Remove Head Injuries Remove Outcomes Remove Stroke
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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. The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. What about head injury , though? This is not good.

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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.

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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

RebelEM

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

CDC 125
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SGEM#406: Homeward Bound…after a dose of Intranasal Fentanyl for Sickle Cell Vaso-occlusive Pain

The Skeptics' Guide to EM

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: (..)

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. MI or stroke).

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SGEM#293: CRASH in the US, CRASH in the US, CRASH-2 in the USA

The Skeptics' Guide to EM

The evidence for TXA providing a patient-oriented outcome (POO) has been mixed. It seems to work for epistaxis ( SGEM#53 and SGEM#210 ), failed to demonstrate a decrease in all-cause mortality in post-partum hemorrhage ( SGEM#214 ), and did not result in an improved neurologic outcome in hemorrhagic strokes ( SGEM#236 ).

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52 in 52 – #39: DAWN – Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct

EMDocs

A second primary outcome was added at the 30-month time frame by request of the FDA, the trial was still blinded at that time. The blinded assessment of the primary outcome was done through both in-person interviews and over the telephone. POWER: 86% to detect a 1-point difference in the group’s first primary outcome.

Stroke 73