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Circulation first – the time has come to question the sequencing of care in the ABCs of trauma; an American Association for the Surgery of Trauma multicenter trial

Overview of attention for article published in World Journal of Emergency Surgery, February 2018
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#15 of 424)
  • High Attention Score compared to outputs of the same age (92nd percentile)

Mentioned by

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43 tweeters
facebook
1 Facebook page

Citations

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4 Dimensions

Readers on

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54 Mendeley
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Title
Circulation first – the time has come to question the sequencing of care in the ABCs of trauma; an American Association for the Surgery of Trauma multicenter trial
Published in
World Journal of Emergency Surgery, February 2018
DOI 10.1186/s13017-018-0168-3
Pubmed ID
Authors

Paula Ferrada, Rachael A. Callcut, David J. Skarupa, Therese M. Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M. Nygaard, Martin A. Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O. Moore, Irene Tabas, Joseph Dubose

Abstract

The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee. We performed a retrospective analysis of all patients that presented to trauma centers with presumptive hypovolemic shock indicated by pre-hospital or emergency department hypotension and need for intubation from January 1, 2014 to July 1, 2016. Data collected included demographics, timing of intubation, vital signs before and after intubation, timing of the blood transfusion initiation related to intubation, and outcomes. From 440 patients that met inclusion criteria, 245 (55.7%) received intravenous blood product resuscitation first (CAB), and 195 (44.3%) were intubated before any resuscitation was started (ABC). There was no difference in ISS, mechanism, or comorbidities. Those intubated prior to receiving transfusion had a lower GCS than those with transfusion initiation prior to intubation (ABC: 4, CAB:9,p = 0.005). Although mortality was high in both groups, there was no statistically significant difference (CAB 47% and ABC 50%). In multivariate analysis, initial SBP and initial GCS were the only independent predictors of death. The current study highlights that many trauma centers are already initiating circulation first prior to intubation when treating hypovolemic shock (CAB), even in patients with a low GCS. This practice was not associated with an increased mortality. Further prospective investigation is warranted. IRB approval number: HM20006627. Retrospective trial not registered.

Twitter Demographics

The data shown below were collected from the profiles of 43 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 54 100%

Demographic breakdown

Readers by professional status Count As %
Other 12 22%
Student > Master 8 15%
Student > Bachelor 7 13%
Student > Doctoral Student 4 7%
Professor > Associate Professor 3 6%
Other 10 19%
Unknown 10 19%
Readers by discipline Count As %
Medicine and Dentistry 28 52%
Nursing and Health Professions 6 11%
Agricultural and Biological Sciences 2 4%
Arts and Humanities 1 2%
Psychology 1 2%
Other 2 4%
Unknown 14 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 26. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 July 2020.
All research outputs
#812,994
of 15,895,825 outputs
Outputs from World Journal of Emergency Surgery
#15
of 424 outputs
Outputs of similar age
#28,319
of 367,487 outputs
Outputs of similar age from World Journal of Emergency Surgery
#1
of 1 outputs
Altmetric has tracked 15,895,825 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 424 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.6. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 367,487 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them