Recommendations for perioperative care of adolescents at risk for suicide.

Suicide is one of the leading causes of death for the adolescent population, and as such, should be considered when adolescents have any contact with the healthcare system, including perioperative appointments. Although some surgical facilities screen patients with a history of suicide attempt or severe mental health conditions, many adolescents who have died by suicide do not have official mental health diagnoses or history of previous suicide attempt. Because of the impact surgery can have on mental health, each adolescent should be screened for suicide risk during pre-surgical consult appointments to assess suicide risk and take proper precautions, as needed. Suicide screening should be implemented as part of the focused assessment prior to surgery to more comprehensively combat the rising suicide rates of adolescents. This paper provides recommendations to direct care of adolescent surgical patients at risk for suicide.

Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. METHODS: A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. RESULTS: The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. CONCLUSION: By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

Older adults with traumatic rib fractures: an evidence-based approach to their care.

It is expected that over the next decade the population of older adults in the United States will increase dramatically. As the older adult population increases, the number of older adults involved in traumatic accidents is also expected to climb. The older population is at an increased risk for complications and poor outcomes following trauma. Practitioners caring for these older adults will need to use evidence-based practice guidelines in an attempt to improve outcomes. This article provides a clinical guideline for the assessment and management of pain in older adults with traumatic rib fractures, and an approach for pain assessment, which includes the use of the numeric rating scale as well as incentive spirometry. The modalities used for pain management include epidural analgesia, paravertebral analgesia, patient controlled analgesia, and the use of oral opioids.