All posts by TheTraumaPro

Cool Video Alert: The Day Everything Changed…

Ever wonder what it’s like to be a patient involved in a major traumatic event? Here’s a video shot from their perspective. It starts from the moment of a motorcycle crash, and includes first responders, aeromedical response, trauma team activation, and more. We trauma professionals take for granted what goes on, but it’s eye-opening to view it from the patient point of view.

This video is 10 minutes long, not including the ending credits. It was shown at the Trauma Education: The Next Generation conference last week. Enjoy!

The Medical Orthopaedic Trauma Service

Our population is aging, and falls continue to be a leading cause of injury and morbidity in the elderly. Unfortunately, many elders have significant medical conditions that make them more likely to suffer unfortunate complications from their injuries and the procedures that repair them.

More and more hospitals around the world are applying a more multidisciplinary approach than the traditional model. One example is the Medical Orthopaedic Trauma Service (MOTS) at New York-Presbyterian Hospital/Weill Cornell Medical Center. Any elderly patient who has suffered a fracture is seen in the ED by both an emergency physician and a hospitalist from the MOTS team. Once in the hospital, the hospitalist and orthopaedic surgeon try to determine the reason for the fall, assess for risk factors such as osteoporosis, provide comprehensive medical management, provide pain control, and of course, fix the fracture. 

This medical center published a paper looking at their success with this model. They retrospectively reviewed 306 patients with femur fractures involving the greater trochanter. They looked at complications, length of stay, readmission rate and post-discharge mortality. No change in length of stay was noted, but there were significantly fewer complications, specifically catheter associated urinary tract infections and arrhythmias. The readmission rate was somewhat shorter in the MOTS group, but did not quite achieve significance with regression analysis.

Bottom line: This type of multidisciplinary approach to these fragile patients makes sense. Hospitalists, especially those with geriatric experience, can have a significant impact on the safety and outcomes of these patients. But even beyond this, all trauma professionals need to look for and correct the reasons for the fall, not just fix the bones and send our elders home. This responsibility starts in the field with prehospital providers, and continues with hospital through the entire inpatient stay.

Related post:

Reference: The medical orthopaedic service (MOTS): an innovative multidisciplinary team model that decreases in-hospital complications in patients with hip fractures. J Orthopaedic Trauma 26(6):379-383, 2012.

August Trauma MedEd Newsletter Released

The August newsletter is now available! Click the image below or the link at the bottom to download. This month’s topic is Potpourri.

In this issue you’ll find articles on:

  • An instant hemoglobin monitor
  • Don’t ignore the naughty bits
  • The referral hospital trauma rule
  • The dogma of putting chest tubes to suction
  • Small hospital, unstable patient
  • How to lose a bet and still win!

Subscribers received the newsletter first last weekend. If you want to subscribe (and download back issues), click here.

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Click here to download and/or subscribe.

How To Reduce A Hip Dislocation

This is the final teaser for Trauma Education: The Next Generation. It’s tomorrow, so plan on tuning in and seeing what we are up to! We’ve got some groundbreaking talks and video for you.

For more information, go to www.tetng.org. If you happen to be hanging around the upper midwest, stop by the History Center in St. Paul and check out the live show. Otherwise, tune in via LiveStream by clicking this link.