Don't Forget the Bubbles

FEBRUARY 5, 2025

All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? In the context of a child with a head injury- what was the best GCS/ GCS on arrival of the crew? Do I need a trauma team activation?

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

The Trauma Pro

OCTOBER 25, 2024

To sum up, both are equally effective in controlling hemorrhage, but the hospital costs for patients undergoing angioembolization are significantly less. The primary outcome was the development of VTE during the hospitalization. All too often, prophylaxis is delayed due to solid organ or head injuries.

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

EMDocs

MARCH 9, 2024

Source Sequence of Epinephrine and Advanced Airway Placement After Out-of-Hospital Cardiac Arrest. 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. JAMA Netw Open. 2024 Feb 5;7(2):e2356863. 2024.01.003.

Head Injuries 97

Head Injuries Airway Management Outcomes EMS 97

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 96

Head Injuries Airway Management Outcomes Burns 96

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 ). Another core element of emergency department (ED) and pre-hospital care is the assessment for potential spinal injuries [1,2].

Head Injuries 95

Head Injuries EMS Research Emergency Department 95

Don't Forget the Bubbles

OCTOBER 19, 2023

Secondary outcome analysis showed there was no difference in length of hospital stay, ICU stay, or duration of oxygen therapy. This time, the group asked a different question – does using early high-flow nasal cannula oxygen instead of standard oxygen therapy reduce hospital length of stay? Which brings us to PARIS-2.

Head Injuries 81

Head Injuries Fractures Outcomes Hospitals 81

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. Included traumatic and nontraumatic brain injuries.

CDC 111

CDC Radiology Radiology Head Injuries 111

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

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 Journal

JULY 22, 2024

Introduction This month’s update comes from the Royal Melbourne Hospital ED in Victoria, Australia. We used a multimodal search strategy, drawing on free, open-access medical education resources and literature searches. Since only 2% require acute interventions, 1 determining who can be safely managed without CT.

Head Injuries 52

Head Injuries Emergency Department Hospitals 52

Sensible Medicine

NOVEMBER 3, 2023

  I usually see people who die alone in the hospital. Some of these patients die alone in the hospital, with nobody at their bedside. Ten years after her husband’s death, MV fell and hit her head. The head injury eventually took her life. .  They say that there is nothing worse than dying alone.

Hospice 125

Hospice Head Injuries Academics Hospitals 125

Downeast Emergency Medicine

APRIL 26, 2021

Four level-1 US trauma centers participated in the study where the inclusion criteria were trauma patients who were within 2 hours of their injury and were transported to the trauma center from either the field or another hospital. The primary outcome was head injury-related death in-hospital within 28 days of injury.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

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

The Skeptics' Guide to EM

FEBRUARY 3, 2024

March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. She is also the director of the Pediatric Otolaryngology Fellowship at Children’s National Hospital. Laryngoscope. I’m the Problem.

Pediatrics 68

Pediatrics Radiology Radiology Head Injuries 68

The Skeptics' Guide to EM

OCTOBER 17, 2020

Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury. Case: A 42-year-old helmeted bicycle rider is involved in an accident where he hits his head on the ground. Reference: Rowell et al. Reference: Rowell et al.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

PHEM Cast

APRIL 19, 2016

Very serious injuries in children is rare – so exposure to severely injured children prehospital is infrequent and the evidence is sparse – highlights the importance of shared experience. If the prehospital team consider the patient to be futile they will take them to the nearest local hospital. It can be a lonely place.

Head Injuries 52

Head Injuries Ambulance Services Hospitals Leadership 52

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

RebelEM

NOVEMBER 20, 2023

Secondary Outcomes: Treatment with REBOA+SC increased the odds of death across all time points measures in the secondary outcomes , as indicated by the ORs for mortality and posterior probabilities of OR > 1 were elevated in the REBOA+SC group across all time points: 6-month, in-hospital, 24-hour, 6-hour, and 3-hour mortality.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

The Skeptics' Guide to EM

JULY 16, 2017

Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. AEM July 2017.

Emergency Department 52

Emergency Department Head Injuries Academics Hospitals 52

Emergency Medicine Journal

NOVEMBER 28, 2023

The data identified pathways with largest impact potential - chest pain, dyspnoea and falls/frailty/head injury. We worked with specialty consultants from Cardiology, Respiratory, Frailty, Emergency Medicine and Acute Medicine to offer senior decision maker input to pre-hospital conversations to define the best urgent care pathways.

Urgent Care 40

Urgent Care Head Injuries Emergency Department Hospitals 40

PHEM Cast

FEBRUARY 23, 2017

Early correction of hypotension (especially if blunt trauma / associated head injury) The balances of harms in the context of blunt trauma between the negative effects of infusing saline versus the negative effects of hypotension are unknown and prehospital actions need to be customised to an individual patient and situation. .:

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

EB Medicine

SEPTEMBER 20, 2019

Kirelik is the Medical Director of the Rocky Mountain Pediatric OrthoONE Center for Concussion and is an attending pediatric emergency medicine physician at the Rocky Mountain Hospital for Children in Denver, Colorado. The Canadian CT Head Rule for patients with minor head injury. 2009;374(9696):1160-1170.

Emergency Department 40

Emergency Department Head Injuries Pediatrics Hospitals 40

The Skeptics' Guide to EM

MAY 30, 2020

You suspect abdomen and pelvic trauma and calculate his injury severity score (ISS) to be 22. Your hospital protocol is to give tranexamic acid (TXA) 1g IV over 10 minutes followed by a 1g infusion over eight hours. It asked if TXA had a mortality benefit in patients with isolated head trauma ( SGEM#270 )? TXA vs. 19.8%

Head Injuries 52

Head Injuries Academics EMS Outcomes 52

Taming the SRU

FEBRUARY 12, 2024

She initially agreed to be transported to the hospital by ambulance, but jumped from the moving vehicle and was subsequently struck and pinned under the fuselage for 10-15 minutes. After rescue, she had an apparent head injury and was confused but protecting her airway with grossly normal vital signs.

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

ACEP Now

JULY 6, 2023

Warfarin pills are inexpensive, but the associated hospital care is not. Gaddis is a “PGY-37” who has stepped away from full-time employment after a 32-year full-time career in academic emergency medicine, and now works a limited number of shifts in a rural Critical Access hospital in Missouri. Schonfeld D, et al. Arch Dis Child.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

RebelEM

AUGUST 24, 2023

2015;29(12):1409–1419. Rezaie, MD (Twitter: @srrezaie ) The post Back in the Game: The Effects of Activity on Youth Concussion Recovery appeared first on REBEL EM - Emergency Medicine Blog.

Pediatrics 84

Pediatrics Outcomes Research Hospitals 84

ACEP Now

MAY 6, 2023

In the case of an unrestrained driver, the most common locations of impact are the steering wheel, the instrument panel, and the windshield (most commonly resulting in head injury). Unrestrained passengers tend to strike the windshield and dashboard, often sustaining trauma to the head, thorax, and legs. Click to enlarge.

Forensics 52

Forensics Documentation/Coding Fractures Head Injuries 52

Don't Forget the Bubbles

JUNE 30, 2023

Whilst you were busy managing head injuries and drownings, Ranulf had been out with a group of boys from school this evening. However, patients in the 1:1 group had the lowest 24-hour mortality ( 14% vs 18% vs 22% vs 24% ; p = 0.01), and in-hospital mortality ( 32% vs 36% vs 40% vs 44% ; p = 0.01).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Mind The Bleep

JUNE 18, 2023

It is a very common presentation or comorbidity to see in community services and general hospital. environmental factors, pain, infection, dehydration, electrolyte disturbance, head injury, medication etc) Does the individual have capacity? The symptoms of BPSD are listed below.

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 52

Emergency Medicine Cases

MAY 9, 2017

Management of the pediatric trauma patient is challenging regardless of where you work.

Pediatrics 52

Pediatrics EMS Hospitals Head Injuries 52

The Skeptics' Guide to EM

MARCH 12, 2022

She is an emergency physician at Mount Sinai Hospital and a Clinician Scientist and the Deputy Director of the Schwartz-Reisman Emergency Medicine Institute. Background: Concussions or mild traumatic brain injury (mTBI) are commonly diagnosed in the Emergency Department (ED).

Emergency Department 40

Emergency Department Head Injuries Pediatrics Research 40

Don't Forget the Bubbles

AUGUST 12, 2024

It occurs when a mechanical force to the head injures the brain. This can be from the brain hitting the skull, shear forces from sudden acceleration and deceleration, or direct injury at the point of impact. The severity of head injuries can be classified according to the GCS.

Seizures 75

Seizures Pediatrics Emergency Department Ambulance Services 75

Rural Doctors Net

AUGUST 30, 2013

James and Casey are used to this kind of stuff (although Casey’s mostly in-hospital and has even got a CT scanner…James is used to working out of a tent wearing just rabbit skins). Allocate someone to activate ambulance, other clinical personnel, notify local hospital and give retrieval services a head’s up.

Burns 52

Burns Hospitals Ambulance Services Wellness 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Early identification of patients at higher risk of death and hospital admission is an important problem in emergency departments. The mortality risk and need for hospital admission associated with the different presenting complaints in a standardised national data set has not been previously reported.

Documentation/Coding 40

Documentation/Coding Sexual Assault Hyperthermia / Hypothermia Head Injuries 40

Taming the SRU

MAY 10, 2024

Factors associated with worse outcomes in the setting of a TCA: Firearm involvement Self-inflicted injury PEA with a rate <40bpm Wide-complex rhythm (excluding VT) Number of pre-hospital procedures Role of chest compressions in TCA: Chest compressions are unlikely to be helpful in the setting of a traumatic cardiac arrest.

Leadership 84

Leadership CPR Head Injuries Hospitals 84

EMDocs

JULY 20, 2023

– Inclusion criteria: Included patients aged 18 or above, who had a baseline NIHSS 10 or greater (obtained within one hour before measuring infarct volume) across 26 hospitals in the United States, Canada, Europe, and Australia. Exclusion criteria: Medical history of severe head injury with lasting neurologic deficit in past 90 days.

Stroke 92

Stroke Outcomes Head Injuries Psychiatric 92

ACEP Now

AUGUST 25, 2023

The Pediatric Pain Management Standard 1 for children was published this year to provide guidance to health organizations on how to deliver equitable and quality pain management across hospital settings. However, adopting IN fentanyl administration does not seem difficult and community hospitals may want to consider this treatment option.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97