OBJECTIVE: Sinusoidal obstruction syndrome (SOS) is one of the most serious complications post haematopoietic stem cell transplantation (HSCT). The diagnosis of SOS is clinical, but nurses should be involved in the pre-transplant risk assessment period and play a crucial role in the early detection of signs and symptoms during and after hospitalization. The aim of this work is to achieve a consensus on nurses\' behaviour in caring for SOS.
METHODS: On behalf of the Italian Group for Bone and Marrow Transplantation (GITMO), a promoter committee was established to put in place a consensus conference approach. A multidisciplinary group of GITMO together with four nurses, three haematology physicians and one patient representative acted as jury, who reviewed the reports and wrote recommendations and suggestions. Recommendations gaining 100% of consensus were considered \'Golden Points of Care\'; if a consensus was achieved by ≥ 75% of the jury\'s members, those recommendations were defined as \'Good Practices\'.
RESULTS: Eighteen papers written by nurses as first authors have been identified. Golden Points of Care and Good Practices were worked out for the following topics: nurses\' role in general, nurses\' role in pre-transplant assessment, pre-transplant risk assessment and risk stratification, baseline monitoring, suspected mild or moderate SOS, suspected severe or very severe SOS and late-onset cases.
CONCLUSIONS: SOS is relatively rare; therefore, a holistic approach to the patients\' needs considering nursing role as essential may result in better care outcomes.

OBJECTIVE: The German society of trauma surgery published the \"Treatment of Patients with Severe and Multiple injuries\" guideline in 2011. This achieved the highest level of recommendation for guidelines published in Germany. This study investigated if there was an improvement in the survival rates of severed injured patients following the introduction of the guideline in clinical treatment.
METHODS: All patients with an injury severity score ≥16 on primary admission to hospital between January 2010 and December 2012 (a total of 373 patients) were included in this study. The data for these patients were collected from the German Trauma Registry and from patients\' hospital records. Patients who were treated in 2010 were compared with patients who were treated in 2011 and 2012, following the introduction of the \"treatment of patients with severe and multiple injuries\" guideline in the authors\' clinic at the beginning of 2011.
RESULTS: Significant differences were found in ISS, RTS, New ISS, and TRISS between 2010 and 2011/2012. No differences were found in the severity of injury when classified by different body regions. Major differences were found in the total volume replacement, the length of emergency surgery, the length of surgery performed within the first 24h and the rate of whole-body computed tomography. The mortality rate dropped from 32.48% in 2010 to 18.75% in 2011/2012 (p=0.003).
CONCLUSIONS: The introduction and use of a guideline-based medical care regime for severely injured patients might reduce the rate of mortality.