Tag: trauma
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
Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild TBI
Early prehospital and in-hospital S100B levels 0.10 μg/L was 100% (95%CI: 89.1;100.0) in prehospital samples and 100% (95% CI 89.1;100.0) in in-hospital samples. The specificity was 15.4% (95%CI: 12.4;18.7) in prehospital... read more
Impact of Marijuana on Venous Thromboembolic Events
Tetrahydrocannabinoids (THC) exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients. We performed... read more
Major Trauma Definition Using Different Revisions of the Abbreviated Injury Scale
Injury Severity Score (ISS) 08 ≥ 11 and ISS 15 ≥ 12 perform similarly to a threshold ISS 98 ≥ 16 for in-hospital mortality and ICU admission. This confirms studies evaluating mapped datasets, and is the... read more
Randomised controlled trials in pre-hospital trauma
This mapping review has highlighted that evidence from trials in prehospital trauma is sparse and where trials have been completed, the reporting is generally poor and study designs sub-optimal. There is a continued need,... read more
Defining Major Trauma: a Delphi Study
Based upon the output of this Delphi study, major trauma may be defined as: "Significant injury or injuries that have potential to be life-threatening or life-changing sustained from either high energy mechanisms or low energy... read more
Safety of Arterial Catheterization Using the Distal Radial Approach in ICU Management
Distal radial approach (DRA) may be a safe option for insertion of a new A-line in the ICU. The study included 20 patients with a median age of 70 (interquartile range (IQR): 58.5–77) years: 10 patients with traumas,... read more
Optimal Needle Position for Decompression of Tension Pneumothorax
Tension Pneumothorax (TP) can occur as a potentially life-threatening complication of chest trauma. With the risk of respiratory and cardiac arrest, an immediate temporizing intervention for this condition is required by... read more
Prehospital Management of Trauma Patients with Rib Fractures
Rib fractures are associated with a direct, blunt force trauma to the thorax. It is estimated that 10% of all patients who were admitted to the hospital after blunt chest trauma have at least one rib fracture. In the prehospital... read more
COVID-19: Critical Care and Airway Management Issues
Among patients hospitalized with coronavirus disease 2019 (COVID-19), up to one-quarter require intensive care unit (ICU) admission. Profound hypoxemic respiratory failure from acute respiratory distress syndrome (ARDS)... read more
Feasibility and Accuracy of ED Frailty Identification in Older Trauma Patients
This prospective study has demonstrated that screening for frailty in older major trauma patients within the Emergency Department is feasible and accurate using Clinical Frailty Scale (CFS). Patients age 65 years and... read more
Retrospective validation of a risk stratification tool developed for the management of patients with blunt chest trauma
The STUMBL score at a cut‐off of 15 predicted prolonged LOS and a score >18 predicted mortality sufficiently to be clinically useful for these outcomes. The STUMBL Score is composed of five simple predictors; patient... read more
