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

Management of Pediatric Severe Traumatic Brain Injury

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

Trauma Electives in South Africa Provide Valuable Training for International Surgeons

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

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

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

Tranexamic Acid For Isolated Penetrating Head Trauma

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

ECMO in the Critical Trauma Patient

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

Selected Imaging Controversies in ED Trauma

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

Why Do Bleeding Trauma Patients Die?

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

Many Doctors Have Distorted Perceptions of the Value of Medical Tests

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

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

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

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

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

Against the Odds – When Statistics Fail the Patient

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

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

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

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

Mortality and Morbidity in Acutely Ill Adults Treated with Liberal vs. Conservative Oxygen Therapy

In acutely ill adults, high-quality evidence shows that liberal oxygen therapy increases mortality without improving other patient-important outcomes. Supplemental oxygen might become unfavourable above an SpO2 range of 94-96%.... read more

Mortality and Morbidity in Acutely Ill Adults Treated with Liberal vs. Conservative Oxygen Therapy

How Doctors Responded After NRA Told Them To “Stay In Their Lane”

If the goal of the National Rifle Association (NRA) was to get doctors' attention, the Tweet posted recently certainly did its job. The NRA editorial that accompanied the Tweet included the following statement: "some doctors’... read more

How Doctors Responded After NRA Told Them To “Stay In Their Lane”

Septic Shock: Innovative Treatment Options in the Wings

Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more

Septic Shock: Innovative Treatment Options in the Wings

The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical ICU patients

Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism.... read more

The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical ICU patients