The Trauma Pro

AUGUST 27, 2024

Steroids are good in head injury. This also contributes to another recognized phenomenon, the half-life of facts. Think about all the things you learned during your training that are no longer believed to be true. Stress causes ulcers. There is a definite decay curve for the old facts that occurs as new knowledge is acquired.

Head Injuries 202

Head Injuries Operations Research 202

EMergucate

FEBRUARY 2, 2023

Simulation report 2/2/23 Interdisciplinary SIM ED/ Anaesthetics Summery: Head injury requiring intubation post agitation and seizure, ambulance called by police … Continue reading →

Head Injuries 40

Head Injuries Seizures 40

The Skeptics' Guide to EM

AUGUST 5, 2023

Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study. He is a […] The post SGEM#412: I Can’t Choose…from all the Head Injury Prediction Rules first appeared on The Skeptics Guide to Emergency Medicine. So, should we CT scan children with minor head injury?

Head Injuries 40

Head Injuries Pediatrics Outcomes Fractures 40

RebelEM

MAY 25, 2023

Lancet 2019 [11] >12,000 Adults with TBI within 3hrs of injury, GCS ≤12 or any ICH on CT scan, and no major extracranial bleeding were eligible Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury (Later amended to within 3hrs of injury) Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs (..)

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

The Trauma Pro

APRIL 26, 2024

Blood usage also dropped quickly after the procedure.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

The Trauma Pro

OCTOBER 6, 2023

The mortality trends do not appear to be related to injury grade, overall injury severity, or the presence of head injury. Taken together, this suggests that we need to rethink the timing of TEVAR in patients with grade II or III injuries.

Head Injuries 147

Head Injuries Research Hospitals Resuscitation 147

The Trauma Pro

MAY 9, 2023

This represents when after arrival, patients start dying due to their injuries. Penetrating injury plus hypotension kills the fastest at 19 minutes and head injuries the slowest at 1:20. It’s less than 20 minutes in victims of penetrating injury with early hypotension.

Head Injuries 130

Head Injuries Operations Documentation/Coding Outcomes 130

RebelEM

AUGUST 7, 2023

The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge. Traditional RSI entails preoxygenation followed by.

Head Injuries 94

Head Injuries Airway Management Outcomes Burns 94

The Trauma Pro

OCTOBER 25, 2024

All too often, prophylaxis is delayed due to solid organ or head injuries. Multivariate analysis suggests that this is not a significant risk factor. The finding that early chemoprophylaxis reduced VTE incidence to only 3% is very interesting.

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

The Trauma Pro

DECEMBER 20, 2024

I started writing about them more than five years ago and was initially pessimistic about their safety profile in patients with head injuries. A new class of anticoagulants, the direct oral anticoagulants (DOACs), were introduced in 2010. The most recent DOAC reversal agent, Andexxa (andexanet alfa), was approved in 2018.

Head Injuries 113

Head Injuries Administration Hospitals 113

EMDocs

MARCH 9, 2024

These findings suggest routine head CT imaging may be helpful for elderly patients with head trauma as clinical assessment may not identify patients with significant pathology. Source Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort. Ann Emerg Med. 2024 Feb 9:S0196-0644(24)00003-9.

Head Injuries 91

Head Injuries Airway Management Outcomes EMS 91

Emergency Medicine Cases

MARCH 7, 2017

In anticipation of the upcoming EM Cases main episode on Pediatric Polytrauma Dr. Suzanne Beno, Co-director of the Trauma Program at the Hospital for Sick Children in Toronto, tells her Best Case Ever of a child who suffers a severe traumatic head injury with signs of raised intracranial pressure and cerebral herniation.

Pediatrics 52

Pediatrics Head Injuries EMS Hospitals 52

The Trauma Pro

SEPTEMBER 12, 2023

Here are the factoids: A total of 12,211 patients were enrolled in this multi-center, and the same outcomes listed above were monitored for 90 days Of the total group, 3052 were judged to be high risk: 46% had a femur fracture, 42% had a pelvic/acetabular fracture, 48% had a thoracic injury, 39% had a spinal injury, and 35% had a head injury There (..)

Fractures 113

Fractures Head Injuries Research Outcomes 113

The Skeptics' Guide to EM

JULY 17, 2018

He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergency department when a seven-year-old girl comes in by EMS with a head injury. She hit a rock, and went over the bars, striking her head on a small tree as she fell. Corey Heitz is an emergency physician in Roanoke, Virginia.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

Emergency Medicine Cases

AUGUST 24, 2021

When can anticoagulation medications be safely resumed after an older person has sustained a minor head injury? The post Ep 159 Geriatric Trauma Part 1: The Under-Triaging Problem, Resuscitation, Airway, Head and C-spine Imaging, Clearing the C-spine appeared first on Emergency Medicine Cases. and many more.

Resuscitation 52

Resuscitation Head Injuries Airway Management Shock 52

EMergucate

NOVEMBER 26, 2019

The ECG below is taken from a 4 year old boy who has presented with multiple episodes of syncope after sustaining a head injury in a fall of <1m.

EKG/ECG 52

EKG/ECG Head Injuries 52

Emergency Medicine Cases

NOVEMBER 5, 2019

The post EM Quick Hits 10 – TXA CRASH-3, CJEM Cellulitis, Double Defib, Serratus Anterior Block, PARC score, Toxic Shock Syndrome appeared first on Emergency Medicine Cases.

Shock 52

Shock Head Injuries EMS Pediatrics 52

Emergency Medicine Journal

JULY 22, 2024

PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study by Holmes et al Topic: Paediatric trauma Rating: Game Changer Children with traumatic abdominal and head injuries frequently present to the ED.

Head Injuries 52

Head Injuries Emergency Department Hospitals 52

Downeast Emergency Medicine

APRIL 26, 2021

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.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

EMergucate

MAY 12, 2020

A 5-year-old boy represented to the emergency with his mother at 11 pm after a head injury earlier in the afternoon. He vomited twice so far and bit drowsy as per mom. He was seen in ED 2 hours ago…

Head Injuries 40

Head Injuries 40

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

The Canadian CT Head Rule [2] is a clinical decision instrument to help you decide if a patient with a mild head injury requires a CT head. Minor head injury was defined as blunt head trauma, resulting in amnesia, loss of consciousness or an altered mental state (confusion or disorientation) with a GCS score ≥13.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

Taming the SRU

DECEMBER 8, 2023

r4 case follow-up WITH DR. milligan CC: Found down The case: A young F was found down in a snow bank after a GSW to the head. She presented with a core temp of 30C and her CT scan did not show a devastating head injury as was expected. EMS had reported she had coded en route. She regained pulses with warming on arrival.

Hyperthermia / Hypothermia 88

Hyperthermia / Hypothermia Head Injuries Resuscitation Documentation/Coding 88

Don't Forget the Bubbles

NOVEMBER 11, 2024

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. A 12-year-old boy presents with a significant head injury following a road traffic accident. Should we aim to prevent fever, or should we cool patients?

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

Emergency Medicine Cases

JANUARY 1, 2019

What should your resuscitation targets be in the first 15 minutes for trauma patients with hemorrhagic shock, neurogenic shock, severe head injury? When is a pelvic binder indicated? Is a bedsheet good enough? What are the most common pitfalls in binding the pelvis?

Head Injuries 52

Head Injuries Resuscitation Shock EMS 52

The Skeptics' Guide to EM

JULY 29, 2023

Background: We have covered head injuries including concussions multiple times on the SGEM. This has included looking at the Canadian CT Head Rules/Tools ( SGEM#106 , SGEM#266 , and SGEM#272 ). He has midline neck tenderness but no limb numbness or paresthesia.

Head Injuries 80

Head Injuries EMS Research Emergency Department 80

Don't Forget the Bubbles

FEBRUARY 5, 2025

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.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

Emergency Medicine Journal

JUNE 22, 2023

2 For example, there was a U-shaped relationship between SI values and mortality in patients with head injuries, which means that hypertension is also associated with increased mortality in patients with head injuries. 4 Calibration measures are essential to determine whether the projected probabilities actually.

Head Injuries 40

Head Injuries 40

EMergucate

NOVEMBER 26, 2019

The ECG below is taken from a 4 year old boy who has presented with multiple episodes of syncope after sustaining a head injury in a fall of <1m.

EKG/ECG 40

EKG/ECG Head Injuries 40

EMergucate

MARCH 1, 2015

The following skull x-ray is from a 3 year old with a history of a head injury 72 hours prior to presentation. He had a fall in the playground with no LOC and one incidence of vomiting post-injury.…

Head Injuries 40

Head Injuries EMS 40

Taming the SRU

FEBRUARY 5, 2024

Several definitions have been set forth for this common injury, with perhaps the most well accepted definition being introduced by the Centers for Disease Control and World Health Organization. For pediatric patients, we recommend using the PECARN Pediatric Head Injury Algorithm.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Medical Law

NOVEMBER 17, 2022

These injuries can be tremendously harmful and even fatal. The victim of a sidewalk fall may fall backward, landing directly on their head.

Head Injuries 52

Head Injuries Fractures 52

The Skeptics' Guide to EM

OCTOBER 17, 2020

However, patients with significant head injury were excluded in this study and it was unclear of the effect of TXA in this group. The authors reported no statistical superiority of TXA compared to placebo for the primary outcome of head injury-related deaths within 28 days.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

The Skeptics' Guide to EM

MAY 22, 2021

One of the issues that comes up with minor head injuries is do we need to get advanced imaging. We looked at the Canadian CT Head Rule (CCHR) published by Dr. Ian Stiell in the Lancet 2001 on SGEM#106. The SGEM has also covered the issue of getting CT scans in pediatric patients with minor head injuries.

Head Injuries 52

Head Injuries Research Emergency Department Pediatrics 52

Medical Law

DECEMBER 14, 2021

If the patient suffers other serious injuries, doctors may focus on treating those injuries and may overlook what appears to be a mild head injury. People experiencing symptoms of subtle brain injury may be embarrassed about having cognitive or emotional issues. Mild head injuries are common among children.

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Head Injuries Shock 52

Sensible Medicine

NOVEMBER 3, 2023

Ten years after her husband’s death, MV fell and hit her head. The head injury eventually took her life. The arrhythmia was largely asymptomatic and we managed it with anticoagulation alone. She suffered a CNS hemorrhage, certainly related to anticoagulation. I do not know if we all die alone.

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Hospice Head Injuries Academics Hospitals 117

The Skeptics' Guide to EM

JUNE 17, 2023

American Journal of Hematology Jan 2023 * Population: Children aged 3-21 years old, with sickle cell disease (Hemoglobin SS disease or Hemoglobin Sβ Thalassemia) who presented with vaso-occlusive pain episodes to * Excluded: Children with upper respiratory infection, concern for stroke or altered mental status, or head injury, acute chest * Intervention: (..)

Emergency Department 72

Emergency Department Pediatrics Head Injuries Administration 72

Emergency Medicine Ireland

MAY 3, 2021

This is part of Oh’s Manual Chapter 77 on head injury and we covered ICP monitoring before in number 20. This is part of Oh’s Manual Chapter 77 on head injury and we covered ICP monitoring before in number 20. Welcome back to the tasty morsels of critical care podcast.

Head Injuries 40

Head Injuries Hyperthermia / Hypothermia Documentation/Coding Outcomes 40