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Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

Pediatric EM Morsels

We last pondered this in 2011 Morsel , just a couple years after PECARN head injury data was published. So, it would seem that now is an opportune time for a Rebaked Morsel on Closed Head Injury and the application of PECARN for children less than 3 months of age. 2021 Sep;78(3):321-330.e1. Epub 2021 Jun 17.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. Predicting outcome in individual patients after severe head injury.

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Trauma Resuscitation Updates

RebelEM

J Trauma Acute Surg 2022 [15] Multicenter prospective observational trial ≈1400 adult patients with extremity trauma injuries requiring a trauma center Patients either received prehospital tourniquets or no tourniquets Tourniquets controlled bleeding in 87.7% Anesth Analg 2021. NEJM 1994. [2] Richards JE et al. JAMA Surgery 2019.

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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

In the context of a child with a head injury- what was the best GCS/ GCS on arrival of the crew? E: Exposure and Environmental Control: Fully expose to check for other life-threatening injuries while maintaining normothermia. In addition, consider if there are any signs of injury with ENT, neurological or respiratory symptoms.

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SGEM#331: Should Patients with a Concussion be told to Walk this Way!

The Skeptics' Guide to EM

Date: May 21st, 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. A randomized trial comparing prescribed light exercise to standard management for emergency department patients with acute mild traumatic brain injury.

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Penetrating chest trauma

Don't Forget the Bubbles

Whilst you were busy managing head injuries and drownings, Ranulf had been out with a group of boys from school this evening. In 2021, Evans and colleagues (1) compared adolescent mortality rates in adult, children’s and mixed major trauma centres across the UK. 2021 Jul;38(7):488-494. 2021 Nov 1;91(5):809-813.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

2021 Jan 1;32(1):37-43. CRASH-3 TRIAL COLLABORATORS This international, multi-center, randomized, placebo-controlled trial looked at the effects of TXA on head injury-related death, disability, and adverse events in adult patients with TBI. The primary outcome was head injury-related death in-hospital within 28 days of injury.