ABSTRACT
INTRODUCTION: Management of blunt cardiac injury is often discussed in trauma literature due to the lack of a "gold standard" for early identification and cost-effective care. The effectiveness of an evidence-based trauma protocol was assessed by comparing patients treated with the new protocol to those managed with prior practice. METHODS: The data of 80 patients prospectively managed using the new trauma protocol were compared with the medical records of 80 former patients treated according to existing practice. RESULTS: Implementing the new protocol improved detection of abnormal troponin I levels and resulted in cost savings. The length of time inpatients required continuous electrocardiographic monitoring decreased by 4.23 days and echocardiography use dropped by 70%. CONCLUSION: Implementation of the evidence-based trauma protocol at our facility improved the early identification of patients with blunt cardiac injury and reduced the number of laboratory and diagnostic tests.
Subject(s)
Cost Savings , Evidence-Based Practice/economics , Heart Injuries/diagnosis , Length of Stay/economics , Wounds, Nonpenetrating/diagnosis , Adult , Aged , Combined Modality Therapy , Electrocardiography/methods , Female , Heart Injuries/economics , Heart Injuries/therapy , Hospital Costs , Humans , Injury Severity Score , Male , Middle Aged , Monitoring, Physiologic/economics , Prognosis , Prospective Studies , Retrospective Studies , Risk Assessment , Trauma Centers/organization & administration , Troponin I/blood , Wounds, Nonpenetrating/economics , Wounds, Nonpenetrating/therapyABSTRACT
Necrotizing fasciitis (NF) is a rapidly spreading infection affecting the subcutaneous soft tissue. Because of its rapid progression and high mortality, it is essential that the patient is diagnosed and treated early. Over the past century and a half, little has changed in the mortality of this disease. The orthopaedic nurse is in a key position to assist with the early detection and treatment of NF. In the following article, the pathophysiology, early disease detection, diagnostic and treatment challenges, and appropriate nursing interventions will be discussed as it relates to improving the care of the patient with NF.
