What’s On The Trauma Professional’s Blog?

Here’s another abstract with a promising title that suffers from low subject numbers. Whole blood is the new darling of trauma resuscitation. Assembling a unit of whole blood from the components it was broken down into produces an inferior product from the standpoint of resuscitation. It makes sense from a... Read more

Until the last few years, massive transfusion in trauma consisted of component therapy, an admixture of packed red cells, plasma, and platelets. Whole blood transfusion is making inroads again, but it is used in a minority of centers. Of the three components, platelets have classically required different handling than the... Read more

Worldwide, the proportion of older people is growing. With that is an increase in the number of older folks with medical comorbidities like diabetes, hypertension, and obesity. Trauma professionals recognize these conditions’ negative impact on recovery after injury. But is being young becoming the new old? The trauma group at... Read more

Today’s abstract continues the theme of VTE prophylaxis. The authors introduce another timing parameter in this one: the “door-to-prophylaxis” time. Just as it sounds, this is the time interval between admission to the ED and initiating chemo-prophylaxis. Just like some centers struggle with how long to wait to start it... Read more

Venous thromboembolic disease (VTE) continues to be a major issue in trauma patients. Most trauma centers have prophylaxis guidelines to try to reduce this problem. These guidelines typically recognize specific injuries that increase the risk of bleeding if anticoagulants are given. Typical ones include hemorrhagic injuries to the brain, pelvic... Read more

There is an art to deciding when to place a  chest tube for either hemothorax or pneumothorax. For the most part, the trauma professional examines the imaging and then uses some unknown internal metric to declare that it is “too big.” Then it’s time to insert some type of chest... Read more

Blunt vehicular trauma is the most common cause of severe lower extremity trauma, particularly motorcycle crashes. Occasionally, the injury is so severe that the limb cannot be saved, and amputation is necessary. The conventional treatment is to protect the amputation incision, provide physical therapy, and fit a prosthesis once the... Read more

The 82nd Annual Meeting of the American Association for the Surgery of Trauma begins next week. As is my custom, I will be reviewing some of the more interesting (to me) oral presentation abstracts until the last day of the meeting. When reading abstracts, keep in mind that you are... Read more

In my previous post, I reviewed a recent paper analyzing which geriatric patients were more likely to have care withdrawn after serious injury. The authors noted that those with significant limitations to daily living activities, increasing age and/or frailty, and ventilator dependence were major factors. Today’s paper was written by... Read more

Traumatic injury is a continuum ranging from very minor to immediately fatal. The mortality rate along that continuum rises exponentially as the Injury Severity Score (ISS) increases. We long ago moved away from the philosophy of keeping someone alive at all costs to embracing the concept of quality of life.... Read more

I am trying to figure out how I missed it! The Eastern Association for the Surgery of Trauma (EAST) snuck a new practice management guideline into the Injury journal last fall. And it desperately tries to answer a question that has been hanging around for several years. Do we vaccinate... Read more