A Little Hope for Traumatic Arrest
If hypoxia is the cause of traumatic arrest, the prognosis is better than expected.
Basilar Skull Fracture in Kids – PECARN
If a child has exam findings concerning for basilar skull fracture, do a head CT. If they have isolated BSF and a completely normal neurological exam after a period of ED observation, they have a low risk of adverse outcome and could be considered for discharge.
Why We Delay Volume Expansion in Penetrating Trauma
Patients with penetrating torso trauma do better when volume expansion is delayed until the time of definitive operative repair, rather than trying to give immediate prehospital volume to normalize BP.
Trauma chest CT – a thoughtful approach
Selective chest CT in trauma is safe if you take a cautious approach and use the NEXUS CT Chest Rule.
Hypotensive GSW- door to OR under 10 minutes
Hypotensive patients with gunshot wounds are almost half as likely to die if in the OR in under 10 minutes.
CT c-spine detects injuries – no MRI needed
Unless the neurological exam was abnormal, CT c-spine detected all clinically significant cervical spine injuries.
Risk of delayed head bleed on warfarin
Risk of a delayed intracranial bleed on warfarin at 24 hours was 0.6% in this meta-analysis.
Simplified GCS – motor score as good as the whole
GCS-motor only predicted as well as the full GCS score.
Lactate correlates with mortality in trauma
Elevated lactate correlated with increased mortality even in the absence of obvious injuries.
Harm from fluid restriction in burn patients
Sub-Parkland restrictive fluid strategies in burn patient led to increased kidney injury.