Let’s go and see your next patient in the pediatric ER: a 4 month baby with a chief complaint of “head injury”. Mom says that she was playing with the baby yesterday. While playing, the baby kicked and then hit his head against the wall! He cried immediately for 10 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…
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…
ED thoracotomies were introduced into medicine circa 1900, with endless debate and controversy to follow. It’s a procedure that no doubt can save a patient’s life, as without this “last ditch” effort, mortality would be 100% in a trauma patient left in cardiac arrest. Survival outcomes have been quoted anywhere Read more…
We’re always talking about reducing health care costs. One of the ways major ways to reduce costs is to stop ordering unnecessary tests. Let’s talk about CT scans for a minute. CT scans can cost anywhere from $300-1500 per scan of the body part for your patient, with CT head Read more…