Canadian CT Head Rule to Reduce CT Use
The Canadian CT Head Rule was 100% sensitive for ruling out clinically important brain injury. It had higher specificity than the New Orleans Criteria, which meant fewer people would need a CT scan by using the Canadian rule.
No Cruising? No Bruising – Outcome of Bruising in Premobile Infants
Bruising in premobile children means trouble. The most important take home is: "More than half of premobile infants with initially unexplained bruises were found to be abused." Bruising before they're cruising needs a workup and DCS referral.
Canadian C-spine Rule for Clinical Clearance
The Canadian C-spine rule has high sensitivity for c-spine injury and higher specificity than the NEXUS rule. It allows clinical clearance of more people.
CRASH-2 Tranexamic Acid in Trauma
Tranexamic acid (TXA) decreased mortality from bleeding in trauma patients. But there are a few caveats to note.
Why We Delay Volume Administration in Penetrating Trauma
In patients with penetrating trauma, it was better to allow prehospital hypotension and hasten transport for definitive repair prior to beginning volume resuscitation than to try to normalize vital signs in the field by giving IV fluid.
SCIWORA in the NEXUS Study
Spinal cord injury without radiographic abnormality (SCIWORA) was very rare, 27/34069 (0.08%). Although NEXUS enrolled 3000 patients <18 years, down to age 1, all patients with SCIWORA were adults in this cohort.
News Flash – Asymptomatic Trauma Patients With Negative Scans Do Well
Asymptomatic blunt trauma patients over age 14 with a negative CT abdomen/pelvis did not have delayed missed injuries.
Why We Use NEXUS for C-Spine Clearance
The NEXUS criteria can be used to determine which patients do not need c-spine x-rays. Since this was published, we have shifted to predominantly CT imaging, which is more sensitive. Also, we have learned that NEXUS is not as sensitive in elderly patients.
More Favorable News on Prehospital Airway Management
Outcome in patients with traumatic brain injury was better in patients with prehospital intubation, but most of the intubations were performed by air transport crews.
Does Peds Damage Control Transfusion Help?
A high plasma to PRBC transfusion ratio (>/= 1:2) was not beneficial in pediatric massive trauma transfusion. But this study was different than adult studies of damage control resuscitation in that these children did not receive platelets