Trends of Self-Inflicted Firearm Injuries at a Rural Level 1 Trauma Center.

Firearm injuries are a major public health concern with much focus on injuries due to violent crimes in urban areas. Less focus has been on self-inflicted injuries and rural settings. This study included 201 patients, of which 124 (61.7%) were accidental and 77 (38.3%) were intentional self-inflicted gunshot wounds (GSWs) sustained over 6 years at a rural level 1 trauma center. Injury severity scores (P < .001), hospital days (P < .001), and mortality (P < .001) were significantly higher among intentional self-inflicted GSWs. Injuries to the head were the most common injury among patients with intentional self-inflicted GSWs (P < .001).Accidental and intentional self-inflicted GSWs make up a large portion of firearm injuries seen at our rural level 1 trauma center, and defining these injuries can facilitate the need for targeted gun safety and injury prevention efforts.

Impact of Trauma Resuscitation Emergency Care Nurse Deployment in Trauma Activations in a Rural Trauma Center.

BACKGROUND: Although the role of a dedicated trauma nurse has been implemented in an urban setting, it has not been studied in the rural trauma setting. We instituted a trauma resuscitation emergency care (TREC) nurse role to respond to trauma activations at our rural trauma center. OBJECTIVE: This study aims to determine the impact of TREC nurse deployment on the timeliness of resuscitation interventions in trauma activations. METHODS: This pre- and postintervention study at a rural Level I trauma center compared the time to resuscitation interventions before (August 2018 to July 2019) and after (August 2019 to July 2020) deploying TREC nurses to trauma activations. RESULTS: A total of 2,593 participants were studied, of which 1,153 (44%) were in the pre-TREC group and 1,440 (56%) in the post-TREC group. After TREC deployment, the median (interquartile range [IQR]) emergency department times within the first hour decreased from 45 (31.23-53) to 35 (16-51) min ( p = .013). The median (IQR) time to the operating room within the first hour decreased from 46 (37-52) to 29 (12-46) min ( p = .001), and within the first 2 hr, decreased from 59 (43.8-86) to 48 (23-72) min ( p = .014). CONCLUSION: Our study found that TREC nurse deployment improved resuscitation intervention timeliness during the first 2 hr (early phase) of trauma activations.

Effects of Trauma Center Consolidation on Pediatric Trauma at an Appalachian Pediatric Hospital.

With the increase in hospital consolidation over the past decade, multiple studies have been performed evaluating patient outcomes after consolidation. To date, there have not been studies performed to assess outcomes in pediatric trauma patients. The goal was to assess pediatric patient outcomes in a children's hospital after consolidation of two Level 1 Trauma centers in a rural Appalachian health system. A retrospective analysis of data from the Trauma Registry between October 2015 - September 2020 was performed. The variables included in analysis were age, injury severity score (ISS), hospital days, intensive care unit days, ventilator days, mortality, discharge disposition, consults, and hospital visit cost. Despite increased ISS, there was no difference in in-patient outcomes. However, these patients were more likely to require orthopedic evaluation and further outpatient care after discharge, suggesting more severely injured patients were evaluated by the trauma service post consolidation.