Injuries

Norton, Robyn; Kobusingye, Olive

doi:10.1056/nejmra1109343

Cited by 331 publications

(232 citation statements)

References 39 publications

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“…According to the 2010 report of the GBD study 89% of trauma-related deaths occur in LMICs. Nearly 6 million people die each year as a result of trauma, accounting for 10% of the world's deaths -32% more than the number of fatalities from malaria, tuberculosis and HIV/AIDS combined 1 .…”

Section: S193mentioning

confidence: 99%

Global neurotrauma research challenges and opportunities

Rubiano

Carney

Chesnut

et al. 2015

Nature

424

277

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Section: S193mentioning

confidence: 99%

Global neurotrauma research challenges and opportunities

Rubiano

Carney

Chesnut

et al. 2015

Nature

424

277

View full text Add to dashboard Cite

“…The global impact of injury has been described as underappreciated, growing by 25% and accounting for more deaths in 2010 (5.1 million) than HIV-AIDS, tuberculosis, and malaria combined (3.8 million). 48 Uncontrolled hemorrhage is the leading cause of potentially preventable death in this group. It is astounding that, today, there are no randomized trials of blood products in this most at-risk population.…”

mentioning

confidence: 99%

Optimal trauma resuscitation with plasma as the primary resuscitative fluid: the surgeon's perspective

Holcomb¹,

2013

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Over the past century, blood banking and transfusion practices have moved from whole blood therapy to components. In trauma patients, the shift to component therapy was achieved without clinically validating which patients needed which blood products. Over the past 4 decades, this lack of clinical validation has led to uncertainty on how to optimally use blood products and has likely resulted in both overuse and underuse in injured patients. However, recent data from both US military operations and civilian trauma centers have shown a survival advantage with a balanced transfusion ratio of RBCs, plasma, and platelets. This has been extended to include the prehospital arena, where thawed plasma, RBCs, and antifibrinolytics are becoming more widely used. The Texas Trauma Institute in Houston has followed this progression by putting RBCs and thawed plasma in the emergency department and liquid plasma and RBCs on helicopters, transfusing platelets earlier, and using thromboelastogram-guided approaches. These changes have not only resulted in improved outcomes, but have also decreased inflammatory complications, operations, and overall use of blood products. In addition, studies have shown that resuscitating with plasma (instead of crystalloid) repairs the "endotheliopathy of trauma," or the systemic endothelial injury and dysfunction that lead to coagulation disturbances and inflammation. Data from the Trauma Outcomes Group, the Prospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study, and the ongoing Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial represent a decade-long effort to programmatically determine optimal resuscitation practices, balancing risk versus benefits. With injury as the leading cause of death in patients age 1 to 44 years and hemorrhage the leading cause of potentially preventable death in this group, high-quality data must be obtained to provide superior care to the civilian and combat injured.

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“…Given that violence and trauma is a public health problem in Colombia, health academic programs should have in PAJT ORIGINAL RESEARCH 1,3,4 Estudiante de Medicina, 2 Estudiante de Enfermeria, 5 Medico de Cuidado Crítico, 6 Neurocirujano de cuidado crítico y trauma; Profesor de Neurociencias y Neurocirugía, Universidad El Bosque, Bogotá, Colombia [1][2][3][4] Universidad Surcolombiana, Neiva, Colombia 5 Director de Programa de Cuidado Prehospitalario, Universidad del Valle, Cali, Colombia PAJT their curriculum, courses that include aspects such promotion, prevention, care and rehabilitation of this group of patients. But these courses are only present in a few programs in medicine and nursing, being necessary to make adjustments to the curriculum in order to improve the overall care and the health public policy development.…”

Section: Discussionmentioning

confidence: 99%

Enseñanza-Aprendizaje de Trauma en Colombia: Un Análisis de Planes de Estudio de Pregrado

Rubiano¹,

Muñoz²,

Ortiz³

et al. 2015

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Jorge Hernán Montenegro Muñoz et al RESUMENIntroduccion: La enseñanza en la prevención, promoción y atención urgente del paciente con trauma ha sido poco implementada en la educación médica de Latinoamérica. La preparación del personal médico y paramédico es fundamental para que el manejo de éste tipo de pacientes sea la adecuada y con calidad. El propósito de este estudio es identificar el estado actual de la enseñanza en el tema específico de cuidado de trauma y violencia tanto de las universidades públicas y privadas colombianas en sus programas académicos de pregrado de Medicina y Enfermería. Materiales Y métodos:Se trata de un estudio descriptivo, con datos obtenidos a través de la revisión del currículo de los programas de pregrado en enfermeria y medicina con registro vigente en el Sistema Nacional de Información de la Educación Superior (SNIES) de Colombia hasta Noviembre de 2013. Se realizaron análisis de frecuencia y bivariados.Resultados: Se analizaron los currículos de 60 Programas Académicos de Enfermería y 52 de Medicina. Solo 7 (13.4%) programas de medicina y 2 (3.3%) de enfermería contaban con asignaturas o materias relacionadas con manejo especifico del paciente con trauma o víctima de violencia. Dentro de los programas de medicina 3 (42.9%) pertenecen al sector público ubicandose la mayor parte en la región central del país. En uno de los currículos se identificaron 3 asignaturas cuyo objetivo es el abordaje y manejo del paciente con trauma. En cuanto a enfermeria los 2 programas hacían parte de la misma Universidad pero en sedes diferentes. Conclusion:Teniendo en cuenta que la violencia y el trauma son un problema de salud pública en Colombia, los diferentes programas académicos en salud deberían contar dentro de su curriculo con asignaturas que incluyan aspectos tan relevantes como la promocion, prevencion, atención y rehabilitación de este grupo de pacientes. Sin embargo dicha cátedra solo esta presente en unos pocos los programas de medicina y enfermería, siendo necesario realizar ajustes al curriculo para lograr su inclusión, con el objetivo de mejorar la atención integral y el desarrollo de políticas públicas. Source of support: Nil Conflict of interest: None ABSTRACTIntroduction: Teaching of prevention, promotion and acute care of the trauma patient has low implementation in Latin American medical education. Preparation of medical and paramedical personnel is fundamental for the appropriate and qualified management of these patients. The purpose of this study is to identify the actual status of medical teaching in this specific topic of trauma and violence care, present in medicine and nursing undergraduate academical programs of private and public universities from Colombia.

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Injuries

Cited by 331 publications

References 39 publications

Global neurotrauma research challenges and opportunities

Global neurotrauma research challenges and opportunities

Optimal trauma resuscitation with plasma as the primary resuscitative fluid: the surgeon's perspective

Enseñanza-Aprendizaje de Trauma en Colombia: Un Análisis de Planes de Estudio de Pregrado

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