital tranexamic acid (TXA) administration following injury is safe and improves survival. However, the effect of prehospital TXA on adverse events, transfusion re…
View article: Increased platelet to red blood cell transfusion ratio associated with acute kidney injury in children with life‐threatening bleeding
Increased platelet to red blood cell transfusion ratio associated with acute kidney injury in children with life‐threatening bleeding Open
Introduction Transfusion may increase the risk of organ failure through immunomodulatory effects. The primary objective of this study was to assess for patient or transfusion‐related factors that are independently associated with the risk …
View article: Patient sex and outcomes in children with life‐threatening hemorrhage
Patient sex and outcomes in children with life‐threatening hemorrhage Open
Background Recent data suggest female sex imparts a survival benefit after trauma in adults. The independent associations between patient sex and age with outcomes have not been examined in children with life‐threatening hemorrhage (LTH) f…
View article: Identifying Trigger Cues for Hospital Blood Transfusions Based on Ensemble Learning Methods
Identifying Trigger Cues for Hospital Blood Transfusions Based on Ensemble Learning Methods Open
Background Traumatic shock is the leading cause of preventable death with most patients dying within the first 6 hours. This underscores the importance of prehospital interventions, and growing evidence suggests prehospital transfusion imp…
View article: Mechanism matters: mortality and endothelial cell damage marker differences between blunt and penetrating traumatic injuries across three prehospital clinical trials
Mechanism matters: mortality and endothelial cell damage marker differences between blunt and penetrating traumatic injuries across three prehospital clinical trials Open
View article: Missingness matters: a secondary analysis of thromboelastography measurements from a recent prehospital randomized tranexamic acid clinical trial
Missingness matters: a secondary analysis of thromboelastography measurements from a recent prehospital randomized tranexamic acid clinical trial Open
Background Tranexamic acid (TXA) has been hypothesized to mitigate coagulopathy in patients after traumatic injury. Despite previous prehospital clinical trials demonstrating a TXA survival benefit, none have demonstrated correlated change…
View article: Commentary on gaps in prehospital trauma care: education and bioengineering innovations to improve outcomes in hemorrhage and traumatic brain injury
Commentary on gaps in prehospital trauma care: education and bioengineering innovations to improve outcomes in hemorrhage and traumatic brain injury Open
Hemorrhage remains the leading cause of preventable death on the battlefield and the civilian arena. Many of these deaths occur in the prehospital setting. Traumatic brain injury also represents a major source of early mortality and morbid…
View article: Platelet-inspired synthetic nanoparticles improve hemostasis and hemodynamics in a rabbit model of abdominal hemorrhage
Platelet-inspired synthetic nanoparticles improve hemostasis and hemodynamics in a rabbit model of abdominal hemorrhage Open
BACKGROUND Early platelet transfusion is associated with reduced mortality in traumatic hemorrhage. However, platelet usage is severely limited because of the challenges of donor availability, platelet portability, and storage. Here, we re…
View article: Prehospital Time Following Traumatic Injury Is Independently Associated With the Need for In-Hospital Blood and Early Mortality for Specific Injury Types
Prehospital Time Following Traumatic Injury Is Independently Associated With the Need for In-Hospital Blood and Early Mortality for Specific Injury Types Open
View article: Association between trauma triage and time-to-vaso-occlusive events in patients with sickle cell disease after traumatic injury: a retrospective study
Association between trauma triage and time-to-vaso-occlusive events in patients with sickle cell disease after traumatic injury: a retrospective study Open
Introduction Sickle cell disease (SCD) is associated with vaso-occlusive events (VOEs) that can lead to disease complications, including early mortality. Given that similar inflammatory responses characterize VOE and traumatic injury, inju…
View article: Doing more with less: low-titer group O whole blood resulted in less total transfusions and an independent association with survival in adults with severe traumatic hemorrhage
Doing more with less: low-titer group O whole blood resulted in less total transfusions and an independent association with survival in adults with severe traumatic hemorrhage Open
View article: Impact of patient, system, and environmental factors on utilization of air medical transport after trauma
Impact of patient, system, and environmental factors on utilization of air medical transport after trauma Open
BACKGROUND Air medical transport (AMT) improves outcomes for severely injured patients. The decision to fly patients is complex and must consider multiple factors. Our objective was to evaluate the interaction between geography, patient an…
View article: Evaluating potential disparities in geospatial access to American College of Surgeons/American Association for the Surgery of Trauma–verified emergency general surgery centers
Evaluating potential disparities in geospatial access to American College of Surgeons/American Association for the Surgery of Trauma–verified emergency general surgery centers Open
BACKGROUND The American Association for the Surgery of Trauma and the American College of Surgeons have recently introduced emergency general surgery (EGS) center verification, which could enhance patient outcomes. Distance and resource av…
View article: Association Between Emergency Medical Service Agency Volume and Mortality in Trauma Patients
Association Between Emergency Medical Service Agency Volume and Mortality in Trauma Patients Open
Objective: The aim of this study was to evaluate the association of annual trauma patient volume on outcomes for emergency medical services (EMS) agencies. Background: Regionalization of trauma care saves lives. The underlying concept driv…
View article: What is the Physical Activity of Emergency Physicians (Residents and Attendings) During a Shift, Measured in Steps Walked? The STEP study: Quantitative Study of Steps Taken in an Emergency Program (STEP)
What is the Physical Activity of Emergency Physicians (Residents and Attendings) During a Shift, Measured in Steps Walked? The STEP study: Quantitative Study of Steps Taken in an Emergency Program (STEP) Open
What is the Physical Activity of Emergency Physicians (Residents and Attendings) During a Shift, Measured in Steps Walked? The STEP study: Quantitative Study of Steps Taken in an Emergency Program (STEP)
View article: Timing, triage, and mode of emergency general surgery interfacility transfers in the United States: A scoping review
Timing, triage, and mode of emergency general surgery interfacility transfers in the United States: A scoping review Open
Interfacility transfer of emergency general surgery (EGS) patients continues to rise, especially in the context of ongoing system consolidation. This scoping review aims to identify and summarize the literature on triage, timing, and mode …