Facial trauma is common, especially in children. And the use of CT scan is even more common, unfortunately for children. What happens when these two events meet? I’ve noted that many trauma professionals almost reflexively order a face CT when they see any evidence of facial trauma. This ranges from... Read more
Published on: 2022-05-20
By now, we are all very familiar with the concept of the distracting injury. Some of our patients sustain injuries that are so painful that they mask the presence of others. The patient is so distracted by the big one that others just slip their notice. This concept has been... Read more
Published on: 2022-05-17
And yes, another consultant reference card. As I wrote previously. we sometimes overuse our consultants and call then at inappropriate times. So what if we diagnose an injury in their area of expertise at 2 am? Does it need attention or an operation before morning? If not, why call at... Read more
Published on: 2022-05-13
Initiating the massive transfusion protocol (MTP) is generally easy. Some centers use the Assessment of Blood Consumption score (ABC). This consists of four easy parameters: Heart rate > 120 Systolic blood pressure < 90 FAST positive Penetrating mechanism The presence of two or more indicators reliably predicts a 50% chance... Read more
Published on: 2022-05-10
Trauma professionals don’t always know everything. Sometimes we have to engage a specialist in the care of our patient. And unfortunately, we don’t always know which conditions demand immediate attention and which can wait. This can lead to overuse of our consultant colleagues and calls  at inappropriate times. So what... Read more
Published on: 2022-05-06
When it comes to repeat CT scanning after splenic injury, there are believers and there are non-believers. In my experience, the majority of centers in the US are non-believers. However, there is a new paper in press that attempts to convince us that more should become believers. I think the... Read more
Published on: 2022-05-03
CT scans are commonly used to aid the workup of patients with blunt trauma. They are occasionally useful in penetrating trauma, specifically when penetration into a body cavity is uncertain and the patient has no hard signs that would send him or her immediately to the operating room. Is there... Read more
Published on: 2022-04-29
We’ve learned a couple of things in the last two posts by reviewing recent systematic review / meta-analysis studies. First, low molecular weight heparin provides better prophylaxis against venous thromboembolism (VTE) than unfractionated heparin. And giving prophylaxis within the first 72 hours of admission significantly decreases the incidence of VTE... Read more
Published on: 2022-04-26
In my last post, we looked at our knowledge base regarding the use of unfractionated heparin versus low molecular weight heparin. And the latter won. Today, let’s dig into the question of early versus late prophylaxis in patients with TBI and intracranial hemorrhage. Neurosurgeons are remarkably cautious when considering anticoagulant... Read more
Published on: 2022-04-22