Don't Forget the Bubbles

JUNE 30, 2023

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%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

The Trauma Pro

APRIL 26, 2024

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. If the patient can be stabilized to some degree, interventional radiology can be very helpful. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

RebelEM

MAY 25, 2023

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]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

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? E.g. burns, neurosurgery, interventional radiology. Team brief and assign roles, e.g. primary survey, airway, scribe, IV access, drugs.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

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. 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 111

CDC Radiology Radiology Head Injuries 111

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

PHEM Cast

FEBRUARY 23, 2017

Priorities for the bleeding trauma patient must include: Minimum time to control of bleeding (tourniquets / haemostatics / knife / interventional radiology) Normothermia Appropriate choice of destination (knife / IR) ? Prehospital transfusion of plasma and red blood cells in trauma patients. Prehosp Emerg Care 19(1):1–9, 2015.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52