Spoon Feed
Presence of a seatbelt sign (SBS) was associated with a higher likelihood of intra-abdominal injury and need for surgical intervention.

Source
Prevalence of intra-abdominal injury among patients with seatbelt signs, a systematic review and meta-analysis. Am J Emerg Med. 2024 Feb;76:199-206. doi: 10.1016/j.ajem.2023.11.058. Epub 2023 Dec 3. PMID: 38086186.

Spoon Feed
REBOA has emerged as a critical intervention for managing hemorrhagic shock, but current guidelines are non-specific. Employing REBOA in unstable trauma patients with SBPs 60-80 mmHg is ideal, before further decompensation and increased mortality.

Source
Critical systolic blood pressure threshold for endovascular aortic occlusion-A multinational analysis to determine when to place a REBOA. J Trauma Acute Care Surg. 2024 Feb 1;96(2):247-255. doi: 10.1097/TA.0000000000004160. Epub 2023 Oct 19. PMID: 37853558

Spoon Feed
The use of radiopaque markers (ROM) in penetrating trauma is based on expert opinion and historical clinical practice; however, there is no high-quality evidence to support their routine use in clinical practice.

Source
The use of radiopaque markers is medical dogma. Acad Emerg Med. 2024 Feb;31(2):193-194. doi: 10.1111/acem.14858. Epub 2024 Feb 6.

Spoon Feed
This study demonstrated that patients 65 years and older with blunt head trauma are at high risk of significant traumatic brain injuries and poor outcomes even with low-risk mechanisms of injury such as ground level falls and no other high-risk criteria besides advanced age. These findings suggest routine head CT imaging may be helpful for elderly patients with head trauma as clinical assessment may not identify patients with significant pathology.

Source
Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort. Ann Emerg Med. 2024 Feb 9:S0196-0644(24)00003-9. doi: 10.1016/j.annemergmed.2024.01.003. Online ahead of print.

Exciting news! JournalFeed and Dr. Amal Mattu's Top Picks Video Series is set to GO LIVE next week! It's free for Gold Spoon members or you can just get the video series. Watch this trailer and get excited!

Spoon Feed
In this systematic review, authors identified clinical practice guideline (CPG) recommendations with moderate to high quality evidence that can be used by the ED practitioner to help in the care of pediatric patients with mild traumatic brain injury (mTBI).

Source
Clinical Practice Guideline Recommendations in Pediatric Mild Traumatic Brain Injury: A Systematic Review. Ann Emerg Med. 2023 Dec 22:S0196-0644(23)01381-1. doi: 10.1016/j.annemergmed.2023.11.012. Epub ahead of print.

Spoon Feed
In trauma patients, 24-hour mortality rate increased with increasing ratio of packed red blood cells (pRBC) to whole blood (WB) transfusion, even when pRBC transfusion was balanced with platelets and fresh frozen plasma (FFP). Mortality rate was lowest in patients transfused with whole blood alone.

Spoon Feed
Trauma patients who were resuscitated with whole blood compared to component therapy had improved 24-hour mortality and a decrease in the total amount of blood products needed for resuscitation.

Source
Doing more with less: low-titer group O whole blood resulted in less total transfusions and an independent association with survival in adults with severe traumatic hemorrhage. J Thromb Haemost. 2024 Jan;22(1):140-151. doi: 10.1016/j.jtha.2023.09.025. Epub 2023 Oct 4.

Spoon Feed
Patients with TBI who were intubated in the prehospital setting had no difference in 30-day mortality when comparing induction with ketamine versus etomidate.

Source
Etomidate versus Ketamine as prehospital induction agent in patients with suspected severe traumatic brain injury. Anesthesiology. 2024. Jan 8. Doi: 10.1097/ALN.0000000000004894. Online ahead of print.

Spoon Feed
Overall rates of intracranial hemorrhage (ICH) in patients >65 years of age with either definite or uncertain head trauma were found to be 11.4% and 1.7%, respectively, leading these authors to recommend head CT imaging on all geriatric patients presenting with possible head trauma.

Spoon Feed
Traumatic cardiac arrest patients receiving either resuscitative endovascular balloon occlusion of the aorta (REBOA) or resuscitative thoracotomy (RT) experienced similar outcomes, though time to successful occlusion of the aorta took significantly longer with REBOA. The limiter? Common femoral artery (CFA) access.

Source
Resuscitative endovascular balloon occlusion of the aorta and resuscitative thoracotomy are associated with similar outcomes in traumatic cardiac arrest. J Trauma Acute Care Surg. 2023 Dec 1;95(6):912-917. doi: 10.1097/TA.0000000000004094. Epub 2023 Jun 29.