Complimentary Roles of Quantitative & Qualitative Research Methods 2015.2.25Borwornsom Leerapan
Discussion of how we learn and create new knowledge. The difference between the implementation gap and the knowledge gap. Philosophy of science that leads to different approaches of quantitative and qualitative research methods. Skill for qualitative study, including deep listening.
Complimentary Roles of Quantitative & Qualitative Research Methods 2015.2.25
Complimentary Roles of Quantitative & Qualitative Research Methods 2015.2.25Borwornsom Leerapan
Discussion of how we learn and create new knowledge. The difference between the implementation gap and the knowledge gap. Philosophy of science that leads to different approaches of quantitative and qualitative research methods. Skill for qualitative study, including deep listening.
Complimentary Roles of Quantitative & Qualitative Research Methods 2015.2.25
The document discusses various trauma scoring systems used to assess injury severity and predict patient outcomes. It describes anatomical indices like the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) which evaluate individual injuries and overall trauma burden. It also outlines physiological scores such as the Trauma Score, Revised Trauma Score, and CRAMS scale that assess vital signs and neurological status. Combination scores like TRISS use both anatomical and physiological factors to determine survival probabilities for trauma patients. Early warning scores evaluate pre-hospital and emergency department patients to guide triage and care.
The document discusses various trauma scoring systems used to assess injury severity, predict survival chances, and guide triage and treatment of trauma patients. It describes anatomical indices like the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) which evaluate individual injuries and overall injury burden. It also covers physiological scales like the Trauma Score, Revised Trauma Score, and CRAMS scale. Multiple organ dysfunction scores like SOFA are presented, along with mass casualty triage algorithms like START and SALT.
This document provides information on the management of traumatic brain injury (TBI). It defines TBI as an alteration in brain function caused by a blow or jolt to the head. The primary survey for a TBI patient involves assessing the airway, breathing, circulation, disability or neurological status, and exposure. Disability is evaluated using the Glasgow Coma Scale. Mild TBI is defined as a brief alteration in mental status or consciousness with a Glasgow Coma Scale score between 13-15. The document also discusses complications, guidelines for CT scans, and classifications of mild versus severe TBI.
This document provides guidance on the management of multiple trauma patients. It outlines the ABCDE approach and trauma concept, which emphasizes rapidly assessing and treating the most life-threatening injuries first before making definitive diagnoses.
The primary survey involves simultaneously assessing the patient's airway, breathing, circulation, disability, and exposure. Adjuncts like monitoring, catheters and imaging may be used but not delayed transfer. The secondary survey obtains a more detailed history and physical exam.
Special considerations for pediatric, geriatric, and pregnant trauma patients are discussed. Key physiological differences and injury patterns are highlighted. The document also reviews complications like tension pneumothorax, cardiac tamponade and hemorrhagic shock and their
5. WHO guideline
containing recommendations about
health interventions; clinical, public health
or policy recommendations.
Recommendations are based on
a comprehensive and objective assessment
of the available evidence.
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6. free from bias, meet a public health need and
are consistent with the following principles.
The process used to develop is clear,
the reader will be able to see how
a recommendation has been developed,
by whom, and on what basis.
WHO guideline
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7. Types of guidelines
• Rapid advice guidelines
• Standard guidelines
• Full guidelines
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8. Rapid advice guidelines
Produced within 1–3 months.
May not be supported by full reviews of
the evidence.
Prepared by staff members with external
consultation and peer review.
updated or converted to a standard guideline.
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9. Standard guidelines
Usually take 9-12 months to complete.
Supported by systematic reviews of the
evidence and one or two meetings group.
May have a specified review-by date of
change of evidence in the topic area.
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10. Full guidelines
Would be expected to include
recommendations in relation to all aspects
of the topic.
Fully based on systematic reviews of the
evidence for each aspect.
Likely to take 2-3 years to complete.
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11. Compilations of guidelines
Using the Appraisal of Guidelines for
Research and Evaluation (AGREE) tool.
http://www.agreetrust.org/
Some guideline do not require GRC
(Guideline Review Committe) review:
have previously been clear.
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13. Adaptations of guidelines
Intended for one setting may be adapted
for use in another.
Adaptations of guidelines must follow
standard GRC procedures.
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14. Guidelines prepared
in collaboration with other organizations
Not by the external group.
No guideline exists or an existing guideline is
outdated.
Met evidence systematically reviewed,
conflicts of interest declared
Reviewing and summarizing evidence should
be consistent.
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15. New JBI (Joanna Brigs Institute)
Levels of Evidence
• Level of Evidence for Effectiveness
• Level of Evidence for Diagnosis
• Level of Evidence for Prognosis
• Level of Evidence for Economic evaluations
• Level of Evidence for Meaningfulness
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16. New JBI Levels of Evidence
Level 1 – Experimental Designs
Level 2 – Quasi-experimental Designs
Level 3 – Observational – Analytic Designs
Level 4 – Observational –Descriptive Studies
Level 5 – Expert Opinion and Bench Research
Level of Evidence for Effectiveness
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17. New JBI Levels of Evidence
Level 1 – Studies of Test Accuracy among
consecutive patients
Level 2 – Studies of Test Accuracy among
non-consecutive patients
Level 3 – Diagnostic Case control studies
Level 4 – Diagnostic yield studies
Level 5 – Expert Opinion and Bench Research
Level of Evidence for Diagnosis
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18. New JBI Levels of Evidence
Level 1 – Inception Cohort Studies
Level 2 – Studies of All or none
Level 3 – Cohort studies
Level 4 – Case series/Case Controlled/
Historically Controlled studies
Level 5 – Expert Opinion and Bench Research
Level of Evidence for Prognosis
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20. การตั้งคาถามด้วย PICO
P Population
ปัญหา หรือผู้ป่วยที่ต้องการศึกษา
I Intervention
สิ่งที่จะแก้ปัญหา หรือให้ผู้ป่วย
C Comparator
สิ่งที่เป็นตัวเปรียบเทียบ
O Outcomes
ผลที่ต้องการ
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41. Fast Track Trauma 2016
(Minimal Data Set)
• Abdominal injury with shock
• Massive hemothorax
• Cardiac injury
• Traumatic amputation
• EDH/SDH/ICH
42. Minimal Data Set
เน้น Fast Tract; Process
ER คุณภาพ
ER to OR
OSCA (out of hospital cardiac arrest)
กาหนดตัวเลขเป็นตัวชี้วัดเวลา.... > 80%
หาตัวเลขกลาง
50. การเฝ้ าระวังภาวะช็อกจากการบาดเจ็บ
ของผู้ป่วยอุบัติเหตุที่ห้องฉุกเฉิน
พยาบาลอุบัติเหตุห้องฉุกเฉิน ควรรวบรวมข้อมูล
เกี่ยวกับการบาดเจ็บของผู้ป่วยอย่างรวดเร็ว และใช้
แนวปฏิบัติที่มีมาตรฐาน ซึ่งระบุการกาซาบเลือดเป็น
ตัวชี้วัดในการค้นหาภาวะช็อกจากการบาดเจ็บและช่วย
ในการตัดสินใจทางคลินิก (ระดับ 4)22
Soderlund, T., Tulikoura, I., Niemela, M., &Handolin, L. (2009). Traumatic
deaths in the emergency room: A retrospective analysis of 115
consecutive cases. European Journal ofTrauma and Emergency Surgery,
5, 455-462.