Archive for category: Trauma

Blunt Cardiac Injury (BCI)

06 Dec
December 6, 2018

Friday, 2300 hours: A 24 year-old woman presents to your Emergency Department after a motor vehicle collision. She was the restrained driver of a car that collided head-on with another vehicle. She is complaining only of chest pain and appears uncomfortable and anxious.  The monitor shows sinus tachycardia and you spot a sternal fracture on […]

REBEL Cast Ep60: COMBAT and PAMPer – Prehospital Plasma in Trauma

05 Nov
November 5, 2018

Background: Care of trauma patients with severe bleeding has advanced in recent years with a focus on damage control resuscitation which includes permissive hypotension, hemostatic resuscitation (blood component resuscitation), and hemorrhage control. Minimizing crystalloids in favor of blood component-based resuscitation in the prehospital setting has the potential to reduce downstream complications by intervening closer to the […]

Cervical Spine Evaluation and Clearance in the Intoxicated Patient

16 Aug
August 16, 2018

Background: Alcohol and drug intoxication is common in trauma patients and a significant proportion of cervical spine (c-spine) injuries occur in patients with intoxication. A standard approach to both intoxicated and sober patients with suspected c-spine injury in many trauma centers includes the placement of a rigid cervical collar for spinal immobilization until the c-spine can […]

Is it Safe to Discharge Patients Home with Isolated Traumatic Subarachnoid Hemorrhage (itSAH)?

05 Jun
June 5, 2018

Background: I received a text message from one of my colleagues inquiring about discharging a patient home with isolated traumatic subarachnoid hemorrhage and to be honest I had heard about this practice, but was not completely aware of the literature around it.  Turns out from a PubMed search there was a meta-analysis published just this past […]

Penetrating Neck Injuries

28 May
May 28, 2018

Background: Patients with penetrating neck trauma can present with a variety of injury patterns including hemorrhagic shock, airway obstruction and neurologic injury. Serious injuries may not be clinically obvious making diagnosis and prompt treatment challenging. Due to the large number of critical structures in the neck, a clear knowledge of the anatomy is necessary for […]