Tag: trauma

Upvote Story 5
In 2014, the Canadian Task Force on Preventive Health Care recommended against the prostate-specific antigen (PSA) test used to screen for prostate cancer in healthy men, concluding that it results in substantial harms via biopsies and surgeries that can lead to infections, impotence or urinary incontinence, and does not save men’s lives. “Amazingly, despite thousands and thousands of patients included in randomized controlled trials, there... Read More | Comment
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Two CT scans performed during blunt trauma encounters demonstrated mixed benefit and were associated with an increased hospital LOS. Additionally, IV contrast was associated with lower rates of AKI. Of 5787 patient encounters, 5335 (93.4%) received IV contrast and 75 (1.3%) received two CT scans. Lower rates of AKI were associated with IV contrast (2.5 vs 12.5%). Receiving two CT scans was associated with increased... Read More | Comment
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A short course of intravenous vitamin C in pharmacological dose seems a promising, well tolerated, and cheap adjuvant therapy to modulate the overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia. Large randomized controlled trials are necessary to provide more evidence before wide-scale implementation can be recommended. Vitamin C is a key circulating antioxidant with anti-inflammatory and immune-supporting effects, and a cofactor for... Read More | Comment
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In a conversational, easy-to-read style, Avoiding Common Errors in the Emergency Department, 2nd Edition, discusses 365 errors commonly made in the practice of emergency medicine and gives practical, easy-to-remember tips for avoiding these pitfalls. Chapters are brief, approachable, and evidence-based, suitable for reading immediately before the start of a rotation, used for quick reference on call, or read daily over the course of one year... Read More | Comment
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Mortality for hypotensive trauma patients undergoing emergency laparotomy have not changed in 20 years. This blog explores the literature and the future! Wait! We’re emergency physicians, why do we care about laparotomies?! Sure, at face value this would appear to have a rather surgical slant to it, but I hope by the end you share my feeling that, as emergency and critical care physicians, this... Read More | Comment
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The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective was to describe these triage decisions in more detail with regard to the most common diagnoses, incidence of direct referral sorted by the prehospital critical care team (PHCCT) and the destination hospital.... Read More | Comment
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This volume provides a comprehensive overview of hematologic issues that clinicians regularly encounter in the critical care environment. The text features hematologic scenarios that affect the adult ICU patient, outlines pathogenesis and challenges associated with the hematologic disorder, and offers treatment modalities. Hematologic issues covered include anemia, hemostatic abnormalities, and risks of transfusion. The book also details challenges in specific ICU populations, such as patients... Read More | Comment
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Use of vasopressor for traumatic hemorrhagic shock was associated with mortality after controlling for biases (trauma severity; volume of fluid resuscitation). Among 236,698 trauma patients, 3,551 were included in the study. Overall, 198 of 459 patients (43%) in the vasopressor+ group expired compared with 481 of 3,092 patients (16%) in the vasopressor– group. Three-thousand five-hundred fifty-one traumatic hemorrhagic shock patients who had systolic hypotension (<... Read More | Comment
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This well-illustrated book provides detailed guidance on all aspects of physical examination in patients requiring emergency or intensive care. After an introductory section covering basic principles and the recognition of pre-terminal signs, the approach to examination of individual organ systems is clearly explained. Examination schemes are then presented for particular conditions or settings, including respiratory distress, shock, neurological disease, trauma, suspected infection, and cardiac arrest.... Read More | Comment
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Sepsis is a heterogeneous disease and identification of its subclasses may facilitate and optimize clinical management. This study aimed to identify subclasses of sepsis and its responses to different amounts of fluid resuscitation. The study identified four subphenotypes of sepsis, which showed different mortality outcomes and responses to fluid resuscitation. Prospective trials are needed to validate our findings. In total, 14,993 patients were included in... Read More | Comment
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High-flow nasal cannula oxygen therapy may be considered as an initial respiratory therapy for trauma patients with blunt chest injury. High-flow nasal cannula therapy could improve lung aeration as noted by the transthoracic lung ultrasound assessment, and LUS may help the attending physicians identify the usefulness of HFNC therapy and decide whether to continue the use of HFNC therapy or intubate the patient. During the... Read More | Comment
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Non-technical skills and human factors are increasingly recognized as critical ingredients in the success or failure of acute care delivery in a number of high stakes clinical domains. This is reflected in the evolution of life support courses, which now incorporate components of the zero point survey (ZPS). For example, the European Trauma Course emphasizes team briefs and equipment checks, and the Advanced Pediatric Life... Read More | Comment
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An immediate classic, this groundbreaking text is based on the premise that neurointensivists must be trained to handle not only the brain, but the entire body. The NeuroICU Book, Second Edition does not limit coverage to the brain and spine – it spans all organ insufficiencies and failures – along with neurologic illnesses. Thoroughly updated to keep pace with all the advances in this emerging... Read More | Comment
Upvote Story 13
Seems like a little thing, but I did this in response to a tweet by the National Rifle Association, asserting that doctors should “stay in our lane” instead of studying or making recommendations when it comes to gun violence. As a trauma surgeon in Newark and an assistant professor of Trauma and Critical Care Surgery at Rutgers New Jersey Medical School, I live in the... Read More | Comment