European Guideline on Managing Post-traumatic Bleeding: 5th Edition

An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more

Ketamine In Acute and Chronic Pain Management

The view of chronic pain as a symptom of a disease, rather than a disease state itself, has contributed to neglect in treating this condition. Although it is generally acknowledged that patients with chronic pain use significantly... read more

Safety of Early Tracheostomy in Trauma Patients After Anterior Cervical Fusion

Cervical spine injuries (CSIs) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or... read more

Indications and Outcomes of Extracorporeal Life Support in Trauma Patients

Data from the largest registry of critically ill trauma patients receiving extracorporeal life support (ECLS) demonstrates reasonable survival. With growing experience and improved safety profile, trauma should not be considered... read more

Extravascular Lung Water as a Target for Intensive Care

Extravascular lung water (EVLW) remains a useful guide for monitoring pulmonary edema (PO) and vascular permeability in sepsis, acute respiratory distress syndrome (ARDS), and heart failure. In addition, EVLW has a prognostic... read more

Management of Pediatric Severe Traumatic Brain Injury

This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more

Trauma Electives in South Africa Provide Valuable Training for International Surgeons

Trauma training and trauma preparedness are increasingly areas of concern worldwide. Formal military conflicts over the past 2 decades have ensured that most military surgeons have been exposed to a significant volume of... read more

Intrathoracic Pressure Regulation Therapy Applied to Ventilated Patients for Treatment of Compromised Cerebral Perfusion from Brain Injury

These data support the notion that active intrathoracic pressure regulation, in this limited evaluation, can successfully augment cerebral perfusion by lowering intracranial pressure and increasing mean arterial pressure... read more

Tranexamic Acid For Isolated Penetrating Head Trauma

An aeromedical crew was dispatched to a local emergency department to transport a fourteen year-old female with self-inflicted gunshot wound to the head to a tertiary pediatric trauma hospital. The patient was previously... read more

ECMO in the Critical Trauma Patient

Growing evidence suggests the potential use of Extracorporeal membrane oxygenation (ECMO) for the treatment of refractory respiratory failure in adults, but the clinical benefit in polytraumatic patients is not clear. The... read more

Selected Imaging Controversies in ED Trauma

Traumatic injuries are amongst the most common presentations for all emergency departments (ED). In 2010, there were over 1 million patients in Canada who visited the ED for trauma, result in an cost of almost 9 billion dollars.... read more

Why Do Bleeding Trauma Patients Die?

It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That's a great thing of course, but we should not be complacent. It's also worth looking at where and how patients die.... read more

Many Doctors Have Distorted Perceptions of the Value of Medical Tests

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... read more

Vitamin C: Should We Supplement?

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.... read more

Avoiding Common Errors in the Emergency Department

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... read more

Avoiding Common Errors in the Emergency Department

What’s the Bleeding Problem with Trauma Laparotomies?!

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?!... read more

Patient-tailored Triage Decisions by Anesthesiologist-staffed Prehospital Critical Care Teams

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... read more

Bedside Ultrasound Assessment of Lung Reaeration in Patients With Blunt Thoracic Injury Receiving High-Flow Nasal Cannula Oxygen Therapy

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... read more

Against the Odds – When Statistics Fail the Patient

Do you want to cut the cord? the nurse asked. I watched my husband pick up the scissors, his hand trembling as he cautiously severed the lifeline that once connected our daughter, Anika, to me. The nurse wrapped her in a... read more

The NeuroICU Book

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... read more

The NeuroICU Book

Dear NRA, I’m a doctor. My lane? I sit in this chair when I tell parents their kids are dead

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.... read more

Mortality of civilian patients with suspected traumatic hemorrhage receiving pre-hospital transfusion of packed red blood cells compared to pre-hospital crystalloid

In a single centre UK HEMS study, in patients with suspected traumatic hemorrhage who received a PRBC transfusion there was an observed, but non-significant, reduction in mortality at 6 h and 28 days, also reflected in... read more