Tag: trauma
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
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
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
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
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
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
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
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
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
Albumin Administration in Sepsis: The Case for and Against
Serum albumin is an essential plasma protein, with a variety of homeostatic and predictive roles in health and disease. Hypoalbuminaemia is common in critical illness. Human albumin solution has been administered clinically... read more
A Trauma Nurse Reflects On Compassion Fatigue
Kristin Laurel, a flight nurse from Waconia, Minn., has worked in trauma units for over two decades. The daily exposure to distressing situations can sometimes result in compassion fatigue. That burnout is what Laurel says... read more
Michael Lewis’ The Undoing Project: How do ER surgeons avoid dumb, deadly mistakes? Ask their doctor
In an excerpt from his new book Michael Lewis examines a Toronto doctor who helps trauma surgeons avoid errors in judgment when life and death are on the line. Doctors tended to see only what they were trained to see: That... read more
Systemic and Microcirculatory Effects of Blood Transfusion in Experimental Hemorrhagic Shock
The microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition, the identification... read more
A Call for Fresh Airway Management Standards
Anesthesiology News recently reported on a study that promoted the LMA in prone position to "avoid intubation, reduce use of relaxants and minimize airway trauma." This study reflects increasing confusion in a complex... read more
The Sick and the Dead: Evidence-Based Trauma Resuscitation
The science of trauma resuscitation has undergone a fairly massive evolution in the past decade. This talk was our attempt to summarize the best-of-the-best in trauma literature from the past several years, and package it... read more
Preadmission Oral Corticosteroids Are Associated With Reduced Risk of ARDS in Critically Ill Adults With Sepsis
The unadjusted occurrence rate of acute respiratory distress syndrome within 96 hours of ICU admission was 35% among patients who had received oral corticosteroids compared with 42% among those who had not (p = 0.107). In... read more
The Emotional Toll of Treating Victims of Violence
Hospital leaders are implementing several techniques to address the lasting trauma of disaster emergencies. Hospital disaster drills often focus on transporting patients to the emergency department and moving them into the... read more
The Toll of Death and Disability From Traumatic Injury in the United States
This viewpoint describes the lack of funding for trauma research as a possible cause of increasing mortality rates from traumatic injury. In a seminal 1966 report, the National Research Council (NRC) declared that unintentional... read more
Ratio-based Transfusion and Non-trauma Patients
Researchers at Massachusetts General Hospital (MGH) urge caution in adopting ratio-based transfusion - a practice previously studied only in patients with severe traumatic injuries - in non-trauma patients. Their study published... read more
Meta-Analysis of Therapeutic Hypothermia for Traumatic Brain Injury in Adult and Pediatric Patients
Therapeutic hypothermia is a likely beneficial treatment following TBI in adults, improving both neurologic outcomes and decreasing mortality rates. Our work suggests that the optimal management strategy to improve both morbidity... read more
Association of Ratio-Based Massive Transfusion With Survival Among Patients Without Trauma
Association Between Ratio of Fresh Frozen Plasma to Red Blood Cells During Massive Transfusion and Survival Among Patients Without Traumatic Injury. This study reports on the use and benefits of ratio-based blood product... read more
