Category: Trauma

Helsloot et al. found in a retrospective analysis that the first several hours of resuscitation in patients with thoracic injuries are absolutely critical. The majority of fatalities occur within the first hour, and a significant portion of deaths occur within the initial six hours following the injury. Link to article

Based on this European study that involved colleagues from France, Italy, Switzerland included 2164 patients, 69% needed emergency hemorrhage control, 6 % received prehospital PRBC transfusion, 25% had massive transfusion. They concluded that “early norepinephrine infusion was not associated with 24-hour or in-hospital mortality among patients with blunt trauma and hemorrhagic shock.” Link to article

We discussed this topic before in here, here, and here! JAMA published a prospective study with overall negative predictive value of 99.2% for patients with cspine injuries and a negative predictive value of 99.8% for ruling out cspine surgeris that required immobilization or stabilization. Link to article

You can find in this blog at least 6 references talking about Contrast vs Non contrast CT, but this new study in Annals of EM showed the same result that oral contrast in detecting intra-abdominal pathologies is useless. Wow, this is a big word. USELESS.

Clearance of suspected c-spine injuries specifically in AMS is one of the challenging topics in trauma. How do you clear C-spine in obtunded  patient? well, as you know there are 2 methods:  MRI or/and Flex-ex xray.There is a new study published in Annals of Internal Medicine in March: Cervical Spine Clearance in Obtunded Patients After […]

Cleveland Clinic Journal of Medicine has a nice review on Rib Fracture and an algorithm to approach rib fracture.

From OHSU, Portland, Oregon study came out in Journal of Trauma and Acute Care Surgery in Dec 2013.  The main idea was that INR should not guide to transfuse FFP in stable trauma patient.

We usually make fun of this topic such as how about have a ct scan in triage and etc.. This is a European study that shows the pan-scan algorithms reduce, but do not eliminate, the risk of missed injuries, and they should not replace close monitoring and clinical follow-up of patients with major trauma. Link […]

Probably  you had this dilemma before. Patient involved  MVC with midline neck tenderness and negative CT scan. Now, what should I do? Should I clear and remove c-collar or consult with trauma.  There are 2 approaches that trauma surgeons usually do. 1:MRI and/or 2: Flex-ex xray.