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Dissertations / Theses on the topic 'Polytrauma'

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Published: 4 June 2021
Last updated: 25 January 2023

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1

Wilder, Schaaf Kathryn. "Polytrauma Family Needs Assessment." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2051.

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There is a great deal of literature in civilian rehabilitation settings that documents the tremendous impact a brain injury has on both the injured person and the family as a whole. TBI is a leading cause of both death and disability world-wide and is often cited as the signature injury of the ongoing OEF/OIF conflict. In 2005, Congress recognized the severity of injuries that military personnel were encountering in the OEF/OIF conflicts and created the Polytrauma System of Care (PSC). While the PSC has made great efforts to provide innovative and effective treatment for active duty and veteran patients, little is known about the needs of their family members. Given the tremendous impact TBI has on families and the important caregiving role assumed by many, there is an urgent need to better understand their needs. The Family Needs Questionnaire (FNQ) was administered to 44 family members of patients at the Polytrauma Rehabilitation Center (PRC) at McGuire Veterans Affairs Medical Center (VAMC) over a 30 month period. Family members rated 40 needs indicating the importance and extent to which needs were met. Results were compared with findings from similar studies in civilian rehabilitation settings. A review of the rated needs indicated that PRC families rated the needs in the Health Information domain as most important and most frequently met. In addition, PRC family members rated Emotional Support and Instrumental Support as least important and most frequently unmet. Overall results were consistent with findings in civilian rehabilitation research, but subtle differences were examined. Exploratory analyses were conducted to examine a subset of family variables associated with needs indices. Needs were rated differently based on respondents', gender, income, relationship to patient, and time since injury. Results highlight similarities across family needs in rehabilitation settings. However, there remains a need for further research within VAMC PRC's that include a larger more diverse sample and participants utilizing both inpatient and outpatient services.
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2

Häusler, Jean-Marc Christian. "Die volkswirtschaftlichen Kosten von Polytrauma /." Bern : [s.n.], 2002. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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3

Ahrberg, Annette B., and Johannes K. M. Fakler. "Missed foot fractures in polytrauma patients." Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-137137.

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BACKGROUND: Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient's life. The aim of this study is to find out how many of these fractures are overlooked in a Level I trauma center and what the consequences for the patients are hypothesing that patients with a delayed diagnosis will have worse clinical results. METHODS: Forty-seven patients (7.3%) with foot fractures could be identified in 642 polytrauma patients, retrospectively. All patients were divided into two groups: early diagnosed fractures and delayed diagnosed fractures, the latter defined as diagnosed after Secondary Survey. Patients were evaluated according to the Hannover Outcome Score, the Short Form-36 Health Survey, the AOFAS Score and the Hannover Scoring System. The average follow-up was 5 years and 8 months. Reasons for overlooking a foot fracture were analyzed. RESULTS: The foot fracture was early diagnosed in 26 (55.3%) patients, but delayed in 21 (44.7%). There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results. CONCLUSIONS: In summary, the results of this study show that foot injuries can be a safety problem for the patient and the examination of the feet in the trauma room has to be a compulsory part of the algorithm. Although the majority of delayed diagnosed foot fractures demonstrated comparable results to the immediately diagnosed fractures, approximately 10% might have benefited from an earlier diagnosis. Even if there were no significant differences in the clinical results, we have to be aware that missing a fracture in the foot can lead to worse results in the complete polytrauma care.
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4

Lampl, Lorenz A. "Veränderungen der Hämostase als unmittelbare Folge der Polytraumatisierung : Untersuchungen zur Charakterisierung von Störungen der Blutgerinnung und der Fibrinolyse im Zeitraum der notärztlichen Versorgung mehrfachverletzter Patienten /." Lengerich : Pabst, 1996. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=007287826&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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5

Negwer, Judith. "Untersuchung eines Jahrgangs Polytraumatisierter in Bezug auf die Lebensführung." [S.l. : s.n.], 2008. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-62439.

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6

Knorr, Karina. "Einfluss unterschiedlicher Konzepte zum primären Volumenersatz bei polytraumatisierten Patienten im Hinblick auf die primäre inflammatorische Entzündungsreaktion." [S.l. : s.n.], 2007. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-60148.

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7

Binner, Johannes [Verfasser]. "Besonderheiten beim Polytrauma im Kindesalter / Johannes Binner." Ulm : Universität Ulm, 2018. http://d-nb.info/1159957746/34.

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8

Шищук, Дмитро Володимирович, Дмитрий Владимирович Шищук, Dmytro Volodymyrovych Shyshсhuk, Юрій Васильович Шкатула, Юрий Васильевич Шкатула, Yurii Vasylovych Shkatula, and А. Г. Биденко. "Алгоритм оказания специализиро-ванной помощи детям с политравмой." Thesis, Видавництво СумДУ, 2008. http://essuir.sumdu.edu.ua/handle/123456789/6869.

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Мы проанализировали результаты лечения 37 детей с политравмой. У пострадавших превалировали закрытые сочетанные травмы опорно-двигательного аппарата и головы. Оперативные вмешательства, выполняемые детям были разнообразны. Представленный перечень оперативных вмешательств свидетельствует о необходимости манипуляций во всех анатомо-функциональных областях, что формирует соответствующие требования к структуре функциональных подразделений стационаров, организации круглосуточного функционирования его служб, составу дежурных бригад хирургов, материально-техническому оснащению. При цитировании документа, используйте ссылку http://essuir.sumdu.edu.ua/handle/123456789/6869
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9

Шевченко, Володимир Порфирович, Владимир Порфирьевич Шевченко, Volodymyr Porfyrovych Shevchenko, О. О. Шевченко, and О. С. Горовой. "Синдром взаємного обтяження у поєднанні з черепно-мозковою та екстракраніальною травмами." Thesis, Видавництво СумДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/5603.

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10

Шкатула, Юрій Васильович, Юрий Васильевич Шкатула, Yurii Vasylovych Shkatula, Є. В. Дорочкін, Антоніна Миколаївна Бабінець, Антонина Николаевна Бабинец, and Antonina Mykolaivna Babinets. "Надання невідкладної допомоги при гострій крововтраті потерпілим з політравмою." Thesis, Вид-во СумДУ, 2007. http://essuir.sumdu.edu.ua/handle/123456789/5332.

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11

Шищук, Володимир Дмитрович, Владимир Дмитриевич Шищук, Volodymyr Dmytrovych Shyshchuk, and И. С. Бхуллар. "Тактика ведения больных с политравмой." Thesis, Изд-во СумГУ, 2005. http://essuir.sumdu.edu.ua/handle/123456789/7404.

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12

Schott, Artjom [Verfasser]. "Wertigkeit von Blutgasanalyseparametern als Prognoseindikatoren nach Polytrauma / Artjom Schott." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/117595537X/34.

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13

Behling, Maike [Verfasser]. "Genexpressionsanalyse septischer Patienten nach Polytrauma im Zeitverlauf / Maike Behling." Gießen : Universitätsbibliothek, 2019. http://d-nb.info/1189066025/34.

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14

Thierer, Felix Johannes [Verfasser]. "Transkriptionelle Sepsissignatur in Patienten mit Polytrauma / Felix Johannes Thierer." Gießen : Universitätsbibliothek, 2011. http://d-nb.info/106119597X/34.

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15

Eisele, Philipp [Verfasser]. "Posttraumatische Gefahrenantwort nach experimentellem Polytrauma und hämorrhagischem Schock / Philipp Eisele." Ulm : Universität Ulm, 2020. http://d-nb.info/1205001786/34.

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16

Leimcke, Benjamin. "Inzidenz von Fußverletzungen bei polytraumatisierten Patienten- ist die verzögerte Diagnose wirklich ein Problem?" Doctoral thesis, Universitätsbibliothek Leipzig, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-81578.

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Diese Arbeit beschreibt verzögert detektierten Fußfrakturen bei 47 Polytraumapatienten, die im Zeitraum zwischen 01.01.2000 und 31.12.2004 aufgrund eines Polytraumas in der Klinik für Unfall-, Wiederherstellungs- und Plastische Chirurgie der Universität Leipzig behandelt wurden. 30 Patienten wurden mittels Fragebogen, davon 19 klinisch und radiologisch nachuntersucht. Für die Ermittlung des Outcome der Patienten wurden der AOFAS- Mittel- und -Rückfuß, HSS-, HS-, und der SF - 36 Fragebogen verwand. Zusätzlich erfolgten native Röntgenaufnahmen der Füße in 3 Ebenen und bei Calcaneusfrakturen nach Broden. Die Gründe für eine verzögerte Diagnose von Fußverletzungen wurden eruiert und die klinischen und im Outcome relevanten Läsionen extrahiert. Probleme welche im prioritätsorientierten Behandlungsablauf auftraten und Folgen für die Lebensqualität der Patienten hatten wurden ermittelt. Die Resultate der Scores wurden mittels T- Test und linearer Regression auf Allgemeingültigkeit und hinsichtlich den singulären Einfluss der verzögerten Detektion der Fraktur nachuntersucht. Die Ergebnisse dieser Arbeit zeigen, dass polytraumatisierte Patienten einem hohen Risiko unterliegen, dass eine Fraktur eines Fußknochens verzögert detektiert wird. Diese Verzögerung führt in 14,4 % der Fälle zu einer Änderung der Therapie. Eine erhöhte Rate an Komplikation während der Behandlung oder einen signifikant negativen Einfluss auf das Outcome der Patienten konnte nicht festgestellt werden. Die Zeitdauer bis diese erkannt wird hat einen negativen Einfluss auf das Outcome der Patienten. Abweichungen im Outcome sowie Komplikationen und Probleme in der Therapie traten in 4,8 % der Fälle auf.
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17

Schwarz, Mathias. "Protein S-100B, diagnostischer und prognostischer Faktor nach Schädelhirntrauma." [S.l. : s.n.], 2006. http://nbn-resolving.de/urn:nbn:de:bsz:289-vts-55852.

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18

Schwabe, Karola [Verfasser]. "Alter und Überlebenswahrscheinlichkeit nach Polytrauma - Local Tailoring des DGU Prognosemodells / Karola Schwabe." Greifswald : Universitätsbibliothek Greifswald, 2012. http://d-nb.info/1020643005/34.

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19

Шкатула, Юрій Васильович, Юрий Васильевич Шкатула, Yurii Vasylovych Shkatula, В. В. Тимощук, and А. Ю. Шкрумада. "Оцінка вірогідності розвитку шоку у постраждалих з політравмою." Thesis, Видавництво СумДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/5412.

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20

Matz, Rainer Michael. "Dynamik des STAT/SOCS-Regulationsmechanismus in der frühen posttraumatischen Phase nach schwerem Polytrauma." Diss., Ludwig-Maximilians-Universität München, 2015. http://nbn-resolving.de/urn:nbn:de:bvb:19-179523.

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21

Baumer, Sebastian Peter [Verfasser], and Peter [Akademischer Betreuer] Angele. "Inzidenz und Outcome der Carotisdissektion beim Polytrauma / Sebastian Peter Baumer. Betreuer: Peter Angele." Regensburg : Universitätsbibliothek Regensburg, 2015. http://d-nb.info/107877417X/34.

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22

Braun, Christian Karl [Verfasser]. "Inflammatory response of cardiomyocytes after experimental polytrauma and haemorrhagic shock / Christian Karl Braun." Ulm : Universität Ulm, 2020. http://d-nb.info/1219577685/34.

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23

Fakler, Johannes K. M., Orkun Özkurtul, and Christoph Josten. "Retrospective analysis of incidental non-trauma associated findings in severely injured patients identified by whole-body spiral CT scans." Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-151581.

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Background: Whole-body Computed Tomography (CT) scan today is considered a crucial imaging technique in the diagnostic work-up of polytrauma patients implicating a potential survival benefit. Apart from prompt identification of life threatening injuries this imaging technique provides an additional benefit by diagnosing incidental non-trauma associated medical diseases. These incidental findings might be also life threatening and warrant urgent therapy. The downside of whole-body CT is a relatively high radiation exposure that might result in an increased life time cancer risk. The aim of this study was to investigate the frequency and type of non trauma associated incidental medical findings in relation to patient age and potential clinical relevance. Methods: Between January 1st 2011 and December 15th 2012, a total of 704 trauma patients were referred to our hospital’s emergency room that triggered trauma room alarm according to our trauma mechanism criteria. Of these 534 (75.8%) received a whole-body CT according to our dedicated multiple trauma protocol. Incidental Findings (IF) were assigned in three groups according to their clinical relevance. Category 1: IF with high medical relevance (urgent life threatening conditions, unless treated) needing early investigations and intervention prior to or shortly after hospital discharge. Category 2: IF with intermediate or low medical relevance, warranting further investigations. Category 3: IF without clinical relevance. Results: Overall 231 IFs (43.3%) were identified, 36 (6.7%) patients had IFs with a high clinical relevance, 48 (9.0%) with a moderate or minor clinical relevance and 147 (27.5%) with no clinical relevance. The distribution of incidental findings with high or moderate relevance according to age showed an incidence of 2.6%, 6.6% and 8.8% for patients younger than 40 years, 40 to 60 years and older than 60 years, respectively. Conclusion: Whole-body CT scans of trauma patients demonstrate a high rate of incidental findings. Potentially life-threatening, medical findings were found in approximately every 15th patient, predominantly aged over 40 years and presenting with minor to moderate injuries and an Injury Severity Score (ISS) of 10 or less.
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24

Torrance, Hew D. T. "Immune dysfunction following severe polytrauma & major surgery : exploring mechanisms & identifying potential therapies." Thesis, Queen Mary, University of London, 2017. http://qmro.qmul.ac.uk/xmlui/handle/123456789/24865.

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Introduction Following polytrauma and major surgery patients experience a period of immunosuppression, which can predispose them to the development of nosocomial infections. This thesis examines how polytrauma and surgery influences T-helper (Th) cell differentiation and antigen presentation, whilst exploring how the detrimental immunomodulatory effects of these insults may be reversed. Methods Serial blood samples were drawn from two cohorts of patients at The Royal London Hospital; following severe polytrauma (n=112) or major abdominal surgery (n=119). mRNA levels of candidate cytokines and transcription factors were assayed, along with protein levels of key cytokines IL-10 and IL-6. Associations between these data, acquisition of nosocomial infection and outcome were described. As a validated surrogate of immune competence CD14+HLA-DR levels were quantified. In vitro models explored the reversibility of tissue damage induced immunosuppression and determined the role of individual circulating mediators in altering host immune function. Results A consistent up-regulation in gene expression of prototypical anti-inflammatory pathways in conjunction with features of depressed pro-inflammatory Th cell pathways was detected across both cohorts. This was accompanied by early down-regulation of CD14+HLA-DR. Gene expression changes were quantitatively associated with the subsequent acquisition of nosocomial infections. Allogeneic blood transfusion exacerbated these findingsand was independently associated with an increased risk of nosocomial infection. Culture experiments determined that postoperative decreases in antigen presentation were IL-10 dependent and reversible in the presence of Interferon-Gamma and Granulocyte Monocyte- Colony Stimulating Factor. Conclusions This thesis describes a significant host immune response immediately following significant tissue damage which is dominated by features of immune suppression. Blood transfusion appears to have a distinct, additive effect. These data identify a potential role for targeted treatment with currently licenced immune stimulants (IFN-γ and GM-CSF). In addition exploitation of the IL-10 signalling pathway may be of importance as a strategy to reduce the incidence of nosocomial infections.
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25

Moloko, Salaminah S. "Nursing outcome standards for polytrauma patients with traumatic brain injuries in the Mafikeng district." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52372.

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Thesis (MCUR)--University of stellenbosch, 2001.
ENGLISH ABSTRACT: In trauma the priority is given to identifying the life-threatening injuries and immediately implementing treatment (Demetriades, 1993:3). Severe trauma resuscitation and assessment often have to be carried out simultaneously to detect and treat conditions that are rapidly fatal if not attended to immediately and according to priority. Urgent priorities in trauma management include maintaining a clear and patent airway to facilitate respiration and cervical spine protection by avoiding rough manipulation of the head and neck by supporting the neck with a neck immobiliser. Any external bleeding has to be controlled by applying direct pressure to the wound. Cardiovascular problems, for example shock or myocardial infarction, respiratory problems and hypoxia which are detrimental, particularly in the case of head injury, should be excluded. A detailed head-to-toe examination which includes the head, neck, chest, abdomen, back, musculo-skeletal system, rectum and vagina has to be performed. For the head-injured patient, correct any condition, which may complicate the existing head injury, for example hypoxia, shock, pneumothorax and fractures of long bones or pelvis. Implement the A (airway), B (breathing), C (circulation), D (disability, neurological and drugs) and E (environment) for structured management of the patient. Muller's, (1996) two-phase model was utilised to formulate and validate nursing outcome standards. In phase one literature was explored to develop provisional standards on polytrauma patients with traumatic brain injuries. In phase two the provisional standards were validated by experts (doctors and nurses) in critical care, trauma and emergency nursing including nurses and a doctor working in the casualty department of a provincial hospital in Mafikeng. Final standards were formulated and adapted accordingly. Standards for the management of a polytrauma patient with traumatic brain injuries included: A safe environment for patients, nurses and doctors Primary survey in casualty department which includes the maintenance of airway, breathing, circulation, disability/ neurological, drugs and exposure The secondary survey that includes the head to toe examination, definitive orthopaedic care and stabilisation before transfer to the intensive care unit A standard on all relevant equipment which might be needed in case the patient goes into cardiac arrest on the way to the intensive care unit, was also formulated. The standard on documentation included the primary and secondary survey in the casualty department, transport to the intensive care unit, activities and the condition of the patient. The final standards dealt with the accurate handing over of the patient to the intensive care personnel. The following recommendations were made: • Implement the outcome standard by means of a quality improvement programme through a top-down approach. • Provide training: Nurses and doctors have an obligation to render quality care, therefore they have the right to be trained in emergency procedures. • All registered nurses working in the casualty or emergency departmentsshould be trained in at least Basic Life Support (CPR), Advanced Cardiac Life Support (ACLS), Advanced Paediatric Life Support (APLS) and Advanced Trauma Life Support (ATLS) while waiting to be sent for the trauma-nursing course. • Improve infection control measures in the casualty department • Emergency drugs must always be available. • Improve the on-call system. • Formulate a policy on sharing of the equipment by both casualty and ICU staff. • Motivate for the necessary equipment. Implement procedures for debriefing of staff, the evaluation of actions during resuscitation and implement measures for psychological support of the family. • For further research, implement and test a training programme whereby nurses can formulate their own standards. • Evaluate whether the standards have improved the quality of trauma care, and develop standards for leu nursing of the brain injured patient and the rehabilitation of polytrauma patients with traumatic brain injuries The uniqueness of the study lies in the fact that no formal outcomes standard for trauma patients with traumatic brain injuries have been developed in any of the North West Provincial hospitals.
AFRIKAANSE OPSOMMING: Die identifisering van lewensbedreigende beserings en die onmiddellike implementering van behandeling, is in trauma 'n eerste prioriteit (Demetriades, 1993: 3). Resussitasie en die beraming van erge traumagevalle noodsaak in baie gevalle, gelyktydige hantering. Sou hierdie hantering nie gelyktydig en onmiddellik volgens prioriteit plaasvind nie, kan dit noodlottige gevolge inhou. Belangrike prioriteite in traumabehandeling sluit in, die instandhouding van 'n patente lugweg om asemhaling te onderhou asook die beskerming van die servikale rugmurgkolom, deur die ruwe manipulasie van die kop en nek te vermy deur die implementering van 'n nekimmobiliseerder. Kardiovaskulere probleme, byvoorbeeld skok of miokardiale infarksie, asook respiratoriese probleme wat lewensbedreigend vir die pasient met 'n hoofbeseering is, moet uitgesluit word. 'n Gedetailleerde van kop-tot-tone ondersoek, wat die kop, nek, borskas, abdomen, rug, muskulo-sketale stelsel, rektum en vagina insluit, moet uitgevoer word. In die pasient met hoofbeserings moet enige toestand byvoorbeeld frakture van die langbene of die pelvis, skok of 'n pneumothorax, eers behandel word. Implementeer die A (Iugweg - "airway"), B (asemhaling - "breathing"), C (sirkulasie -"circulation"), D (gestremdheid - "disability", neurologies- "neurological" en drogerye-"drugs") en E (omgewing - "environment") vir die gestruktureerde behandeling van die pasient. Die twee fase model van Muller (1996) is gebruik vir die formulering en validering van die verpleeguitkomsstandaarde. In fase een is die literatuur verken om die voorlopige standaarde vir polytrauma pasiente met traumatiese breinbeserings te ontwikkel. In fase twee is die voorlopige standaarde gevalideer deur kundiges (dokters en verpleegkundiges) in kritieke sorg, trauma en noodverpleging. Die verpleegkundiges en dokter wat werksaam is in die ongevalle-eenheid van 'n plaaslike provinsiale hospitaal in Mafikeng is ook ingesluit. Finale standaarde is geformuleer en dienooreenkomstig aanvaar. Die standaarde vir die politrauma pasient met traumatiese breinbeserings, sluit in: 'n Veilige omgewing vir pasiente, verpleegkundiges en dokters. Die prirnere beraming in ongevalle ten opsigte van instandhouding van die lugweg, asemhaling, sirkulasie, gestremdheid, drogerye en blootstelling. Die sekondere beraming: wat behels die kop-tot-tone ondersoek. Definitiewe ortopediese behandeling en stabilisering voor oorplasing na die intensiewe-sorg-eenheid. 'n Standaard met betrekking tot die nodige toerusting wat benodig mag word tydens 'n hart stilstand, oppad na die intensiewe-sorg-eenheid, is ook geformuleer. Die standaard ten opsigte van dokumentasie sluit die primere, en sekondere beraming, vervoer na die intensiewe-sorg-eenheid, aktiwiteite en toestand van die pasient, in. Die finale standaarde is gebaseer op die oorhandiging van die pasient aan die intensiewe-sorg-personeel. Die volgende aanbevelings word gemaak: • Implementeer die uitkomsstandaarde deur middel van 'n gehalteverbeteringsprogram deur gebruik te maak van 'n "top-down" benadering -, • Voorsien opleiding: Verpleegkundiges en dokters het 'n verpligting om gehaltesorg te lewer, hulle het dus 'n reg om onderrig te ontvang in noodprosedures, en verder het die pasient die req op gehalter noodbehandeling. • Aile geregistreerde verpleegkundiges wat in die ongevalle en die noodafdeling werk, behoort opgelei word in ten minste basiese lewensondersteuning (CPR), Gevorderde Trauma Lewens Ondersteuning (ACLS), Gevorderde Pediatriese lewensondersteuning (APLS) en Gevorderde Trauma lewensondersteuning (ATLS), terwyl gewag word om die trauma verpleegkundigekursus te deurloop. • Verbeter mteksiebeheermaatreels in ongevalle. • Noodmedikasie moet ten aile tye beskikbaar wees. • Verbeter die op-roepstelsel ("on cali"). • Formuleer 'n beleid oor die gesamentlike gebruik van toerusting deur beide ongevalle- en intensiewe-sorg-eenheid-personeel. • Motiveer vir die nodige toerusting. • Implementeer prosedures om personeel to te laat vir ontlonting (debriefing), die evaluering van aksies tydens die resusitasie prosedure en implementeer metodes vir die sielkundige ondersteuning van die familie. • Ten opsigte van verdere narvorsing behoort 'n opleidingsprogram qeunplernenteer en getoets te word met betrekking tot verpleegkundiges wat hulle eie standaarde will formuleer. • Evalueer of die standaarde die gehalte van traumasorg verbeter het en ontwikkel standaarde vir intensierwe-sorg-verpleging van die breinbeseerde pasient asook die rehabilitasie van politrauma pasiente met traumatise breinbeesering. Die unieke bydra van die studie word gevind in die feit dat daar nog geen gerformaliseerde uitkomstandaarde vir traumapasiente met breinbeseerings in enige van die Noord Wes Provinsie se hospitale ontwikkel is nie.
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Raida, Markus [Verfasser], Rainer [Gutachter] Meffert, and Thomas [Gutachter] Wurmb. "Kosteneffizienzanalyse der Polytrauma-Patienten im Jahr 2010 / Markus Raida. Gutachter: Rainer Meffert ; Thomas Wurmb." Würzburg : Universität Würzburg, 2014. http://d-nb.info/1110028148/34.

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Hubbard, W. Brad. "Investigating Injury Pathology of Blast-induced Polytrauma and Assessing the Therapeutic Role of Hemostatic Nanoparticles after Blast Exposure." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/79722.

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Explosions cause the majority of injuries in the current conflicts, accounting for 79% of combat related injuries (Ramasamy et al. 2008). Blast overpressure from explosions can cause barotrauma to the lungs and the brain. Blast-induced mild traumatic brain injury has been labeled the "signature wound" of current military conflicts in Iraq and Afghanistan (Snell and Halter 2010). In addition to elevated number of blast-induced traumatic brain injuries due to increased military conflicts overseas and the usage of improvised explosive devices, the incidence of blast-induced polytrauma has risen due to the prevalence of terrorist events around the world (Arnold et al. 2004, Rodoplu et al. 2004). Blast-induced polytrauma is a major concern as lung injury can cause immediate mortality and brain injury causes long-lasting neurocognitive impairment. There is a critical lack of understanding the pathology of blast-induced polytrauma since the needs are multifaceted and therefore few options for treatment. Thus, the research presented in this dissertation required the development of a military-relevant blast polytrauma model to examine injury pathology and subsequently study the effects of hemostatic nanoparticle therapy after blast-induced polytrauma. The pre-clinical model was characterized and static overpressure thresholds were determined for lethality risk. It was confirmed to have many of the classic hallmarks of primary blast lung injury (PBLI), as well as blast-induced neurotrauma (BINT) (Clemedson 1950). Global hemorrhaging was found in the lungs and well as reduced oxygen saturation. Markers of astrogliosis and blood-brain barrier disruption were examined in the amygdala after blast. The novel nanoparticle configuration (hemostatic dexamethasone-loaded nanoparticles (hDNP) functionalized with a peptide that binds with activated platelets) was investigated and hypothesized to increase survival, reduce cellular injury and reduce anxiety-like disorders after blast polytrauma. After investigating hDNP, it was found that the hDNP treatment benefited survival percentage after injury as well as reduced percent hemorrhage in the lungs and improved physiology. Elevated anxiety parameters found in the controls were lower as compared to the hDNP group. Glial fibrillary acidic protein (GFAP) and cleaved caspase-3 were significantly elevated in the controls compared to the hDNP group in the amygdala. SMI-71 was also significantly elevated with the hDNP and hemostatic nanoparticle (hNP) treatments, similar to sham. In addition to the nanoparticles offering immediate life-saving qualities, administration of hemostatic nanoparticles improved amygdala pathology attributed to secondary mechanisms of blast injury, including blood-brain barrier disruption. This model of polytrauma can serve as a foundation for detailed pathological studies as well as testing therapeutics for injury modalities. References (Abstract) Arnold, J. L., P. Halpern, M. C. Tsai and H. Smithline (2004). "Mass casualty terrorist bombings: a comparison of outcomes by bombing type." Ann Emerg Med 43(2): 263-273. Clemedson, C. J., Granstom, S.A. (1950). "Studies on the genesis of "rib markings" in lung blast injury." Acta Physiol Scand. 21: 131-144. Ramasamy, A., S. E. Harrisson, J. C. Clasper and M. P. Stewart (2008). "Injuries from roadside improvised explosive devices." J Trauma 65(4): 910-914. Rodoplu, U., Arnold, J. L., Tokyay, R., Ersoy, G., Cetiner, S., Yucel, T. (2004) "Mass-casualty terrorist bombings in Istanbul, Turkey, November 2003: reports of the events and the prehospital emergency response." Prehosp Disaster Med 19(2):133-145. Snell, F. I. and M. J. Halter (2010). "A signature wound of war: mild traumatic brain injury." J Psychosoc Nurs Ment Health Serv 48(2): 22-28.
Ph. D.
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Jalil, Sales Mohammadreza. "Die Versorgung Polytraumatisierter und Schädel-Hirn-Verletzter unter besonderer Berücksichtigung mund-, kiefer- und gesichtschirurgischer Verletzungen im Zeitraum vom 1. Juli 1998 bis 30. Juni 1999." [S.l. : s.n.], 2006.

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Halbgebauer, Rebecca [Verfasser]. "Early changes in immune, coagulation, and organ function after clinical and experimental polytrauma / Rebecca Halbgebauer." Ulm : Universität Ulm, 2019. http://d-nb.info/1180496949/34.

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Kroczek, Eduard Konstanty [Verfasser]. "Zufallsbefunde in der Ganzkörper-Computertomographie bei Polytrauma-Patienten : Prävalenz, Kommunikation und Kodierung / Eduard Konstanty Kroczek." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2017. http://d-nb.info/1148425195/34.

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Costa, Samuel André Bailador. "Maneio do paciente politraumatizado na clínica de animais de companhia." Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2014. http://hdl.handle.net/10400.5/7577.

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Dissertação de Mestrado Integrado em Medicina Veterinária
Resumo: O politraumatismo consiste em múltiplas lesões orgânicas causadas por um mesmo acidente, com pelo menos uma delas a causar risco de vida. A pesquisa bibliográfica pretende demonstrar a importância da abordagem de urgência nestes pacientes segundo o ABCDE, que é o sistema universalmente aceite para diagnosticar e corrigir estas lesões e também da correta monitorização para evitar as complicações que surgem mais frequentemente. São também abordados os tipos de trauma mais importantes e o tratamento comum a todos. Finalmente são analisados os indicadores de trauma que dão uma noção da gravidade do processo e do prognóstico, permitindo a adoção de medidas precoces que visam reduzir a mortalidade. O estudo clínico realizado propõe a caraterização de uma população de pacientes politraumatizados principalmente quanto às suas causas mais frequentes e tipos de trauma. Para além disso é determinado o valor na triagem do lactato e, de forma inovadora, do índice de choque, como indicadores da mortalidade nesta população. Observou-se que o trauma cutâneo e músculo-esquelético apresentaram maiores prevalências, alertando a importância da deteção e correção destas lesões, para além das que causam risco de vida eminente. Mesmo com uma única medição na triagem, o lactato apresentou uma relação fiável com a mortalidade, sendo valores superiores a 6 mmol/L associados prognósticos mais reservados. O índice de choque não demonstrou uma correlação clara com a mortalidade sendo de interesse explorar mais a sua função como indicador do prognóstico.
ABSTRACT - MANAGEMENT OF POLYTRAUMA IN THE SMALL ANIMAL CLINICAL PRACTICE - Polytrauma refers to multiple organ systems injuries caused by a single accident, with at least one of them being life threatening. The bibliographic research intents to show the importance of the emergency approach to these patients according to the ABCDE witch is the universally accepted system to diagnose and correct these injuries. Additionally, there must be an adequate monitoring to avoid the complications witch frequently arise. The most important types of trauma and their common treatment are also mentioned. The indicators of trauma are finally analyzed, giving a notion of gravity and prognosis, allowing precocious measures to be taken to reduce mortality. The clinical study conducted characterizes a population of polytrauma patients by causes and types of trauma. In addition, lactate and innovatively, shock index, are determined as indicators of mortality in this population. Cutaneous and musculoskeletal were the most prevalent traumas, alerting the importance of detecting and correcting these lesions, besides the ones that are life threatening. Lactate was showed to be related with mortality in polytrauma even with a single measurement during triage, with values greater than 6 mmol/L associated with worst prognosis. Shock index didn’t show a clear correlation with mortality but it might be of interest to further explore its role as a prognostic indicator.
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Томин, Любов Василівна, Любовь Васильевна Томин, and Liubov Vasylivna Tomyn. "Особливості лікування переломів кісток гомілки у дітей з політравмою в Сумській області." Thesis, Сумський державний університет, 2014. http://essuir.sumdu.edu.ua/handle/123456789/36530.

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Одним з розповсюджених ушкоджень опоно-рухової системи є переломи кісток гомілки, які складають більше третини від усіх переломів довгих кісток. При їх лікуванні широко використовуються консервативні (кісткове витягування і гіпсова іммобілізація) та оперативні методи з використанням апаратів різноманітних конструкцій для внутрішньокісткового, накісткового та позавогнищевого остеосинтезу. Особливу актуальність проблема лікувальної тактики при переломах кінцівок у дітей із поєднаною і множинною травмою. Зберігаються розбіжності не тільки при визначенні методу остеосинтезу, але й стосовно термінів проведення оперативного втручання. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/36530
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Jodkowski, Jakub [Verfasser]. "Primary Pan-CT is associated with improved clinical course and outcome in polytrauma patients / Jakub Jodkowski." Greifswald : Universitätsbibliothek Greifswald, 2013. http://d-nb.info/1035043726/34.

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Reinhold, Jens Michael [Verfasser]. "Einfluss des IL-6 Transsignaling-Mechanismus auf die Frakturheilung im Mono-/ Polytrauma-Mausmodell / Jens Michael Reinhold." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/1223927296/34.

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Röse, Marc [Verfasser]. "Das schwere Polytrauma mit einem ISS≥50 : eine retrospektive Studie zur Epidemiologie und Prognose / Marc Röse." Lübeck : Zentrale Hochschulbibliothek Lübeck, 2011. http://d-nb.info/1009670204/34.

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Höch, Andreas. "Polytrauma mit Beckenfraktur und schwerem Thoraxtrauma – Hat der Zeitpunkt der definitiven Beckenfrakturstabilisierung Einfluss auf den klinischen Verlauf?" Doctoral thesis, Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-172342.

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Die definitive osteosynthetische Versorgung von Beckenfrakturen im Rahmen eines Polytraumas mit begleitendem schwerem Thoraxtrauma erfolgt nach dem Damage Control Konzept. Nicht geklärt ist der optimale Zeitpunkt der definitiven Stabilisierung von Beckenfrakturen. Aktuelle Empfehlungen geben den Zeitraum zwischen dem 1. und 21. posttraumatischen Tag in der sekundären Behandlungsphase an. Mit dieser Studie sollte untersucht werden, ob Patienten von einer frühzeitigen Versorgung der Beckenfraktur im Rahmen des Damage Control Konzepts profitieren und ob hiefür ein optimales Zeitfenster besteht. Zur Überprüfung wurden die Einflüsse des gewählten Operationszeitpunktes auf den klinischen Verlauf, speziell die Lungenfunktion, untersucht. Zwischen Januar 2007 und Dezember 2009 konnten 100 Patienten mit schwerem Thoraxtrauma (AIS ≥ 3) und instabiler Beckenfraktur (AIS ≥ 3) in zwei überregionalen Traumazentren eingeschlossen werden. Es wurden alle relevanten klinischen und perioperativen Daten prospektiv erfasst. Die Ergebnisse zeigen, dass mit Zunahme des zeitlichen Intervalls vom Unfall bis zur definitiven Stabilisierung die Beatmungsdauer, der intensivmedizinische Aufenthalt, die Krankenhausverweildauer sowie der Bedarf an Erythrozytenkonzentraten steigen. Eine Versorgung zwischen dem 7. und 12. Tag nach Trauma erwies sich als besonders geeignet. In diesem Zeitrahmen ergab sich die günstigste perioperative Entwicklung des pulmonalen und klinischen Gesamtzustandes der Patienten.
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Gropengiesser, Dirk. "Entwicklung eines modularen Rehabilitationsverfahrens für Patienten mit Zustand nach Polytrauma der unteren Extremitäten auf der Grundlage sportwissenschaftlicher Gesetzmässigkeiten." [S.l.] : [s.n.], 2004. http://deposit.ddb.de/cgi-bin/dokserv?idn=972030174.

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Barelkowska, Zuzanna Verfasser], and Thomas [Akademischer Betreuer] [Schneider. "Prognose bewusstloser Patienten nach Schädel-Hirn-Verletzung und Verdacht auf Polytrauma : eine Multicenterstudie / Zuzanna Barelkowska. Betreuer: Thomas Schneider." Magdeburg : Universitätsbibliothek, 2014. http://d-nb.info/1054639132/34.

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Uhle, Florian [Verfasser]. "Der Receptor for Advanced Glycation Endproducts (RAGE) und seine Liganden in der systemischen Entzündungsreaktion nach Polytrauma / Florian Uhle." Gießen : Universitätsbibliothek, 2015. http://d-nb.info/1068874724/34.

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Schlafer, Otmar [Verfasser]. "Erweitertes medizinisches Qualitätsmanagement am Beispiel der Tracer-Diagnose Polytrauma. Eine Pilotstudie aus dem Bereich des Luftrettungsdienstes / Otmar Schlafer." Ulm : Universität Ulm, 2016. http://d-nb.info/1111635374/34.

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Afaneh, Diana [Verfasser], and Klaus [Akademischer Betreuer] Püschel. "Polytrauma mit Gesichtsschädelverletzung : eine retrospektive Analyse von Sektionsakten des Hamburger Instituts für Rechtsmedizin / Diana Afaneh. Betreuer: Klaus Püschel." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2011. http://d-nb.info/1020384719/34.

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Kunze, Julia Franziska [Verfasser]. "The effect of C5a activity on adrenal functionality (following polytrauma) in male C57BL/6 mice / Julia Franziska Kunze." Ulm : Universität Ulm, 2020. http://d-nb.info/121996476X/34.

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Turek, Susanne [Verfasser], and Sonja [Akademischer Betreuer] Kirchhoff. "Evaluation der postmortalen Computertomographie (pmCT) im Vergleich zur Obduktion als Goldstandard bei Polytrauma-Patienten / Susanne Turek ; Betreuer: Sonja Kirchhoff." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2019. http://d-nb.info/1191691470/34.

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Höch, Andreas [Verfasser], Christoph [Akademischer Betreuer] Josten, Jörg [Akademischer Betreuer] Böhme, Uwe [Gutachter] Eichfeld, and Gunter O. [Gutachter] Hofmann. "Polytrauma mit Beckenfraktur und schwerem Thoraxtrauma – Hat der Zeitpunkt der definitiven Beckenfrakturstabilisierung Einfluss auf den klinischen Verlauf? : Polytrauma mit Beckenfraktur und schwerem Thoraxtrauma – Hat der Zeitpunkt derdefinitiven Beckenfrakturstabilisierung Einfluss auf den klinischen Verlauf? / Andreas Höch ; Gutachter: Uwe Eichfeld, Gunter O. Hofmann ; Christoph Josten, Jörg Böhme." Leipzig : Universitätsbibliothek Leipzig, 2015. http://d-nb.info/1239566980/34.

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Puljić, Patrik [Verfasser], and Frank [Akademischer Betreuer] Hildebrand. "Der prädiktive Wert verschiedener Thoraxtrauma-Scores beim Polytrauma / Patrik Puljić. Klinik für Unfallchirurgie der Medizinischen Hochschule Hannover. Betreuer: Frank Hildebrand." Hannover : Bibliothek der Medizinischen Hochschule Hannover, 2012. http://d-nb.info/1028131526/34.

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Mögele-Schmid, Caroline [Verfasser], and Eugen [Akademischer Betreuer] Faist. "Endotoxinaktivität und deren Auswirkungen auf immunologische Parameter im Verlauf nach schwerer Verbrennungsverletzung und Polytrauma / Caroline Mögele-Schmid ; Betreuer: Eugen Faist." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2018. http://d-nb.info/1170582648/34.

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Matz, Michael [Verfasser], and Karl-Georg [Akademischer Betreuer] Kanz. "Dynamik des STAT/SOCS-Regulationsmechanismus in der frühen posttraumatischen Phase nach schwerem Polytrauma / Rainer Michael Matz. Betreuer: Karl-Georg Kanz." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2015. http://d-nb.info/1069069647/34.

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Богма, Е. В., О. Н. Зацарная, О. Л. Медведь, and Л. Ю. Свириденко. "Влияние малообъемного восстановления гемодинамики при политравме на выделительную функцию почек." Thesis, Сумский государственный университет, 2015. http://essuir.sumdu.edu.ua/handle/123456789/41575.

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Föhrweiser, Carolin [Verfasser], and Peter [Akademischer Betreuer] Angele. "Korrelation der Schockraumversorgung polytraumatisierter Patienten am Universitätsklinikum Regensburg mit der aktuellen S3-Leitlinie Polytrauma/Schwerverletzten-Behandlung / Carolin Föhrweiser. Betreuer: Peter Angele." Regensburg : Universitätsbibliothek Regensburg, 2015. http://d-nb.info/1080609830/34.

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Malysch, Tom [Verfasser]. "Immunomodulation of IL6 transsignaling in polytrauma : organ specific effects of in vivo simulation in a murine multiple trauma model / Tom Malysch." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2020. http://d-nb.info/122392761X/34.

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