Tag: trauma
Predicting Outcomes in Pediatric Trauma Patients Using rSI Multiplied by GCS
Reverse shock index multiplied by Glasgow Coma Scale outperformed SI and shock index pediatric age-adjusted (SIPA) in the early identification of traumatically injured children at risk for early interventions, such as blood... read more
The Small Percutaneous Catheter vs. Large Open Chest Tube For Traumatic Hemothorax
Small caliber 14-Fr PCs are equally as effective as 28- to 32-Fr chest tubes in their ability to drain traumatic HTX with no difference in complications. Patients reported better IPE scores with PCs over chest tubes,... read more
High resuscitative endovascular balloon occlusion of the aorta procedural volume is associated with improved outcomes
Resuscitative endovascular balloon occlusion of the aorta survival is increased at high versus low utilization centers. Increased experience with REBOA may be associated with earlier deployment and subsequently improved patient... read more
Which Injured Patients with Moderate Fibrinogen Deficit Need Fibrinogen Supplementation?
We have shown in this study an association between shock parameters and fibrinogen administration. Further studies are needed to determine how these parameters may be used to guide fibrinogen administration in trauma patients... read more
Foley Catheter Tamponade Usage for Bleeding Control in Penetrating Injuries
We recently used a Foley catheter to manage a stab wound to the left anterior neck (zone 1) in a 26 year-old male. Police arrived shortly after the incident but couldn’t stop the bleeding with external compression with... read more
To Bronch or Not to Bronch – That Is the Question
Percutaneous tracheostomy was safely and effectively performed by an experienced surgical team both with and without bronchoscopic guidance with no difference in the complication rates. This study suggests that the use... read more
Intravenous Push Levetiracetam Safety in a Neuro-Spine ICU
Administration of levetiracetam doses up to 2000 mg via IVP is a safe method of administration that results in a reduction of time to medication administration and a reduction of benzodiazepine use. Of the 2,055 hospital-wide... read more
Prehospital FAST Reduces Admission Time and Treatment
The focused assessment with sonography in trauma (FAST) exam is an established trauma care diagnostic procedure. Ultrasound performed during prehospital care can improve early treatment and management of the patients. According... read more
Approach to the Critically Ill Poisoned Patient
Toxicology histories are notoriously unreliable. Any available medical records, especially medication lists. Timing & amount of ingestions. Immediate vs. sustained-release formulations. Consider inquiring specifically... read more
Continuous Pneumatic Regulation of Tracheal Cuff Pressure to Decrease VAP in Mechanically Ventilated Patients
Continuous regulation of cuff pressure of the tracheal tube using a pneumatic device was not superior to routine care in preventing Ventilator-associated pneumonia (VAP) in patients with severe trauma. A total of 434 patients... read more
Imputation Strategies for Missing Baseline Neurological Assessment Covariates After TBI
Statistical models for outcome prediction are central to traumatic brain injury (TBI) research and critical to baseline risk adjustment. Glasgow coma score (GCS) and pupil reactivity are crucial covariates in all such models... read more
Managing Rising COVID-19 Cases in ICU
I have been working in intensive care for over 20 years, including a decade as a consultant, and facing winter pressures has always been the norm. However, the past 18 months have been something else. During the winter... read more
Transcatheter arterial embolization for severe blunt liver injury in hemodynamically unstable patients
Transcatheter arterial embolization (TAE) in hemodynamically unstable patients who responded to initial infusion therapy to some extent has acceptable in-hospital mortality and clinical failure rates. Hemodynamic instability... read more
Preoperative vena cava filter placement in recurrent cerebral fat embolism following traumatic multiple fractures
Despite scarce evidence, we reckon that Inferior Vena Cava Filter (IVCF) could improve prognosis in selected patients with fat embolism syndrome (FES), especially those presenting high risk factors, after accurately weighing... read more
Point-of-Care Transcranial Doppler by Intensivists
In the unconscious patient, there is a diagnostic void between the neurologic physical exam, and more invasive, costly and potentially harmful investigations. Transcranial color-coded sonography and two-dimensional transcranial... read more
What is the Ideal Approach for Emergent Pericardiocentesis Using POCUS Guidance?
A total of 166 pericardial effusions were identified during the study period. The mean skin-to-pericardial fluid distance was 5.6 cm for the subxiphoid views, which was significantly greater than that for the parasternal... read more
Lactate = LactHATE
Like many others who attended SMACC earlier this year I returned home dazed and confused about the significance of lactate in the septic patient. So like any good (aspiring to be) evidence-based medicine practitioner,... read more
