Active clinical trials for "Multiple Trauma"

The present study predicts that concomitant chest injuries in polytraumatized pediatric patients are a potential source of substantial morbidity and mortality.

Trauma is a major medical and public health problem facing all countries in the world today. Trauma is the leading cause of death worldwide for people under 45 years of age, and more than 5 million people die each year from severe trauma. According to the "China Injury Prevention Report" issued by the Ministry of Health in August 2007, about 200 million injuries occur annually in China, with 700,000 to 750,000 deaths, accounting for about 9% of the total number of deaths. Serious trauma has the characteristics of high mortality and disability rate, and often affects the main groups of young and middle-aged people of social labor force. It has a tremendous impact on social and economic development, and has brought a heavy burden to society and families. The treatment of severe trauma is extremely important, and its treatment process needs a standardized model. In many links of trauma treatment, accurate assessment of injury is the precondition of classification and grading of diagnosis and treatment, and also provides a good basis for the follow-up standardized treatment of patients. The accuracy and consistency of injury assessment are also the reflection of diagnosis and treatment ability. ISS score is an evaluation method for severe trauma and multiple trauma patients. It has been used by emergency personnel for a long time. It also plays a very good auxiliary role in the evaluation and treatment of patients'injuries. However, there are still many problems in the clinical use of ISS scores: 1. Some hospitals do not attach importance to the application of ISS scores, and do not fully understand the scoring method; 2. Low frequency of use, inaccurate grasp of the method; 3. Three-level physicians have different valuations of ISS scores for the same kind of trauma; 4. Use AIS scoring table to calculate. It takes a long time to calculate the ISS score, which affects the normal first aid efficiency. To this end, our research team designed a questionnaire on the use of ISS score. The main purpose of the questionnaire is to assess and register the severity of injury in multiple trauma patients to understand the current use and proficiency of ISS score system by Chinese trauma surgeons, the difference of ISS score between three-level doctors and the same patient, and ISS score. The consistency between the software and AIS scoring table and the scoring time of the two methods are also discussed. This study hopes that through this survey, we can understand the current situation of the application of the scoring system in Chinese hospitals, in order to promote the standardization of severe trauma assessment and promote the use of the evaluation system in hospitals throughout the country, so as to provide optimized trauma treatment process for trauma patients.

Capillary or venous lactate level evaluation in prehospital care could be simple and beneficial tool for optimising prehospital care in patients with severe trauma.

The study is based on the premise that ultrasound is not commonly used in an ambulance. There are some departments that do deploy it into the field, but of those departments there is almost no data collected about its use. Currently Paramedics are not recognized by insurance companies as health care providers capable of performing ultrasound. If there were more data on the subject that may eventually change. We are hoping to prove that not only is ultrasound useful in an ambulance, but that paramedics are good at interpreting the results. We will save images, the paramedic's diagnosis and some basic information about the call. We will not save any protected health information (PHI) or any information linking the subject to the study. The data collected will be sent to a non-biased ultrasound reviewer to grade the images for the accuracy of diagnosis and the quality of the view obtained. This data will be used to formulate a report and statistics on paramedic's ability to perform ultrasound in the field.

Early intervention and resuscitation based upon a lot of clinical, laboratory findings make a big difference regarding outcome in poly trauma patients, the study uses the dynamic lactate change and the difference between arterial and venous CO2, oxygen tension or content as indicators for tissue perfusion.

About 90% of chest injuries in America are due to blunt forces, mostly as a result of motor vehicle collisions and falls. Severity varies from minor bruising to severe chest injuries. For several years, clavicle ("collarbone") fractures have been treated without surgery (non-operatively), even when the fracture is out of place (displaced). Over the last few years, however, treatment has changed more towards surgical fixation (operative), because of the sometimes difficult healing in clavicle fractures that are displaced. Several research studies have shown that cases in which the clavicle fracture never heals completely (non-union) are more frequent after nonoperative treatment, compared to operative fixation. In those cases, surgery is still required, only later (secondary surgery). Further, clavicle malunion, in which the fracture heals but is still out of place) has been shown to be high after nonoperative treatment. Recent published research studies have shown better function, higher patient satisfaction, earlier return to activity (use of the arm) and decreased nonunion and malunion following surgery, also called open reduction/internal fixation. Despite recent published research, there is still a lack of agreement on when surgical fixation should be performed for clavicle fractures. Patients with chest injuries often have clavicle fractures. Chest injuries can restrict patients' ability to breathe, cough, stand, walk and leave the hospital. Although it is unusual that chest injuries can be improved with surgery, patients with clavicle fractures and chest injuries might recover faster if the clavicle fractures were repaired. Patients are being asked to take part in the study they have sustained a clavicle fracture associated with a chest injury with or without any other injury to the abdomen, or arms or legs. The aim of this study is to determine the difference in the hospital length of stay, intensive care unit length of stay, respiratory rehabilitation (recovery of good respiratory function), functional outcome, ability to become mobile again, complications and risk of dying in trauma patients with chest injury and clavicle fracture treated operatively versus non-operatively.

Patients who have sustained and survived a polytrauma do heavily depend on the support and functioning of their family. This is only possible if the family members are physically and mentally able to cope with the situation. It is the investigators' hypothesis that the true percentage of polytrauma patients' relatives suffering under relevant psychological distress is higher than commonly assumed. The investigators conduct a prospective cohort study where we follow up on a cohort of patients and their relatives over 1 year after trauma - one group with severely injured patients (case) and one group with minor musculo-skeletal injuries (control). In order to assess the influence of the patients' disability and their own psychological distress on the psychological distress of the relatives, the investigators also collect corresponding data from the patients themselves. In order to assess the influence of the trauma itself, the investigators compare a group of multiple injured patients and their relatives with a group of patients with isolated musculoskeletal injuries and their relatives. In addition, the investigators record the ISS of each patient. In order to investigate the changes in relatives' distress over time and to find out more about potential risk factors or con-founders it is necessary to conduct a prospective study.

Modifications of the human gut microbiota have been associated with different pathological conditions such as obesity, inflammatory bowel diseases and neurodegenerative diseases. Recently the " Brain-Gut Axis ", a bidirectional communication axis between brain and gut, has been described. In recent animal studies, an acute brain injury was associated with rapid modifications of the gut microbiota. In humans, traumatic brain injury (TBI) is a leading cause of death and disability. The patterns of gut and oropharyngeal microbiota following TBI are unknown. The primary purpose of this study is to characterize gut and oropharyngeal microbiota of patients with severe TBI.

The NTF_PT_2014 multicenter study aims to collect, store, and analyse plasma and serum from polytrauma-patients (injury severity score ≥25) and corresponding clinical data to address 1) how trauma modulates the release of danger molecules, inflammatory mediators, coagulation factors and novel biomarkers, 2) how the specific injury pattern affects the posttraumatic response and regenerative potential on an organ-, cell, and molecular level, and 3) how could a specific organ- and immune-monitoring predict the clinical outcome.

Quality control and improvement project: Assessment and analysis of processes and outcome in trauma emergency room and major trauma patients at the Aarau trauma center (cantonal hospital) with regard to initial emergency management, hospital processes and short- and long-term (1-and 2-year) outcome of patients (subjective and objective). Comparison of processes and outcome pre- and post- project initiative. Benchmarking with the literature and by participation in the German and Swiss Trauma registry each.