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The UK-REBOA trial

First 10 EM

REBOA (resuscitative endovascular balloon occlusion of the aorta) has been discussed in the emergency medicine world for quite some time now, but always with very limited data. Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM. (Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM.

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

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Early Vs Delayed Thoracic Endovascular Repair

The Trauma Pro

At the time, there was a debate about whether the procedure should be done immediately versus waiting until the patient was well-resuscitated. Although many of these injuries were managed within hours, a growing number were delayed by a few days to improve outcomes. This study did not detect any trend toward this, however.

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Trauma Resuscitation Updates

RebelEM

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

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Predictors of post-intubation hypotension in trauma patients following prehospital emergency anaesthesia: a multi-centre observational study | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Full Text

PHARM

Consecutive sampling of trauma patients who underwent PHEA using a fentanyl, ketamine, rocuronium drug regime were included, 2015–2020. The variables significantly associated with PIH only account for a small proportion of the observed outcome. Read on sjtrem.biomedcentral.com/articles/10.1186/s13049-023-01091-z

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Episode 28: LOST

PHEM Cast

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

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Hypothermia and drowning

Don't Forget the Bubbles

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Emergency Medical Services found her apneic and pulseless. C and remained pulseless.