Evidence-based articles on management of trauma in the emergency department
I will often dump on the use of secondary analysis to drive clinical practice but studying children with trauma is not easy, so you have to take the data from where you can. From the PECARN group they went back and mined the original 42,112 children that were used in 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…
Do you take care of kids with possible head injuries? Do you use the PECARN clinical decision aid when you do? Should you be using the the PECARN clinical decision aid when you do? It has never been externally validated, until now. Find out if it works as well as we assume it 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…
Thanks to Dr. McMillan for today’s Morning Report! Traumatic Brain Injury – American Association of Neurological Surgeons Guidelines Case#1: A 45 year-old man helmeted motorcyclist struck by van, negative loss of consciousness, and currently GCS 15 and appropriate but complaining of headache. CT scan shows a small, lenticular hematoma 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…
Dr. Grock presents today’s Morning Report! C- Spine Immobilization: A Critical Review of the Evidence Cervical collars have been in use for over 30 years, yet, there have been no randomized, controlled trials evaluating their effectiveness. Per the most recent Cochrane review in 2009, there is no evidence 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…