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TXA in head injuries

Don't Forget the Bubbles

No, I don’t give TXA to kids with isolated head injuries We want to stop any clot breakdown to try and slow any potential bleeding. What about head injury , though? Along came the CRASH 3 trial, another huge study looking specifically at TXA in traumatic brain injury. This is not good. in the TXA group vs 53.7%

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Dysphagia and Cervical Spine Injury

The Trauma Pro

Patients with cervical fractures more commonly need a tracheostomy for ventilatory support and/or have a head injury , and these are well known culprits in dysphagia Normal soft tissue (<6mm at C2, <22mm at C6) A study in the Jan 2011 Journal of Trauma outlined the dysphagia problem seen with placement of a halo vest.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

We have mentioned the Glasgow Coma Scale in multiple delicious morsels: Minor closed head injuries in <3 month olds and in the rebaked morsel , Blunt cerebrovascular injury , Cerebral edema in DKA , Pediatric Trauma Pitfalls , and Carbon monoxide poisoning. Predicting outcome in individual patients after severe head injury.

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Trauma Resuscitation Updates

RebelEM

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% NEJM 1994. [2]

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Early Vs Delayed Thoracic Endovascular Repair

The Trauma Pro

vs. 2.1%), but significantly shorter ICU stay (7 vs 10 days) When patients who died within the first 24 hours were excluded, the in-hospital mortality remained significantly higher, and the ICU and hospital lengths of stay were significantly shorter Bottom line: Some society guidelines began recommending delayed TEVAR in 2015.

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Preperitoneal Packing Vs Angioembolization: Part 1

The Trauma Pro

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. Next, I’ll review an early paper that compared the snippets of information we had to angioembolization. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures 147
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SGEM#412: I Can’t Choose…from all the Head Injury Prediction Rules

The Skeptics' Guide to EM

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?