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Blast injuries are commonly thought of as incidents that occur in other countries, not here in the United States. The majority of clinicians are not prepared to deal with the devastation of a civilian blast incident and the resulting injury patterns. The author reviews expected injury patterns, triage decisions, and current therapies.
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This paper reviews the most common injuries related to winter sports. Over the past decades, there has been an increase in the variety of winter sports, as well as increased participation by individuals at all levels of fitness. There have also been some improvements made that reduce injuries. For example, breakaway ski boots have reduced the number of tibia and ankle fractures. With some sports becoming more dangerous with jumps and aerial moves, helmets are beginning to be more common, but sadly not fast enough.
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This was a comprehensive, interdisciplinary, 2-year quality improvement project to reduce continuous sedation infusions and improve the recognition and prevention of delirium in patients with acute lung injury. It resulted in less infusion use, more days per patient without sedation, and more patient days awake and not delirious, although the median proportion of days with delirium per patient actually increased.
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This large, multicenter, quality improvement project showed a dramatic reduction in mortality among patients with severe sepsis or septic shock after implementation of a sepsis treatment bundle.
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In this study, closed-loop, titrated pressure support ventilation was associated with a significantly shorter time course until patients passed a spontaneous breathing trial and were successfully extubated compared to a standardized weaning protocol.
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