The Prognostic Value of MRI in Moderate and Severe TBI

Traumatic brain injury (TBI) is a major cause of death and disability, yet many predictors of outcome are not precise enough to guide initial clinical decision-making. Although increasingly used in the early phase following... read more

The Prognostic Value of MRI in Moderate and Severe TBI

Hypoxia and Hypotension in Patients Intubated by Physician Staffed Helicopter EMS

The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators... read more

Hypoxia and Hypotension in Patients Intubated by Physician Staffed Helicopter EMS

The Quiet Room

The grim reality for trauma healthcare clinicians. From the vantage point of a trauma surgeon, conversation seems a terribly feeble response. Gun violence, whether on the streets of Chicago or in the churches of Charleston... read more

The Quiet Room

The Dark Sides of Fluid Administration in the Critically Ill Patient

The administration of intravenous fluids is probably the most frequently initiated therapy in critically ill patients. With very few exceptions, such as severe congestive heart failure, IV fluids are considered as a safe... read more

The Dark Sides of Fluid Administration in the Critically Ill Patient

Predicting outcomes after trauma to the brain

UMMS researchers help develop novel tool to predict survival after penetrating brain injury. Using the new tool they developed, the SPIN-Score (Surviving Penetrating Injury to the Brain), two factors were by far the strongest... read more

Predicting outcomes after trauma to the brain

Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe hemorrhage

Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. We obtained data for 40,138 patients from two randomised... read more

Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe hemorrhage

Shock Trauma to Study Body Cooling for Patients in Cardiac Arrest from Massive Bleeding

The R Adams Cowley Shock Trauma Center at the University of Maryland has opened a clinical trial to study whether rapidly cooling the body temperature of patients whose hearts stop due to massive blood loss will give surgeons... read more

Shock Trauma to Study Body Cooling for Patients in Cardiac Arrest from Massive Bleeding

Rapid Retriage of Critically Injured Trauma Patients

Critically injured patients presenting to nontrauma hospitals require timely transfer to trauma centers; however, the transfer process varies and differences in outcomes for patients from trauma centers are unknown. We evaluated... read more

Rapid Retriage of Critically Injured Trauma Patients

Clinical Review: Paracetamol in fever in critically ill patients

Paracetamol is a synthetic, nonopioid, centrally acting analgesic and antipyretic drug. Its antipyretic effect occurres because it inhibits cyclooxygenase-3 and the prostaglandin synthesis.... read more

Clinical Review: Paracetamol in fever in critically ill patients

Maryland emergency doctors find new life-saving use in old machine

A little used machine designed to detox people who overdose on Tylenol and other medications found another use. Doctors at Shock Trauma used it to save a teenage gunshot victim and then a college football player and an amateur... read more

Maryland emergency doctors find new life-saving use in old machine

Variation in Monitoring and Treatment Policies for Intracranial Hypertension in TBI

Substantial variation was found regarding monitoring and treatment policies in patients with Traumatic Brain Injury (TBI) and intracranial hypertension. The results of this survey indicate a lack of consensus between European... read more

Variation in Monitoring and Treatment Policies for Intracranial Hypertension in TBI

Individualizing Thresholds of Cerebral Perfusion Pressure Using Estimated Limits of Autoregulation

Individualized autoregulation-guided cerebral perfusion pressure management may be a plausible alternative to fixed cerebral perfusion pressure threshold management in severe traumatic brain injury patients. Prospective randomized... read more

Individualizing Thresholds of Cerebral Perfusion Pressure Using Estimated Limits of Autoregulation

Hyperventilation Therapy for Control of Post-Traumatic Intracranial Hypertension

During traumatic brain injury, intracranial hypertension (ICH) can become a life-threatening condition if it is not managed quickly and adequately. Physicians use therapeutic hyperventilation to reduce elevated intracranial... read more

Hyperventilation Therapy for Control of Post-Traumatic Intracranial Hypertension

Role of Preventability in Redefining Failure to Rescue Among Major Trauma Patients

Failure to rescue (FTR) is defined as death after a major complication and has been adopted as a measure of quality in surgical patients. Current definitions of FTR are limited because they do not account for the influence... read more

Role of Preventability in Redefining Failure to Rescue Among Major Trauma Patients

Why Point-of-Care Ultrasound Should be a Mainstay in EMS

A former firefighter/EMT turned medical student describes the functional components, diagnostic uses and roadblocks of using this imaging technology. From the first enormous and hefty ultrasound scanners, circa 1965, to today's... read more

Sepsis Prediction in Critically Ill Patients by Platelet Activation Markers on ICU Admission

Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical... read more

Sepsis Prediction in Critically Ill Patients by Platelet Activation Markers on ICU Admission

Should All Massively Transfused Patients Be Treated Equally?

Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This... read more

Should All Massively Transfused Patients Be Treated Equally?

Focus on Brain Injury – The Staircase Approach

Focus on brain injury, staircase approach for the treatment of intracranial hypertension after TBI. The development of clinical protocols based on both laboratory and clinical data has underpinned the achievements of neurocritical... read more

Focus on Brain Injury – The Staircase Approach

Why a stay in the ICU can leave patients worse off

Almost 6 million patients land in an intensive care unit every year, and for many, it marks a turning point in their lives. A substantial number of patients leave the ICU with newly acquired problems, from dementia to nerve... read more

Why a stay in the ICU can leave patients worse off

Neuro ICU Early Mobilization Protocol

Researchers in the U.S. have developed a multidisciplinary Neuro Early Mobilization Protocol for complex patients in the neuroscience intensive care unit (NSICU). Developing an evidence-based protocol with inter-professional... read more

Neuro ICU Early Mobilization Protocol

Burnout Syndrome in Critical Care: A Call for Action

Burnout syndrome (BOS) is a work-related constellation of symptoms and signs that usually occurs in individuals with no history of psychological or psychiatric disorders. BOS is triggered by a discrepancy between the expectations... read more

Burnout Syndrome in Critical Care: A Call for Action