The January issue of the Trauma MedEd newsletter will be sent out soon! It’s chock full of general stuff of interest to all you trauma professionals. This issue is being released Sunday evening. If you sign up any time before then, you will receive it, too. Otherwise, you’ll have to... Read more
Published on: 2023-01-26
The lymphatic system is a network of vessels that helps regulate fluid homeostasis, waste clearance, and immune response. Most tissues in the body have some type of lymphatic drainage. The main holdouts have been the brain, the eyes, and our bones. Ten years ago, the brain lymphatic system (called glymphatics since... Read more
Published on: 2023-01-24
Time for another abstract on venous thromboembolic disease (VTE) prophylaxis, but this time in patients with severe head injury. VTE is a significant problem for trauma patients. Those with a potential source of bleeding from their injuries cause us to hesitate and consider the timing of chemical prophylaxis closely. Do... Read more
Published on: 2023-01-19
More stuff on TXA! I published two posts back in December on TXA hesitancy. This Friday, the trauma group at Wake Forest is presenting an abstract on TXA use by prehospital trauma professionals. It is very likely that EMS carries tranexamic acid (TXA) in your area. Each agency has its own... Read more
Published on: 2023-01-18
Chemoprophylaxis against venous thromboembolism (VTE) is routine in trauma care. In most cases, it can be initiated shortly after admission in most trauma patients. However, there are a few major exceptions, including eye injuries and brain injuries with intracranial hemorrhage. Solid organ injury used to be cause for concern when... Read more
Published on: 2023-01-17
It is becoming clearer and clearer that patients with suspicion for fractures of the thoracic (T) and lumbar (L) spine should be imaged only with CT scan. Conventional imaging just doesn’t have enough sensitivity, even in younger patients with healthy bones. But when we obtain CT of the T&L spines... Read more
Published on: 2023-01-16
Artificial intelligence systems (AI) are increasingly finding their way into medical practice. They have been used to assist pathologists in screening microscope specimens for years. Although still amazingly complicated, one of the most obvious applications for trauma is in reading x-rays. Counting rib fractures may be helpful for care planning,... Read more
Published on: 2023-01-13
Back in the day, autopsy after trauma death was fairly commonplace. Nowadays, it is typically reserved for fatalities that involve a potential crime. And it can be challenging to get the medical examiner to release copies for trauma performance improvement. One potential remedy for this began to surface in the... Read more
Published on: 2023-01-12
Forty years ago, the presumption was that the best way to intubate a trauma patient was to take them to a fully equipped operating room and have an anesthesiologist perform it. Then, a few years later, we finally figured out it could be done in the emergency department. The key... Read more
Published on: 2023-01-10
Several papers have been published over the years regarding underdiagnosis when applying the usual imaging guidelines to elderly trauma patients. Unfortunately, our elders are more fragile than the younger patients those guidelines were based on, leading to injury from lesser mechanisms. They also do not experience pain the same way... Read more
Published on: 2023-01-09
We know that even a brief shock episode in patients with severe TBI dramatically increases mortality. Therefore, standard practice is to ensure good oxygenation with supplemental O2 and an adequate airway ASAP and to guard against hypotension with crystalloids and blood if needed. Many papers (and several abstracts in this... Read more
Published on: 2023-01-06
Decades ago, blood banks discovered they could fractionate units of whole blood into components for focused use. This was useful for patients who were thrombocytopenic or needed specific plasma factors. But trauma patients bleed whole blood, and trying to reassemble whole blood from components does not work well. Have a... Read more
Published on: 2023-01-05
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) remains one of the shiny new trauma toys. Yet, with nearly a decade of human study, we are still struggling to define the right patients to benefit from it. A group of REBOA superfans sought to perform a secondary analysis of a... Read more
Published on: 2023-01-03
I’ve been reading and reviewing scientific papers for years. One of my biggest pet peeves is the preponderance of studies that have been thrown together with insufficient thought given to research design. One of the most common issues I see in any study is the failure to look at study... Read more
Published on: 2023-01-02
It’s that time of year again! The Eastern Association for the Surgery of Trauma (EAST) Annual Scientific Assembly is just around the corner. And as usual, I have selected a number of the more interesting and intriguing abstracts to analyze here. I will look at the idea behind each abstract,... Read more
Published on: 2022-12-30