Emergency Medicine Cases

MARCH 9, 2021

Recent literature suggests that pediatric patients take longer to recover from mild traumatic brain injury compared to adults, and persistent post-concussive symptoms (PPCS) after 1 month occur in up to 30% of children after minor head injury.

Head Injuries 52

Head Injuries Pediatrics EMS 52

University of Maryland Department of Emergency Med

SEPTEMBER 30, 2023

"The main findings were the following: (1) there was no evidence of an effect of HTS compared with other agents (mainly mannitol) on long-term n. Click to view the rest

Head Injuries 71

Head Injuries 71

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

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

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

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 98

Head Injuries Outcomes Airway Management Burns 98

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

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

Pediatric EM Morsels

JUNE 9, 2023

Maybe injuries to the spleen or kidney come to mind. Perhaps thoughts of pelvic injuries or severe head injury dominate our considerations. When we think of severe hemorrhage in children, we typically think about trauma.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

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 83

Head Injuries Airway Management Outcomes EMS 83

Don't Forget the Bubbles

OCTOBER 19, 2023

The primary survey confirms isolated head injury – Bee’s drowsy, and a formal GCS is 12 – E3, V4, M5. But what about the evidence of TXA in isolated head injury? of patients in the TXA group died from their head injuries, compared to 19.8% Disaster strikes when the car hits Bee, hurtling her into the air.

Head Injuries 81

Head Injuries Fractures Outcomes Hospitals 81

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

EMDocs

MARCH 2, 2024

4] Epidemiology: Pneumocephalus is seen in almost all post-craniotomy cases, whereas the incidence of pneumocephalus seen in trauma involving head injury varies between 3.9% There is no evidence that steroids (D) are beneficial in head injury. Pneumocephalus after lumbar epidural catheter: a case report.

EMS 114

EMS Fractures Seizures Head Injuries 114

Pediatric EM Morsels

JULY 5, 2024

risk of C Spine injury) Altered Mental Status (GCS 3-8 or U on AVPU) Abnormal ABCs on exam Focal Neurologic Deficits (paresthesia, numbness, weakness) Not Negligible Risk (2.8% High Risk (12.8%

Pediatrics 161

Pediatrics Head Injuries Dislocations Research 161

RebelEM

FEBRUARY 29, 2024

11 Curiously, VAP in patients with traumatic head injury does not appear to increase mortality, but does increase ventilator time, ICU, and hospital length of stay. Bacterial colonization patterns in mechanically ventilated patients with traumatic and medical head injury. El-Ebiary, M.; Fábregas, N.; Hernández, C.;

CDC 125

CDC Outcomes Radiology Radiology 125

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

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

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 116

Hyperthermia / Hypothermia Outcomes Pediatrics Resuscitation 116

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

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

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 75

Head Injuries EMS Research Emergency Department 75

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

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