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 87

Hyperthermia / Hypothermia Head Injuries Resuscitation Documentation/Coding 87

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? What are the best ways to maintain team situational awareness during a trauma resuscitation? When is a pelvic binder indicated? Is a bedsheet good enough?

Head Injuries 52

Head Injuries Resuscitation Shock EMS 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. In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. Significantly more patients achieved haemostasis in the balanced ratio group ( 86% vs 78% p =.006),

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Downeast Emergency Medicine

APRIL 26, 2021

The primary outcome was 30-day mortality with secondary outcomes looking at 24 hour in-hospital mortality, blood resuscitation at 6 and 24 hours, incidence of multiorgan failure, ARDS, nosocomial infection, early seizures, PE/DVT, crystalloid resuscitation after 24 hours, and the incidence of coagulopathy.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

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

Taming the SRU

FEBRUARY 12, 2024

After rescue, she had an apparent head injury and was confused but protecting her airway with grossly normal vital signs. Discussion of Evidence for Management Initial management of DOAC overdose centers around establishing large-bore intravenous access and providing adequate resuscitation for hemodynamically unstable patients.

Administration 78

Administration Fractures Anaphylaxis Head Injuries 78

Dr. Smith's ECG Blog

JULY 22, 2012

A 6 yo girl had significant trauma from an MVC, with head injury (initial GCS 10, but no intracranial bleeding) and mild orthopedic injuries. Inpatient stay : She quickly awoke and was observed for a couple days, treated for minor orthopedic injuries, and recovered well from the head injury.

Head Injuries 52

Head Injuries EKG/ECG Ultrasounds Outcomes 52

Mind The Bleep

MAY 1, 2024

Children’s Injuries – particularly in non-ambulant children, or a suspicious history, consider non-accidental injury. Appropriate first line management will help protect and resuscitate the soft tissues and keep the fracture still either to allow healing or until definitive management (operative fixation) is possible.

Fractures 52

Fractures Documentation/Coding Head Injuries Dislocations 52

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

The Injectable Orange

JUNE 20, 2017

Mental practice: a simple tool to enhance team-based trauma resuscitation. The ED team had just finished an in situ simulation where the focus was on rapid sequence intubation (RSI) in head injury, and using the new intubation checklist. doi: 10.1136/bmjopen-2013-003525 Lorello, G, Hicks, C et al. 2016 Mar;18(2):136-42.

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

Rural Doctors Net

AUGUST 30, 2013

Whilst we’ve ‘re-discovered’ balanced resuscitation (first described by Cannon back after WWI), there remains some limited controversy – listen to this 2013 take from Simon Carley at St. Check his pupils – any signs of head injury or subdural from flying debris? Emlyns on the PROMMT data. Keep him warm and covered.

Burns 52

Burns Hospitals Wellness Ambulance Services 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

Emergency Medicine Cases

APRIL 21, 2020

Anand Swaminathan on recognition and ED management of adrenal crisis, Maria Ivankovic on indications for antibiotics in strep throat from EM Cases Course 2020, Jesse McLaren on recognition of posterior MI from ECG Cases, Justin Yan & Hans Rosenberg on just the facts of approach to DKA, Brit Long on ovarian torsion imaging myths, Walter Himmel on (..)

EMS 52

EMS EKG/ECG Head Injuries Resuscitation 52

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 82

Leadership CPR Head Injuries Outcomes 82

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 63

Documentation/Coding Seizures Psychiatric Wellness 63