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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. Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. What about head injury , though? This is not good. in the TXA group vs 53.7%

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

EMDocs

Pre-stroke disability had to be insignificant measured by mRS (modified Rankin Scale) of 0 or 1. Presentation consistent with diagnosis of an acute ischemic stroke, with the patient meeting criteria of: Failing IV t-PA therapy; OR Patient is contraindicated for IV t-PA administration. Life expectancy had to be 6 months or greater.

Stroke 97
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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

In the context of a child with a head injury- what was the best GCS/ GCS on arrival of the crew? E: Exposure and Environmental Control: Fully expose to check for other life-threatening injuries while maintaining normothermia. Establish IV access for potential fluid resuscitation.

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

RebelEM

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. 11 Curiously, VAP in patients with traumatic head injury does not appear to increase mortality, but does increase ventilator time, ICU, and hospital length of stay. Westendorp, W. Vermeij, J.

CDC 119
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SAEM Clinical Images Series: Seeing Double

ALiEM

The two main causes of internuclear ophthalmoplegia are demyelination of the medial longitudinal fasciculus (MLF) from multiple sclerosis (MS) and ischemic cranial nerve damage from stroke. Usually, MS is seen in younger patients where both eyes are affected whereas strokes occur more often in older patients and only one eye is affected.

Stroke 67
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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: (..)