Category Archives: Trauma

Crash-2

By Nelson Wong, MD Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomized, placebo-controlled trial Lancet 2010;376:23-32 Background Trauma is a major cause of death worldwide.  Lethal triad … Continue reading

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Severe Trauma with Karim Brohi

By George Lim, MD Please refer to EMCrit PERMISSIVE HYPOTENSION -       For Dr. Brohi, permissive hypotension is more of a mindset more so than goal BP’s If he had to give number, SBP < 60 or 70 then provide crystalloid/blood … Continue reading

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Trauma and the Primary Survey

By Felipe Teran, MD Please refer to EMRAP: C3 Project  ABCDE done simultaneously (unlike ATLS) One person will run the trauma and should be standing at the foot of the bed Primary survey: goal is to identify the life threatening … Continue reading

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EMCRIT #72 – Hemodynamically Unstable Pelvic Trauma

By Christie Lech, MD http://emcrit.org/podcasts/severe-pelvic-trauma/ Check the iliac crest and push in, if you don’t feel movement, then you know there isn’t an open book pelvic trauma. If you feel the pelvis move inward under your hand, push harder until … Continue reading

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EMCRIT #71– Massive Transfusion

By Christie Lech, MD http://emcrit.org/podcasts/massive-transfusion-kenji/ Criteria to initiate massive transfusion protocol: no good studies – Inaba reports that when a patient requires a threshold of 6 units of blood, massive transfusion protocol is initiated. There are studies that show that … Continue reading

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EMCRIT 67 – Tranexamic Acid (TXA)

By Tatiana Havryliuk MD TXA: inhibits the breakdown of clot It is an anti-fibrinolytic Possibly anti-inflammatory too. Crash 2 trial (Lancet 2010) – >20,000 subjects all over the world – primary outcome: survival – absolute mortality reduction of 1.5% in … Continue reading

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EMCrit Podcast 63: Pain in the neck

EMCrit Podcast 63:   Pain in the neck   By Kei Ko, MD Nexus* C spine radiography unless: 1. No posterior midline cervical-spine tenderness 2. No evidence of intoxication a. No smell, observation, or suspicion of intoxication 3. Normal level … Continue reading

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EMCRIT 12 : Trauma Resus

by Christie Lech, MD Trauma Resus MAP 65 Patients should be resuscitated to a MAP of 65 as the goal with signs of good tissue perfusion (i.e. good radial pulse, warm feet and hands) if MAP is greater than 65, … Continue reading

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Ocular Ultrasound in Head Trauma

Post by Raashee Kedia MD Detect Findings of Increased Intracranial Pressure in Adult Head Injury Patients Article here  There are times CT scan may not be suitable to evaluate a patient for intra-cranial trauma. Such as unstable multiorgan injuries, remote … Continue reading

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Traumatic Arrest

Post by Dena Asaad Reiter, MD EMCRIT #36 Traumatic cardiac arrest is a completely different entity from non-traumatic arrest and should thus be approached very differently. Closed chest compressions and ACLS medications have no role in traumatic arrest, as the … Continue reading

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