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Preperitoneal Packing Vs Angioembolization: Part 1

The Trauma Pro

In this series, I will review the two major techniques for addressing troublesome bleeding from pelvic fractures. In the last post in the series, I’ll discuss a paper in press that compares the efficacy and hospital charges of the two techniques. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures 147
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Preperitoneal Packing Vs Angioembolization: Part 3

The Trauma Pro

In the previous post in this series, I described an early review article summarizing several older studies comparing these two hemorrhage control techniques for pelvic fractures. They separated all patients with acetabular and pelvic ring fractures using ICD-10 codes. Bottom line: This is the largest comparison of AE and PPP to date.

Fractures 113
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New Technology: Using AI To Interpret Pelvic X-rays

The Trauma Pro

The trauma group at Stanford paired up with the Chang Gung Memorial Hospital in Taiwan to test the use of AI for interpreting images to identify a specific set of common pelvic fractures. The algorithms generated a “heat map” that showed the areas that were suspicious for fracture. Stay tuned!

Fractures 147
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Transfers In: Direct Admit vs Send To The ED

The Trauma Pro

This necessitates an inter-hospital transfer that is subject to scrutiny by the trauma performance improvement program of both trauma centers. The work-up from the referring hospital can be re-evaluated. In some hospitals, orthopedics may choose to place a traction pin to provide initial fracture management.

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SGEM#451: I’ve Become So Numb – Serratus Anterior Plane Blocks for Rib Fractures

The Skeptics' Guide to EM

Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. He has three left-sided rib fractures on imaging without underlying complications.

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Preperitoneal Packing Vs Angioembolization: Part 2

The Trauma Pro

Angioembolization requires the presence of a special interventional radiology team and a reasonably stable patient. They performed a systematic search of the literature, analyzing the impact of each procedure on in-hospital mortality. The use of both is becoming more widespread, and each has its pros and cons.

Radiology 113
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Trauma Resuscitation Updates

RebelEM

Pelvic Fracture A score ≥2 present, consider MTP Clinical Take Home Point: Use of balanced transfusion (including PRBCs and clotting factors) helps avoid dilutional coagulopathy WHOLE BLOOD VS COMPONENT THERAPY Kronstedt S et al. NEJM 1994. [2]