3 research outputs found
Smoke inhalation injury: a narrative review
Burn Units frequently provide care to patients who have burn injuries and concomitant smoke inhalation injury. Inhalation damage is a complex multifaceted lung and systemic disease process, and the leading cause of mortality and morbidity in victims of fire tragedies. The degree of airway injury depends on the composition of smoke and the duration of smoke exposure. The prevalence of inhalation damage and related mortality rates among fire victims is high all over the world. This article presents the potential clinical impacts of this syndrome and the most important factors to consider when examining patients that have survived the scene of an accident who require hospital admission. Anatomically, injuries are divided into three classes: (I) heat injury which is restricted to upper airway; (II) local chemical irritation throughout the respiratory tract and (III) systemic toxicity as may occur with inhalation of carbon monoxide or cyanide. Treatment options between these three subtypes differ based on the pathophysiologic changes that each one elicits. Supportive respiratory care remains essential in managing inhalation injury. In addition, we have also reviewed current treatment strategies and future lines of research in this field. These advances provide hope for reversal of specific mechanisms of morbidity and improvement in outcomes
Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey
Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons' knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society's website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI
Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey
Background
Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons.
Methods
Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile.
Results
A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly.
Discussion
Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions