Don't Forget the Bubbles

JUNE 30, 2023

No, I don’t give TXA to kids with isolated head injuries We want to stop any clot breakdown to try and slow any potential bleeding. What about head injury , though? Along came the CRASH 3 trial, another huge study looking specifically at TXA in traumatic brain injury. She’s wheeled to radiology. Brakes off.

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

The Trauma Pro

APRIL 26, 2024

If the patient can be stabilized to some degree, interventional radiology can be very helpful. Unfortunately, it’s generally not feasible to operatively fix the pelvis acutely, and external fixation has limited impact on ongoing hemorrhage. Unfortunately, access after hours involves some degree of time delay.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

The Skeptics' Guide to EM

FEBRUARY 3, 2024

Excluded: Oropharyngeal trauma combined with other severe head injury or multisystem trauma, not primary research, non-English publication * Intervention: CTA * Comparison: No CTA * Outcome: radiologic and clinical outcomes including infection, injury to vasculature, cerebrovascular injury, and neurologic abnormalities.

Pediatrics 63

Pediatrics Radiology Radiology Head Injuries 63

Emergency Medicine Journal

NOVEMBER 28, 2023

Admission ITBI coagulopathy is common and associated with head injury severity and radiological evidence of BCC. Several admission tests were good or excellent predictors of BCC (d-dimer AUROC 0.832, fibrinogen AUROC 0.745) and 7-day mortality (aPTT AUROC 0.781, FIBTEM CT AUROC 0.717).

Head Injuries 40

Head Injuries Radiology Radiology Outcomes 40

PHEM Cast

FEBRUARY 23, 2017

Priorities for the bleeding trauma patient must include: Minimum time to control of bleeding (tourniquets / haemostatics / knife / interventional radiology) Normothermia Appropriate choice of destination (knife / IR) ?

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

RebelEM

MAY 25, 2023

Lancet 2019 [11] >12,000 Adults with TBI within 3hrs of injury, GCS ≤12 or any ICH on CT scan, and no major extracranial bleeding were eligible Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury (Later amended to within 3hrs of injury) Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs (..)

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

FEBRUARY 29, 2024

It is possible that the ceftriaxone altered baseline bacterial colonization within the respiratory tract, causing cultures to be negative despite positive clinical and radiological signs, leaving room for a false negative diagnosis. Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury.

CDC 94

CDC Outcomes Radiology Radiology 94