I’ve visited several hundred trauma centers over the past 25 years, and recently I’ve begun to appreciate that there are two tribes when it comes to the use of tranexamic acid: the TXA believers and the TXA hesitant. There have been a number of large studies that seem to suggest... Read more
Published on: 2022-12-06
I’ve just spent two days here looking at the phenomenon of “delayed diagnosis” or missed injury. I believe that there are only two fundamental reason why this occurs: Insufficient diagnostic technique – A good physical exam and/or specific diagnostic techniques were not performed. Or rarely, the injury cannot be readily... Read more
Published on: 2022-11-29
Delayed diagnoses / missed injuries are with us to stay. The typical trauma activation is a fast-paced process, with lots of things going on at once. Trauma professionals are very good about doing a thorough exam and selecting pertinent diagnostic tests to seek out the obvious and not so obvious... Read more
Published on: 2022-11-25
Major trauma victims are evaluated by a team to rapidly identify life and limb threatening injuries. This is accomplished during the primary and secondary surveys done in the ED. The ATLS course states that it is more important for the team to identify that the patient has a problem (e.g.... Read more
Published on: 2022-11-22
Last week, I published a preliminary practice guideline for nonoperative management of abdominal stab wounds. Click here to view it. A key part of that guideline is the serial abdominal exam. Surgeons talk about this a lot, but how do you do it? I posted about many of the details... Read more
Published on: 2022-11-15
The October issue of the Trauma MedEd newsletter is now available to everyone! This issue contains a collection of some of the most requested posts from the blog. In this issue, you will learn about: How Quickly Does Hemoglobin Drop? How To Remember The “Classes of Hemorrhage” How To: The... Read more
Published on: 2022-11-11
In my previous post, I reviewed a new paper that examined the appropriate amount of time that patients should be observed for nonoperative manage of an abdominal stab wound. Many of you know that I am a fanatic of properly crafted clinical practice guidelines (CPG). I decided to make a... Read more
Published on: 2022-11-08