Triaging Children in Mass Casualty – Which Tool Is Best?
Four mass casualty incident (MCI) triage sorting systems performed similarly in children, each 57-59% accurate. Those considered were SALT, JumpSTART, Triage Sieve, and CareFlight.
Distracting Injury and C-Spine Clearance
Clinical clearance of the c-spine missed an equal number of c-spine injuries on CT (10-13%) whether distracting injury (DI) was present or not.
Which Head Injury Rule for Adults – CHIP, New Orleans, Canadian, NICE?
The CHIP rule performed better than other head injury rules in patients >16 years old in striking the balance between avoiding CT in 21% of patients while missing only 2 potential neurosurgical lesions on CT.
Spinal Motion Restriction Guidelines
The American College of Surgeons Committee on Trauma, American College of Emergency Physicians, and the National Association of EMS Physicians have offered a joint consensus statement on spinal motion restriction in trauma patients.
COMBAT – Plasma First During Ground Transport
Administration of plasma first for traumatic hemorrhagic shock when brought by ground did not change 28-day mortality.
New Risk After TBI – Suicide
The incidence of suicide nearly doubled in patients who had traumatic brain injury (TBI) compared to baseline. Risk increased with severity of injury, number of visits, and was highest in the first 6 months post-injury.
Scan ‘Em All – Anticoagulated Minor Head Trauma
Incidence of intracerebral hemorrhage (ICH) on CT following minor head trauma in anticoagulated patients was 9%, which means we have to CT all these people.
Head Ultrasound Can’t Screen for Trauma in Infants
Head ultrasound (HUS) via open fontanelle was a poor screening tool for intracranial bleed due to accidental or inflicted trauma.
New CATCH2 Highly Sensitive for Pediatric Brain Injury
CATCH2 is the CATCH rule plus ≥4 episodes of vomiting. It was highly sensitive for neurosurgical intervention and predicting injury on CT.
Risk of Emergent Thoracotomy
ED thoracotomy was associated with a risk of exposure to blood or body fluid in 7.6% of the 305 cases and 1.6% of the 1360 participants.