The Trauma Professional’s Blog has officially moved!New...
The Trauma Professional's Blog
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1y ago
The Trauma Professional’s Blog has officially moved! New site: www.TheTraumaPro.com I moved the blog to another site off of Tumblr several years ago. As posts were added to that site, they were usually cross-posted here. However, the software plug-in that accomplished that is not working so well, and cross-posts have become less and less frequent.  Please change your bookmarks so you can take advantage of the extra features found only on TheTraumaPro.com. All of my content is housed there, including a lot of material that never made its way to this site. This includes information o ..read more
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The September Issue of the TraumaMedEd Newsletter is Live!
The Trauma Professional's Blog
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1y ago
The September issue of the Trauma MedEd newsletter is now available to everyone! In this issue, get some tips on: Managing Penetrating Injury Nursing Tips For Pediatric Orthopedic Injury Abdominal Packing Tips Geriatric Trauma Management Tips For Trauma In Pregnancy Managing CSF Leaks To download the current issue, just click here! Or copy this link into your browser: https://www.traumameded.com/courses/practical-tips/ This newsletter was released to subscribers a few weeks ago. If you would like to be the first to get your hands on future newsletters, just click here to subscribe! Sou ..read more
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Animals vs Cars: What To Do
The Trauma Professional's Blog
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1y ago
This is a bad time of year in much of the United States for striking animals on the road. In my part of the country, the deer are out in full force. Car vs animal can be challenging, and motorcycle vs animal is frequently deadly. What can our patients do to protect themselves? Be especially vigilant when driving for the first few hours after sunset and just before sunrise. More animal activity occurs during these hours. If one animal is spotted, look out for others. Drive with high beams on as much as possible. In many animals, this will show reflections from their eyes. Some large animals ..read more
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Do We Really Need To Admit Children With Low-Grade Solid Organ Injury?
The Trauma Professional's Blog
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1y ago
Over the years, we have slowly gotten wiser about solid organ injuries (SOI). Way back when, before CT and ultrasound, if there was a suspicion a patient had such an injury you were off to the operating room. We learned (from children, I might add) that these injuries, especially the minor ones, were not such a big deal. However, we routinely admit adults and children with solid organ injury of any grade. Many centers have streamlined their practice guidelines so that these patients don’t spend very long in the hospital, but most are still admitted. A number of researchers from Level I pediatr ..read more
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Adding A Hospitalist To The Trauma Service
The Trauma Professional's Blog
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1y ago
Hospitals are increasingly relying on a hospitalist model to deliver care to inpatients on medical services. These medical generalists are usually trained in general internal medicine, family medicine, or pediatrics and provide general hospital-based care. Specialists, both medical and surgical, may be consulted when needed. In most higher level trauma centers in the US (I and II), major trauma patients are admitted to a surgical service (Trauma), and other nonsurgical specialists are consulted based on the needs of the patients and the competencies of the surgeons managing the patients.  ..read more
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Hitting The Brakes May Intracranial Pressure Changes During The Ambulance Ride!
The Trauma Professional's Blog
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1y ago
One of the most common injuries encountered by trauma professionals is blunt head trauma, and it’s one of the leading causes of death in young people. Keeping the level of intracranial pressure (ICP) within a specified range is one of the basic tenets of critical neurotrauma care in these patients. Most trauma centers have sophisticated algorithms that provide treatment guidance for various levels of ICP or cerebral perfusion. The vast majority of patients with severe head injuries are transported to the hospital in some type of ambulance. Obviously, the exact ICP level is not known during tra ..read more
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TXA, Thromboembolic Events, And Mortality
The Trauma Professional's Blog
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1y ago
I’ve visited several hundred trauma centers over the past 25 years, and recently I’ve begun to appreciate that there are two camps  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 a benefit with respect to survival from major hemorrhage, particularly if given soon after injury (CRASH-2, MATTERs). This drug is dirt cheap and has been around a long time, so it has a clearly defined risk profile. However, many of those hesitant to use it point to the possibility of thromboembolic events that ..read more
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Best Of AAST 2021: Trauma Transfers Discharged From The ED
The Trauma Professional's Blog
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1y ago
Aren’t these embarrassing? A referring center sends you a patient with the idea that they will be evaluated and admitted to your hospital. But it doesn’t work out that way. The patient is seen, possibly by a surgical specialist, bandaged up, and then sent home. Probably to one that is quite a few miles away. Not only is this a nuisance for the patient and an embarrassment for the sending center, it may use resources at the trauma center that are already tight. Transfer patients who are seen and discharged are another form of “ultimate overtriage.” In this case, the incorrect triage takes place ..read more
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Best Of AAST 2021: Chest Tube Based On Pneumothorax Size
The Trauma Professional's Blog
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1y ago
How big is too big? That has been the question for a long time as it applies to pneumothorax and chest tubes. For many, it is a math problem that takes into account the appearance on chest x-ray, the physiology of the patient, and their ability to tolerate the pneumothorax based on any pre-existing medical conditions. The group at Froedtert in Milwaukee has been trying to make this decision a bit more objective. They introduced the concept of CT based size measurement using a 35mm threshold at this very meeting three years ago. Read my review here. My criticisms at the time centered around the ..read more
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Best Of AAST 2021: Comparing Two Different Doses Of Enoxaparin
The Trauma Professional's Blog
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1y ago
Oh, look, my favorite topic! Prevention of venous thromboembolism (VTE) and complications. We’ve grown accustomed to using enoxaparin at the standard 30mg bid dose for a long time.  The orthopedic surgeons like to use 40mg qd, and there is some literature that shows this is reasonable for fracture patients. The group at OHSU in Portland wanted to show that the single dose regimen is just as safe and effective as the bid dose. They performed a seven year, prospective, randomized trial of the two dose regimens. Weekly screening duplex exams were performed. The outcome measured was the occur ..read more
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