We discussed an informative and interesting review article on stroke management in October’s Critical Care Minifellowship meeting. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062315/ This article highlights some important points (that shed light on how complicated the brain truly is) and touches upon some interesting neurological trials. A few points to mention are: – The idea of Read more…
How many times have you been in the ER when a trauma patient comes in and you take a pen and paper and begin to calculate an injury severity score? I know what you’re thinking… #aintnobodygottimeforthat… especially in a busy County ER with multiple traumas presenting simultaneously, but hear me Read more…
Hemorrhage is one of the leading causes of mortality in trauma patients: responsible for approximately 30-40% of deaths overall and 50% of deaths within the first 24-hours post-trauma. Wow. That’s a great deal. So let them have blood? Well… not so simple. First, there is the poorly understood “coagulopathy of Read more…
I think we can all agree that seatbelts are wonderful inventions. Developed in the 1960s, these protective devices have been shown to cause a 45-60% decrease in fatal injury associated with motor vehicle collisions. However, as with anything in life—there are risks. Seatbelts have been associated with patterns of injury Read more…
We’ve all experienced the scenario where a trauma patient appears in your trauma bay, blood pressure barely palpable, whose IV line is near impossible to obtain. Solution? IO access. A wonderful advancement in trauma care that has led to the stabilization of critically ill patients in whom IV access cannot Read more…
Gunshot wound mortality is related in large part to rapid hemorrhage, usually direct pressure/tourniquet/gauze packing are all ways to help control the bleeding urgently. Well, one startup company was inspired by the “Fix-a-Flat” tire device and created a similar device to prevent exsanguination from penetrating wounds. XSTAT dressing created by Read more…
“The heart was made to be broken.” ― Oscar Wilde Blunt thoracic trauma accounts for 25% of all traumatic fatalities. Blunt Cardiac Injury (BCI) has been quoted to be present in up to 76% of blunt thoracic trauma patients. BCI encompasses a spectrum of injuries from myocardial contusion to myocardial Read more…
We recently had a case of pediatric GU injury after blunt trauma. This inspired me to write a piece on GU injuries. Enjoy! Most GU injuries are a result of blunt trauma. Up to 10% of patients in the ED with abdominal trauma will have GU injuries. They are Read more…
Recently, I reviewed a pediatric spinal trauma case. The recommendation for steroids was the most controversial part of the case. One service recommended it, another didn’t. One service from another hospital where the patient was to be transferred recommended it, but another service at the same hospital adamantly was opposed Read more…
“Life is tough enough without having someone kick you from the inside.”—Rita Rudner Thankfully, these teeny kicks don’t cause trauma!! Critical illness, including trauma, actually affects less than 1% of all pregnancies in the US. However, this patient population can be exceedingly complicated due to the plethora of physiologic alterations Read more…