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Tools you should use: Pediatric NIH Stroke Scale

PEMBlog

There is a validated Pediatric Stroke Scale from the NIH that can be used in conjunction with a stroke protocol that involves Neurology, Radiology, and a local/regional Stroke Team. Pediatric strokes are rare and challenging to diagnose. Retrospective use has been shown to be valid and reliable in one cross-sectional study ( Beslow 2012 ).This

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NFTI And STAT: Can They Replace The Cribari Grid?

The Trauma Pro

After several iterations, they settled on six “ need for trauma intervention ” (NFTI) criteria: blood transfusion within 4 hours of arrival discharge from ED to OR within 90 minutes of arrival discharge from ED to interventional radiology (IR) discharge from ED to ICU AND ICU length of stay at least three days require mechanical ventilation (..)

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Trauma Resuscitation Updates

RebelEM

The Role of Whole Blood Transfusions in Civilian Trauma: A Review of Literature in Military and Civilian Trauma. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Cureus 2022.

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Episode 16: “Blood”

PHEM Cast

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) ? Prehospital transfusion of plasma and red blood cells in trauma patients. Prehosp Emerg Care 19(1):1–9, 2015.

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ToxCard: Iron

EMDocs

Blood transfusion for clinically significant blood loss. 5 Consider exchange transfusion in addition to deferoxamine for serum iron concentrations greater than 1000 g/dL, or those who clinically deteriorate despite supportive care and chelation. Radiology in the management of acute iron poisoning. doi: 10.1097/PEC.0b013e3182302604.

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Pelvic Management

RCEM Learning

Case courtesy of Dr Paul Clarke Learning bite Avoid unnecessary movement of the patient. DO NOT “spring” the pelvis on examination and DO NOT log-roll if pelvic injury suspected.

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Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

This is a unique scenario where interventional radiology, orthopedic surgery, and trauma surgery all have potential roles, and it is most important for emergency physicians to know their own institutional policies on unstable pelvic trauma. Note placement over the greater trochanters. 2021;52(10):2697-2701. doi:10.1016/j.injury.2020.01.042