PEMBlog

APRIL 24, 2024

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

Stroke 59

Stroke Pediatrics Blood Transfusions Radiology 59

The Trauma Pro

MAY 10, 2024

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 (..)

Blood Transfusions 147

Blood Transfusions Documentation/Coding Radiology Radiology 147

RebelEM

MAY 25, 2023

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.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

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

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

RCEM Learning

NOVEMBER 28, 2022

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.

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

EMDocs

JUNE 3, 2023

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

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

MAY 30, 2023

Frederick 1st trimester pregnancy accounts for 10% of all ED visits from women of reproductive age 28% present on weekends 37% present after hours Despite the fact that a lot of these patients present after hours, radiology is rarely available 24/7 TVUS diagnoses nearly 50% of early pregnancies after an inconclusive transabdominal US ED-performed TVUS (..)

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52