In today’s post, I will review the diaphragmatic injury practice guidelines published by the Eastern Association for the Surgery of Trauma (EAST).  I will follow this up on Friday with an interesting delayed diaphragm injury case. Diaphragm injury is a troublesome one to diagnose. It is essentially an elliptical sheet... Read more
Published on: 2023-06-06
Over the recent decades, there has been a huge push toward “evidence-based” medicine. Unfortunately, the available amount of high-quality literature is relatively low. And the field of neurotrauma is even less-represented than most. Debates have raged over the years regarding the proper timing of surgical spine decompression in patients with... Read more
Published on: 2023-06-02
Here’s the final post on my series covering serial hemoglobin testing in the management of solid organ injury. We developed our first iteration of a solid organ injury practice guideline at Regions Hospital way back in 2002. It was borne out of the enormous degree of clinical variability I saw... Read more
Published on: 2023-05-26
In my last post, I waxed theoretical. I discussed the potential reasons for measuring serial hemoglobin or hematocrit levels, the limitations due to the rate of change of the values, and conjectured about how often they really should be drawn. And now, how about something more practical? How about an... Read more
Published on: 2023-05-23
The serial hemoglobin (Hgb) determination. We’ve all done them. Not only trauma professionals, but other in-hospital clinical services as well. But my considered opinion is that they are not of much use. They inflict pain. They wake patients up at inconvenient hours. And they are difficult to interpret. So why... Read more
Published on: 2023-05-19
The Rural Trauma Team Development Course (RTTDC) was introduced by the American College of Surgeons (ACS) to improve the care of trauma patients in rural communities. It is a staple of education for Level III and IV trauma centers in rural areas. Like everything else, most courses were shut down... Read more
Published on: 2023-05-17
Any trauma professional who has dealt with spleen injuries knows that the white blood cell (WBC) count rises afterwards. And unfortunately, this elevation can be confusing if the patient is at risk for developing inflammatory or infectious processes that might be monitored using the WBC count. Is there any rhyme... Read more
Published on: 2023-05-12