Mind The Bleep

MAY 1, 2024

Children’s Injuries – particularly in non-ambulant children, or a suspicious history, consider non-accidental injury. Appropriate first line management will help protect and resuscitate the soft tissues and keep the fracture still either to allow healing or until definitive management (operative fixation) is possible.

Fractures 52

Fractures Head Injuries Documentation/Coding Dislocations 52

The Injectable Orange

JUNE 20, 2017

Mental practice: a simple tool to enhance team-based trauma resuscitation. The ED team had just finished an in situ simulation where the focus was on rapid sequence intubation (RSI) in head injury, and using the new intubation checklist. doi: 10.1136/bmjopen-2013-003525 Lorello, G, Hicks, C et al. 2016 Mar;18(2):136-42.

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

RebelEM

MAY 25, 2023

Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8% CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Don't Forget the Bubbles

NOVEMBER 11, 2024

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. A 12-year-old boy presents with a significant head injury following a road traffic accident. Should we aim to prevent fever, or should we cool patients?

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

Emergency Medicine Cases

MAY 9, 2017

Management of the pediatric trauma patient is challenging regardless of where you work.

Pediatrics 52

Pediatrics EMS Hospitals Head Injuries 52

Emergency Medicine Cases

APRIL 21, 2020

Anand Swaminathan on recognition and ED management of adrenal crisis, Maria Ivankovic on indications for antibiotics in strep throat from EM Cases Course 2020, Jesse McLaren on recognition of posterior MI from ECG Cases, Justin Yan & Hans Rosenberg on just the facts of approach to DKA, Brit Long on ovarian torsion imaging myths, Walter Himmel on (..)

EMS 52

EMS EKG/ECG Head Injuries Resuscitation 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

The Trauma Pro

OCTOBER 6, 2023

At the time, there was a debate about whether the procedure should be done immediately versus waiting until the patient was well-resuscitated. The mortality trends do not appear to be related to injury grade, overall injury severity, or the presence of head injury.

Head Injuries 147

Head Injuries Research Hospitals Resuscitation 147

Don't Forget the Bubbles

JUNE 30, 2023

Whilst you were busy managing head injuries and drownings, Ranulf had been out with a group of boys from school this evening. In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. Significantly more patients achieved haemostasis in the balanced ratio group ( 86% vs 78% p =.006),

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

PHEM Cast

FEBRUARY 23, 2017

Early correction of hypotension (especially if blunt trauma / associated head injury) The balances of harms in the context of blunt trauma between the negative effects of infusing saline versus the negative effects of hypotension are unknown and prehospital actions need to be customised to an individual patient and situation.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

Downeast Emergency Medicine

APRIL 26, 2021

The primary outcome was 30-day mortality with secondary outcomes looking at 24 hour in-hospital mortality, blood resuscitation at 6 and 24 hours, incidence of multiorgan failure, ARDS, nosocomial infection, early seizures, PE/DVT, crystalloid resuscitation after 24 hours, and the incidence of coagulopathy.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Taming the SRU

MAY 10, 2024

Factors associated with worse outcomes in the setting of a TCA: Firearm involvement Self-inflicted injury PEA with a rate <40bpm Wide-complex rhythm (excluding VT) Number of pre-hospital procedures Role of chest compressions in TCA: Chest compressions are unlikely to be helpful in the setting of a traumatic cardiac arrest.

Leadership 85

Leadership CPR Head Injuries Hospitals 85

Don't Forget the Bubbles

AUGUST 12, 2024

It occurs when a mechanical force to the head injures the brain. This can be from the brain hitting the skull, shear forces from sudden acceleration and deceleration, or direct injury at the point of impact. The severity of head injuries can be classified according to the GCS.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

Rural Doctors Net

AUGUST 30, 2013

Whilst we’ve ‘re-discovered’ balanced resuscitation (first described by Cannon back after WWI), there remains some limited controversy – listen to this 2013 take from Simon Carley at St. Check his pupils – any signs of head injury or subdural from flying debris? Emlyns on the PROMMT data. Keep him warm and covered.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Emergency Medicine Cases

NOVEMBER 12, 2024

Dr. George Kovacs and Dr. Andrew Petroniak answer this and other questions such as: how should we re-sequence the trauma resuscitation depending on immediate life-threats? The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma?

Airway Management 121

Airway Management Resuscitation EMS Head Injuries 121

ACEP Now

APRIL 14, 2025

10 Standardizing evidence-based care ensures that every child, regardless of where they present, receives optimal initial resuscitative care. Emergency physicians need to make fast-paced decisions regarding imaging to evaluate for serious injuries. Cervical spine injury patterns in children. Lancet Child Adolesc Health.

Pediatrics 75

Pediatrics Emergency Department Best Practices Outcomes 75

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65