Roed Crockett (harborboy9)

While massive transfusion protocols (MTP) are associated with decreased mortality in adult trauma patients, there is limited research on the impact of MTP on pediatric trauma patients. The purpose of this study was to compare pediatric trauma patients requiring massive transfusion to all other pediatric trauma patients to identify triggers for MTP activation in injured children. Using our level I trauma center's registry, we retrospectively identified all pediatric trauma patients from January 2015 to January 2018. Massive transfusion (MT) was defined as infusion of 40 mL/kg of blood products in the first 24 hours of admission. Patients missing prehospital vital sign data were excluded from the study. We retrospectively collected data including demographics, blood utilization, variable outcome data, prehospital vital signs, prehospital transport times, and injury severity scores (ISS). Statistical significance was determined using Mann-Whitney U test and chi-square test. P values less than 0.05 were consir shock indexes and lower pulse pressures. We found that shock index and systolic blood pressure are highly specific tools with promising likelihood ratios that could be used to identify patients requiring early transfusion. Therapeutic/Care Management, Level V. Therapeutic/Care Management, Level V. Uncontrolled truncal hemorrhage remains the most common cause of potentially preventable death after injury. The notion of earlier hemorrhage control and blood product resuscitation is therefore attractive. Some systems have successfully implemented prehospital advanced resuscitative care (ARC) teams. Early identification of patients is key and is reliant on rapid decision-making and communication. The purpose of this simulation study was to explore the feasibility of early identification of patients who might benefit from ARC in a typical U.S. setting. We conducted a prospective observational/simulation study at a level I trauma center and two associated EMS agencies over a 9-month period. The participating EMS agencies were asked to identify actual patients who might benefit from the activation of a hypothetical trauma centerbased ARC team. This decision was then communicated in real time to the study team. 63 patients were determined to require activation. The number of activations per months ranged from 2 to 15. The highest incidence of calls occurred between 4pm to midnight. Of the 63 patients, 33 were transported to the trauma center. The most common presentation was with penetrating trauma. The median age was 27 years (IQR 24-45), 75% were male, and the median injury severity score was 11 (IQR 7-20). Based on injury patterns, treatment received, and outcomes, it was determined that 6 of 33 (18%) patients might have benefited from ARC. Three of the patients died en-route to or soon after arrival at the trauma center. The prehospital identification of patients who might benefit from ARC is possible but faces challenges. Identifying strategies to adapt existing processes may allow better utilization of the existing infrastructure and should be a focus of future efforts. IVStudy TypeEpidemiological. IVStudy TypeEpidemiological. To measure the prevalence of burnout among healthcare workers (HCWs) in primary care during the COVID-19 pandemic and to understand the association between burnout, job-person fit, and perceptions of the pandemic. We surveyed 147 HCWs (73% response rate) in two clinics in the summer of 2020 on their burnout, job-person fit, perceptions of the pandemic, and demographic/job characteristics. Logistic regression analyses were conducted to explore relationships between these variables. Forty-three percent of HCWs reported burnout. Lower HCW burnout was associated with better job-person fit in the areas of recognition or appreciation at work (odds ratio [OR] 0.26, 95% confidence interval [CI]