Clinical Research Directory

Effects of a Contextual Decision-making Materials on Junior Nurses in Traumatic Learning Performance

Trauma leading to severe bleeding is one of the reasons for the high mortality rate in trauma patients, resulting in multiple and complex injuries from various accidental mechanisms. However, patients with abdominal-pelvic trauma accidents rank among the top three common accidents in the emergency department. There is a potential for both trauma and severe internal bleeding, making the care of such patients even more challenging. Currently, trauma nursing education focuses on emergency medical care, and teaching on the care of abdominal-pelvic trauma occupies only a small part of the entire nursing curriculum. In addition to insufficient knowledge teaching in emergency trauma medical care, learning relies heavily on the arrangement of clinical internships, and obtaining practical experience in the care of abdominal-pelvic trauma is often difficult. In the current era of thriving digital learning, allowing learning to be more diverse and unrestricted by time and location, it is essential to integrate appropriate guiding strategies alongside digital technology to make learning more efficient and promote meaningful learning. Therefore, this study introduces decision trees into an interactive scenario-based learning environment for the care of severe bleeding due to abdominal-pelvic trauma. The decision tree is coupled with a decision-making strategy, utilizing the relationships between leaf nodes to guide learners in clarifying their misconceptions, ultimately leading them to make appropriate decisions to reach the final nodes and solve problems. To understand the effectiveness of this study, a real experimental research design is adopted to investigate the impact of introducing decision tree-based interactive teaching materials on the care of severe bleeding in abdominal-pelvic trauma situations on the professional knowledge, self-efficacy, clinical reasoning assessment ability, and technology acceptance of surgical nursing students over a two-year period. It is hoped that this interactive teaching material for the care of severe bleeding in abdominal-pelvic trauma scenarios will enhance learners' professional knowledge, self-efficacy, clinical reasoning assessment, and technology acceptanc.

A Research Study of Abdominal Ultrasound (FAST) in Children With Blunt Torso Trauma

Bleeding from intra-abdominal injuries is a leading cause of traumatic deaths in children. Abdominal CT is the reference standard test for diagnosing intra-abdominal injuries. Compelling reasons exist, however, to both aggressively evaluate injured children for intra-abdominal injuries with CT and to limit abdominal CT evaluation to solely those at non-negligible risk. The focused assessment sonography for trauma (FAST) examination can help focus patient evaluation in just this manner by potentially safely decreasing abdominal CT use in low risk children. This research study is a multicenter, randomized, controlled trial to determine whether use of the FAST examination, a bedside abdominal ultrasound, impacts care in 3,194 hemodynamically stable children with blunt abdominal trauma. The overall objectives of this proposal are 1) to determine the efficacy of using the FAST examination during the initial evaluation of children with blunt abdominal trauma, and 2) to identify factors associated with abdominal CT use in children considered very low risk for IAI after a negative FAST examination. The long-term objective of the research is to determine appropriate evaluation strategies to optimize the care of injured children, leading to improved quality of care and a reduction in morbidity and mortality.

Developing a Decision Instrument to Guide Abdominal-pelvic CT Imaging of Blunt Trauma Patients

Unrecognized abdominal and pelvic injuries can result in catastrophic disability and death. Sporadic reports of "occult" injuries have generated concern, and physicians, fearing that they may miss such an injury, have adopted the practice of obtaining computed tomography on virtually all patients with significant blunt trauma. This practice exposes large numbers patients to dangerous radiation at considerable expense, while detecting injuries in a small minority of cases. Existing data suggest that a limited number of criteria can reliably identify blunt injury victims who have "no risk" of abdominal or pelvic injuries, and hence no need for computed tomography (CT), without misidentifying any injured patient. It is estimated that nationwide implementation of such criteria could result in an annual reduction in radiographic charges of $75 million, and a significant decrease in radiation exposure and radiation induced malignancies. This study seeks to determine whether "low risk" criteria can reliably identify patients who have sustained significant abdominal or pelvic injuries and safely decrease CT imaging of blunt trauma patients. This goal will be accomplished in the following manner: All blunt trauma victims undergoing computed tomography of the abdomen/pelvis in the emergency department will undergo routine clinical evaluations prior to radiographic imaging. Based on these examinations, the presence or absence of specific clinical findings (i.e. abdominal/pelvic/flank pain, abdominal/pelvic/flank tenderness, bruising abrasions, distention, hip pain, hematuria, hypotension, tachycardia, low or falling hematocrit, intoxication, altered sensorium, distracting injury, positive FAST imaging, dangerous mechanism, abnormal x-ray imaging) will be recorded for each patient, as will the presence or absence of abdominal or pelvic injuries. The clinical findings will serve as potential imaging criteria. At the completion of the derivation portion of the study the criteria will be examined to find a subset that predicts injury with high sensitivity, while simultaneously excluding injury, and hence the need for imaging, in the remaining patients. These criteria will then be confirmed in a separate validation phase of the study. The criteria will be considered to be reliable if the lower statistical confidence limit for the measured sensitivity exceeds 98.0%. Potential reductions in CT imaging will be estimated by determining the proportion of "low-risk" patients that do not have significant abdominal or pelvic injuries.

Pediatric Intravenous Contrast-Enhanced Ultrasound(CEUS) in China

The goal of this clinical trial is to evaluate the application of intravenous contrast-enhanced ultrasound examination in children with intra-abdominal diseases that require clear diagnoses. The main questions it aims to answer are: * Is intravenous contrast-enhanced ultrasound helpful for the diagnosis of intra-abdominal diseases in children? * What medical problems do participants have when participating in intravenous contrast-enhanced ultrasound examination? * How can ultrasound doctors conduct intravenous contrast-enhanced ultrasound examinations in a standardized manner? Researchers will performing intravenous contrast-enhanced ultrasound examinations on participants and collecting research subjects to establish a multicenter clinical data database. Participants will: * Perform abdominal ultrasound examination to assess the condition. * At least conduct one intravenous contrast-enhanced ultrasound examination. Based on the result of the contrast examination, decide whether to conduct another examination. * Keep a diary of their symptoms and therapeutic process in 30 days.