Trauma

What’s the Trigger to Activate Pediatric Massive Transfusion

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A transfusion threshold of 20 ml/kg of any blood product during the first hour of pediatric trauma resuscitation maximizes sensitivity and specificity for in-hospital mortality, need for intervention, and additional bleeding episodes and may identify children in need of massive transfusion.

Source
Recognizing Life-Threatening Bleeding in Pediatric Trauma: A Standard for When to Activate Massive Transfusion Protocol. J Trauma Acute Care Surg. 2022 Sep 19. doi: 10.1097/TA.0000000000003784. Online ahead of print.

Do We Need Sterile Gloves for Laceration Repair?

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This trial suggests that there is unlikely to be a large difference in wound infection rates between non-sterile gloves and dressings and sterile gloves, dressings, and drapes for suturing of traumatic wounds in the ED.

Source
Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial. Emerg Med J. 2022 Jul 26;emermed-2021-211540. doi: 10.1136/emermed-2021-211540. Online ahead of print.

The TBI SBP Sweet Spot – Is 130-180 mmHg the New Normotension?

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In-hospital mortality of TBI patients decreased linearly as the lowest observed out-of-hospital systolic blood pressure increased, with the lowest mortality between 130 and 180 mmHg.

Source
Optimal Out-of-Hospital Blood Pressure in Major Traumatic Brain Injury: A Challenge to the Current Understanding of Hypotension. Ann Emerg Med. 2022 Jul;80(1):46-59. doi: 10.1016/j.annemergmed.2022.01.045. Epub 2022 Mar 24.

How Accurate Is CT for Hollow Viscus Injury After GSW?

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Contrast enhanced CT can help predict the risk of hollow viscus injury after thoracoabdominal gunshot wounds. Specifically, there is low probability of hollow viscus injury in the absence of abdominal free fluid, focal gastrointestinal wall thickness, or fat stranding on CT.

Source
Diagnostic accuracy of computed tomography findings for hollow viscus injuries following thoracoabdominal gunshot wounds. J Trauma Acute Care Surg. 2022 Jul 15. doi: 10.1097/TA.0000000000003743. Online ahead of print.

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