Relevant bibliographies by topics / Management of trauma

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Management of trauma'

Author: Grafiati
Published: 4 June 2021
Last updated: 2 February 2022

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Journal articles on the topic "Management of trauma"

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Frawley, Philip A. "Trauma management." Medical Journal of Australia 154, no. 5 (March 1991): 364. http://dx.doi.org/10.5694/j.1326-5377.1991.tb112895.x.

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Buchman, Timothy G. "Trauma Management." Critical Care Medicine 16, no. 12 (December 1988): 1259. http://dx.doi.org/10.1097/00003246-198812000-00028.

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Kreis, David J., Gerardo A. Gomez, and Federico Gonzalez. "Trauma Management." Plastic and Reconstructive Surgery 86, no. 6 (December 1990): 1230. http://dx.doi.org/10.1097/00006534-199012000-00035.

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Pullarkat, Ranjit R. "Trauma Management." Journal of Trauma and Acute Care Surgery 51, no. 3 (September 2001): 539. http://dx.doi.org/10.1097/00005373-200109000-00020.

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&NA;. "TRAUMA MANAGEMENT." Shock 16, no. 2 (August 2001): 163. http://dx.doi.org/10.1097/00024382-200116020-00015.

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LANE, P. L. "Trauma Management." Journal of Trauma: Injury, Infection, and Critical Care 30, no. 4 (April 1990): 371–76. http://dx.doi.org/10.1097/00005373-199004000-00001.

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LANE, P. L. "Trauma Management." Journal of Trauma: Injury, Infection, and Critical Care 30, no. 4 (April 1990): 371–76. http://dx.doi.org/10.1097/00005373-199030040-00001.

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ALPAR, E. K., and J. BULL. "TRAUMA MANAGEMENT." Journal of Bone and Joint Surgery. British volume 79-B, no. 6 (November 1997): 1038. http://dx.doi.org/10.1302/0301-620x.79b6.0791038a.

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Horn, Jan K. "Trauma Management." Annals of Plastic Surgery 26, no. 6 (June 1991): 606. http://dx.doi.org/10.1097/00000637-199106000-00023.

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London, P. S. "Trauma management." Injury 20, no. 1 (January 1989): 57. http://dx.doi.org/10.1016/0020-1383(89)90055-7.

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Dissertations / Theses on the topic "Management of trauma"

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Lampi, Maria. "TRIAGE : Management of the trauma patient." Doctoral thesis, Linköpings universitet, Avdelningen för kliniska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-134595.

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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient’s clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems. The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya. The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training.
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Ho, Chuen-tak Douglas. "Trauma Centre Prototype." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25947813.

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MacFie, Christine. "Work related trauma, culture and the police : towards an effective trauma management scheme." Thesis, University of Sussex, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270737.

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This action research based thesis focuses on work-related psychological trauma and its management, within the context of the British police service. A case study on one force facilitates detailed exploration of ways in which police occupational culture may impede the provision and acceptance of trauma management schemes. A national questionnaire-based survey of United Kingdom police forces establishes the scope and nature of their trauma management provisions and identifies strengths and weaknesses. Few trauma research studies have concentrated upon the affective domain of the British police service and there is limited understanding of how personal emotions are managed in the police organisation, or how its culture can affect the individual's experience of work-related trauma in an unhelpful way. The study aims to increase knowledge and understanding in this area and to assist British police forces in their attempts to reduce police sickness absences and ill health retirements, which may result from exposure to workrelated trauma. Two main study concerns are addressed by different means. The thesis is arranged as an introduction that includes discussion of the methodological approach adopted, seven chapters, conclusions and recommendations. Chapter one sets the scene by scrutinising the police service as a modern work organisation. Having clarified the basic principles of British policing, it outlines how the service has developed, exploring the difficulties and tensions police officers at all levels experience in trying to fulfil their current roles and responsibilities. Chapter two looks at the nature and potential effects of 'critical' incidents and traces the history of trauma recognition and critical incident debriefing, discussing the current debate on the efficacy of the latter and its value for police personnel. Chapter three examines current national and local police trauma management provisions and chapter four focuses on the identification and management of key risks posed to the police organisation, arising from work-related trauma. Chapter five explores police officers' experiences of trauma through descriptions of three 'service' roles and critical incident scenarios and by focusing on how certain aspects of police culture may intensify and prolong their initial distress. Chapter six shows the ways in which the police organisation seeks to manage its members' emotions through its selection, training and socialisation processes and how its success in doing so can impede the delivery and takeup of trauma management services. Chapter seven then outlines the main theoretical concepts underpinning the thesis, explaining why the police organisation requires officers to manage their emotions in particular ways and outlining mechanisms it has adopted as corporate defences against anxiety. A summary of conclusions follows and the thesis ends with recommendations to effect improvements to the quality and consistency of services being offered.
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Nicol, Andrew John. "The current management of penetrating cardiac trauma." Doctoral thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/11633.

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The vast majority of patients with penetrating cardiac injuries do not reach the hospital alive as the pre-hospital mortality rate for these injuries is in the region of 86%. The patients that do reach the hospital alive are potential survivors and it is obviously crucial that any cardiac injury is detected and managed appropriately. Most of these injuries present with either cardiac tamponade or hypovolaemic shock and are relatively straightforward to diagnose and require immediate surgery. There is, however, a group of patients that are relatively stable with an underlying cardiac injury and it is in these patients that a potential or occult cardiac injury needs to be identified.
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Curtis, Kathleen Anne Public Health &amp Community Medicine Faculty of Medicine UNSW. "Trauma nursing case management: impact on patient outcomes." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/33367.

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Aim The purpose of the study was to formally identify trauma care delivery problems at the study institution, implement a solution in the form of trauma case management (TCM), and measure the effect of TCM on staff satisfaction, clinical coding accuracy and patient outcomes, using practice-specific outcome variables such as in-hospital complication rates, length of stay, resource use and allied health service intervention rates. This research also aimed to make a unique contribution to the international trauma literature by addressing the lack of any evidence specifically measuring the impact of trauma case management intervention. Methods St George Hospital is a 600 bed urban Teaching Hospital of the University of NSW. It is a designated Trauma Centre, seeing around 200 severely injured patients and around 2500 injury admissions per year. A series of focus groups and a staff satisfaction survey identified perceived problems associated with trauma care, and a trauma case management program was implemented. A preliminary study was conducted with positive results and funding was obtained to provide TCM seven days a week to all trauma patient admissions. A larger clinical trial was conducted and data from 754 patients were collected over fourteen months after TCM was introduced at the study hospital. These data were compared with 777 matched patients from the previous 14 months as a control group. An audit was conducted on trauma patient clinical coding using the daily progress record kept by the trauma case manager. The data were analysed with SPSS. The statistical tests used were Mann-Whitney U, chi-squared (2) logistic regression and generalised linear models. Results Focus groups and the staff satisfaction survey identified communication and coordination as the main problems associated with trauma care delivery. Following the initial implementation of the program, staff support for TCM was overwhelming. TCM greatly improved the rate of and time to Allied Health intervention (p<0.0001). Results demonstrated a decrease in the occurrence of deep vein thrombosis (p<0.038), coagulopathy (p=0.041) and respiratory failure. A reduced hospital length of stay (LOS), particularly in the paediatric (p<0.05) and 45 - 64 years age group was noted. There were 6621 fewer pathology tests performed (p<0.0001) and the total number of bed days was 483 days less than predicted from the control group. Many hospital clinical coding errors and omissions were highlighted by the TCM record comparison. The use of TCM records resulted in Twenty eight percent of recoded records having their Australian national diagnostic related group (AN-DRG) changed, which resulted in the identification over $39,000 in unidentified funding. Conclusion TCM improves staff satisfaction, communication and clinical coding accuracy. The introduction of TCM improved the efficiency and effectiveness of trauma patient care in our institution. This initiative demonstrates that TCM results in improvements to quality of care, trauma patient morbidity, financial performance and resource use. This research makes an important and original contribution to the international trauma literature by providing the results of a clinical trial formally measuring the impact of trauma nursing case management intervention.
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何存德 and Chuen-tak Douglas Ho. "Trauma Centre Prototype." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31984575.

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Fagelson, Marc A. "Tinnitus and Trauma." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1959.

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Fagelson, Marc A. "Implementing Psychological Methods in the Management of Trauma-Associated Tinnitus." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1663.

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Dr. Fagelson, (Professor Audiology, ETSU) will discuss the unusual challenges facing patients and providers when tinnitus severity is linked to traumatic exposure. Interactions between neural mechanisms associated with tinnitus, posttraumatic stress-disorder (PTSD), and traumatic memory will be reviewed with particular attention to the way and degree to which such interactions affect tinnitus and disorders of sound tolerance. Conference attendees will be provided theoretical models of emotional memory consolidation that underscore trauma‘s durable effects on a patient‘s emotional state, reaction to the tinnitus signal, and to potentially-triggering environmental sounds. The putative benefits of tinnitus counseling will be presented in the context of trauma interventions that employ well-established counseling techniques as an element of patient-centered care. Audiologists must provide trauma patients a safe environment and opportunity for dialogue that contributes to a holistic understanding of the patient‘s situation and perceptions; the ultimate goal is to employ interventions and self-assessment instruments that can be used to evaluate patient needs and progress when tinnitus is related to trauma. The potentially-exacerbating effects of comprehensive audiologic assessment will also be addressed.
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Fagelson, Marc A. "Tinnitus and Trauma." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1659.

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Thomson, David Alexander. "The role of endoscopic retrograde pancreatography in the management of pancreatic trauma." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/14312.

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Background: Endoscopic retrograde pancreatography (ERP) has various applications in the diagnosis and management of pancreatic trauma. The utility of ERP in pancreatic trauma presenting to a level 1 equivalent trauma centre was analysed. Methods: Patients who sustained pancreatic trauma and underwent ERP were identified. Patient demographics, mechanism of injury, time to presentation, diagnostic modalities, associated injuries, clinical management, endoscopic interventions and their timing, surgical treatment and patient outcomes were recorded. Results: Forty-eight patients with pancreatic trauma were referred for ERP after blunt (26), gunshot (15), or stab (7) injury. The average time from injury to ERP was 38 days (range 2 – 365). An ERP visualized the duct in 47 patients. Twenty-four patients had a pancreatic fistula, 12 patients had a main pancreatic duct stricture or cut-off and 10 patients had a pseudocyst. Endoscopic interventions were pancreatic duct sphincterotomy (15), pancreatic duct stent (7) or pseudocyst drainage (6). Ten patients demonstrated minor injuries and no interventions were performed. One patient had a normal pancreatogram. Ten patients required pancreatic surgery following ERP (distal pancreatectomy n=6, pancreaticojejenostomy n=3 and cystjejenostomy n=1). One patient unable to tolerate ERP had a distal pancreatectomy. Conclusion: The majority of ERPs were performed post surgery or after a delayed presentation. Diagnostic success was high and in conjunction with therapeutic interventions 77% of patients avoided surgery for their pancreatic complications. ERP is an effective tool in the delayed management of the local complications of pancreatic trauma.
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Books on the topic "Management of trauma"

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Scaletta, Tom. Emergent management of trauma. 2nd ed. Boston: McGraw-Hill, 2001.

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Scaletta, Tom. Emergent management of trauma. New York: McGraw-Hill, Health Professions Division, 1996.

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Management of pediatric trauma. Philadelphia: Saunders, 1995.

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Iyer, K. Mohan, ed. Trauma Management in Orthopedics. London: Springer London, 2013. http://dx.doi.org/10.1007/978-1-4471-4462-5.

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Emergent management of trauma. 3rd ed. New York: McGraw Hill Professional, 2011.

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Robertson, Colin. The management of major trauma. 2nd ed. Oxford: Oxford University Press, 1994.

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D, Redmond Anthony, ed. The Management of major trauma. 2nd ed. Oxford: Oxford University Press, 1994.

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D, Redmond Anthony, ed. The management of major trauma. Oxford: Oxford University Press, 1991.

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Hörer, Tal, Joseph J. DuBose, Todd E. Rasmussen, and Joseph M. White, eds. Endovascular Resuscitation and Trauma Management. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-25341-7.

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Seligson, David. The primary management of musculoskeletal trauma. Philadelphia: Lippincott-Raven, 1997.

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Book chapters on the topic "Management of trauma"

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Goonewardene, Sanchia S., Peter Pietrzak, and David Albala. "Renal Trauma." In Basic Urological Management, 205–7. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-98720-0_75.

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Goonewardene, Sanchia S., Peter Pietrzak, and David Albala. "Ureteric Trauma." In Basic Urological Management, 217–19. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-98720-0_79.

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Goonewardene, Sanchia S., Peter Pietrzak, and David Albala. "Bladder Trauma." In Basic Urological Management, 227–29. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-98720-0_83.

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Goonewardene, Sanchia S., Peter Pietrzak, and David Albala. "Urethral Trauma." In Basic Urological Management, 237–40. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-98720-0_87.

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Goonewardene, Sanchia S., Peter Pietrzak, and David Albala. "Testicular Trauma." In Basic Urological Management, 247–49. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-98720-0_91.

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Smith, Jason. "Emergency Department Management." In Ballistic Trauma, 87–94. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-61364-2_9.

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Robertson, Jason O., and Adam M. Vogel. "Pediatric ICU management." In Pediatric Trauma, 121–36. Second edition. | Boca Raton : CRC Press, [2017] | Preceded by: CRC Press, 2017. http://dx.doi.org/10.4324/9781315113746-13.

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Van Horn, Jonathan R. "Trauma Floor Management." In Encyclopedia of Trauma Care, 1638–42. Berlin, Heidelberg: Springer Berlin Heidelberg, 2015. http://dx.doi.org/10.1007/978-3-642-29613-0_357.

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Goonewardene, Sanchia S., Peter Pietrzak, and David Albala. "Management Urethral Trauma." In Basic Urological Management, 245. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-98720-0_90.

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"Hemodynamic Management." In Trauma, 355–72. CRC Press, 2007. http://dx.doi.org/10.3109/9781420016840-25.

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Conference papers on the topic "Management of trauma"

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Lu, Yanping. "After Trauma of Gaokao." In 2017 World Conference on Management Science and Human Social Development (MSHSD 2017). Paris, France: Atlantis Press, 2018. http://dx.doi.org/10.2991/mshsd-17.2018.87.

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Severin, Florentina, Mihail Dan Cobzeanu, Doina Vesa, Victor Vlad Costan, and Bogdan Mihail Cobzeanu. "Management of complex cervical trauma — Case report." In 2015 E-Health and Bioengineering Conference (EHB). IEEE, 2015. http://dx.doi.org/10.1109/ehb.2015.7391535.

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Kale, Shashank, Dattaraj Sawarkar, Deepak Gupta, Deepak Agarwal, and Pankaj Singh. "Complications in Surgical Management of Craniovertebral Junction Trauma." In 29th Annual Meeting North American Skull Base Society. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679788.

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Liu, Wenwen. "Emergency Treatment and Nursing Care of 148 Multiple Trauma Patients Complicated with Severe Thoracic Trauma." In 4th International Conference on Management Science, Education Technology, Arts, Social Science and Economics 2016. Paris, France: Atlantis Press, 2016. http://dx.doi.org/10.2991/msetasse-16.2016.127.

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Chin, Shy Wei, Seng Tong Chong, Abu Bakar Bin Musa, and Kee Shyuan Loh. "The Data Management of the Language of Trauma Narrative Communication." In 2021 IEEE Global Engineering Education Conference (EDUCON). IEEE, 2021. http://dx.doi.org/10.1109/educon46332.2021.9454015.

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McCORMACK, LYNNE, and TAMRA SILLICK. "REBUILDING LIVES: PSYCHOLOGICAL TRAUMA AND GROWTH IN THE AFTERMATH OF A CATASTROPHIC AUSTRALIAN BUSHFIRE." In DISASTER MANAGEMENT 2017. Southampton UK: WIT Press, 2017. http://dx.doi.org/10.2495/dman170091.

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Darbar, Arun A. "Laser therapy in the management of dental and oro-facial trauma." In Biomedical Optics (BiOS) 2007, edited by Michael R. Hamblin, Ronald W. Waynant, and Juanita Anders. SPIE, 2007. http://dx.doi.org/10.1117/12.702578.

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Halvachizadeh, S., L. Gröbli, T. Berk, KO Jensen, C. Hierholzer, R. Pfeifer, and HC Pape. "Geriatric trauma patients at one Level 1 trauma center before and after ortho-geriatric co-management (OGC): an 8-year comparison." In Deutscher Kongress für Orthopädie und Unfallchirurgie. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1717505.

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Trainer, C., CY Kowa, and T. Egan. "ESRA19-0187 Regional anaesthesia in the management of major chest trauma: an audit of current practice in a major trauma centre." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.307.

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Jin, Daoxin, and Yanhua Guan. "Nursing Cooperation in the Craniotomy of Severe Craniocerebral Trauma." In 2016 4th International Education, Economics, Social Science, Arts, Sports and Management Engineering Conference (IEESASM 2016). Paris, France: Atlantis Press, 2016. http://dx.doi.org/10.2991/ieesasm-16.2016.266.

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Reports on the topic "Management of trauma"

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Harwood, Rachel, Andrew Healey, and Simon Kenny. Urinary tract trauma management in the child. BJUI Knowledge, October 2019. http://dx.doi.org/10.18591/bjuik.0259.

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Carney, Nancy, Tamara Cheney, Annette M. Totten, Rebecca Jungbauer, Matthew R. Neth, Chandler Weeks, Cynthia Davis-O'Reilly, et al. Prehospital Airway Management: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), June 2021. http://dx.doi.org/10.23970/ahrqepccer243.

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Objective. To assess the comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) by emergency medical services in the prehospital setting, and how the benefits and harms differ based on patient characteristics, techniques, and devices. Data sources. We searched electronic citation databases (Ovid® MEDLINE®, CINAHL®, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus®) from 1990 to September 2020 and reference lists, and posted a Federal Register notice request for data. Review methods. Review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center Program methods guidance. Using pre-established criteria, studies were selected and dual reviewed, data were abstracted, and studies were evaluated for risk of bias. Meta-analyses using profile-likelihood random effects models were conducted when data were available from studies reporting on similar outcomes, with analyses stratified by study design, emergency type, and age. We qualitatively synthesized results when meta-analysis was not indicated. Strength of evidence (SOE) was assessed for primary outcomes (survival, neurological function, return of spontaneous circulation [ROSC], and successful advanced airway insertion [for SGA and ETI only]). Results. We included 99 studies (22 randomized controlled trials and 77 observational studies) involving 630,397 patients. Overall, we found few differences in primary outcomes when airway management approaches were compared. • For survival, there was moderate SOE for findings of no difference for BVM versus ETI in adult and mixed-age cardiac arrest patients. There was low SOE for no difference in these patients for BVM versus SGA and SGA versus ETI. There was low SOE for all three comparisons in pediatric cardiac arrest patients, and low SOE in adult trauma patients when BVM was compared with ETI. • For neurological function, there was moderate SOE for no difference for BVM compared with ETI in adults with cardiac arrest. There was low SOE for no difference in pediatric cardiac arrest for BVM versus ETI and SGA versus ETI. In adults with cardiac arrest, neurological function was better for BVM and ETI compared with SGA (both low SOE). • ROSC was applicable only in cardiac arrest. For adults, there was low SOE that ROSC was more frequent with SGA compared with ETI, and no difference for BVM versus SGA or BVM versus ETI. In pediatric patients there was low SOE of no difference for BVM versus ETI and SGA versus ETI. • For successful advanced airway insertion, low SOE supported better first-pass success with SGA in adult and pediatric cardiac arrest patients and adult patients in studies that mixed emergency types. Low SOE also supported no difference for first-pass success in adult medical patients. For overall success, there was moderate SOE of no difference for adults with cardiac arrest, medical, and mixed emergency types. • While harms were not always measured or reported, moderate SOE supported all available findings. There were no differences in harms for BVM versus SGA or ETI. When SGA was compared with ETI, there were no differences for aspiration, oral/airway trauma, and regurgitation; SGA was better for multiple insertion attempts; and ETI was better for inadequate ventilation. Conclusions. The most common findings, across emergency types and age groups, were of no differences in primary outcomes when prehospital airway management approaches were compared. As most of the included studies were observational, these findings may reflect study design and methodological limitations. Due to the dynamic nature of the prehospital environment, the results are susceptible to indication and survival biases as well as confounding; however, the current evidence does not favor more invasive airway approaches. No conclusion was supported by high SOE for any comparison and patient group. This supports the need for high-quality randomized controlled trials designed to account for the variability and dynamic nature of prehospital airway management to advance and inform clinical practice as well as emergency medical services education and policy, and to improve patient-centered outcomes.
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McDonagh, Marian, Andrea C. Skelly, Amy Hermesch, Ellen Tilden, Erika D. Brodt, Tracy Dana, Shaun Ramirez, et al. Cervical Ripening in the Outpatient Setting. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepccer238.

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Objectives. To assess the comparative effectiveness and potential harms of cervical ripening in the outpatient setting (vs. inpatient, vs. other outpatient intervention) and of fetal surveillance when a prostaglandin is used for cervical ripening. Data sources. Electronic databases (Ovid® MEDLINE®, Embase®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) to July 2020; reference lists; and a Federal Register notice. Review methods. Using predefined criteria and dual review, we selected randomized controlled trials (RCTs) and cohort studies of cervical ripening comparing prostaglandins and mechanical methods in outpatient versus inpatient settings; one outpatient method versus another (including placebo or expectant management); and different methods/protocols for fetal surveillance in cervical ripening using prostaglandins. When data from similar study designs, populations, and outcomes were available, random effects using profile likelihood meta-analyses were conducted. Inconsistency (using I2) and small sample size bias (publication bias, if ≥10 studies) were assessed. Strength of evidence (SOE) was assessed. All review methods followed Agency for Healthcare Research and Quality Evidence-based Practice Center methods guidance. Results. We included 30 RCTs and 10 cohort studies (73% fair quality) involving 9,618 women. The evidence is most applicable to women aged 25 to 30 years with singleton, vertex presentation and low-risk pregnancies. No studies on fetal surveillance were found. The frequency of cesarean delivery (2 RCTs, 4 cohort studies) or suspected neonatal sepsis (2 RCTs) was not significantly different using outpatient versus inpatient dinoprostone for cervical ripening (SOE: low). In comparisons of outpatient versus inpatient single-balloon catheters (3 RCTs, 2 cohort studies), differences between groups on cesarean delivery, birth trauma (e.g., cephalohematoma), and uterine infection were small and not statistically significant (SOE: low), and while shoulder dystocia occurred less frequently in the outpatient group (1 RCT; 3% vs. 11%), the difference was not statistically significant (SOE: low). In comparing outpatient catheters and inpatient dinoprostone (1 double-balloon and 1 single-balloon RCT), the difference between groups for both cesarean delivery and postpartum hemorrhage was small and not statistically significant (SOE: low). Evidence on other outcomes in these comparisons and for misoprostol, double-balloon catheters, and hygroscopic dilators was insufficient to draw conclusions. In head to head comparisons in the outpatient setting, the frequency of cesarean delivery was not significantly different between 2.5 mg and 5 mg dinoprostone gel, or latex and silicone single-balloon catheters (1 RCT each, SOE: low). Differences between prostaglandins and placebo for cervical ripening were small and not significantly different for cesarean delivery (12 RCTs), shoulder dystocia (3 RCTs), or uterine infection (7 RCTs) (SOE: low). These findings did not change according to the specific prostaglandin, route of administration, study quality, or gestational age. Small, nonsignificant differences in the frequency of cesarean delivery (6 RCTs) and uterine infection (3 RCTs) were also found between dinoprostone and either membrane sweeping or expectant management (SOE: low). These findings did not change according to the specific prostaglandin or study quality. Evidence on other comparisons (e.g., single-balloon catheter vs. dinoprostone) or other outcomes was insufficient. For all comparisons, there was insufficient evidence on other important outcomes such as perinatal mortality and time from admission to vaginal birth. Limitations of the evidence include the quantity, quality, and sample sizes of trials for specific interventions, particularly rare harm outcomes. Conclusions. In women with low-risk pregnancies, the risk of cesarean delivery and fetal, neonatal, or maternal harms using either dinoprostone or single-balloon catheters was not significantly different for cervical ripening in the outpatient versus inpatient setting, and similar when compared with placebo, expectant management, or membrane sweeping in the outpatient setting. This evidence is low strength, and future studies are needed to confirm these findings.
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Classification and management of genital and testicular trauma. BJUI Knowledge, October 2018. http://dx.doi.org/10.18591/bjuik.0683.

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