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EM Journal Update: Prehospital Narrow Pulse Pressure Predicts Need for Resuscitative Thoracotomy and Emergent Intervention After Trauma

Core EM

95% CI (1.46, 2.84)) and the need for an emergent intervention (aOR 1.38, 95% CI (1.15, 1.66)).

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The PROTECTION Trial – A Randomized Trial of Intravenous Amino Acids for Kidney Protection

REBEL EM

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

ICU 81
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Episode 35: When to operate in trauma with Dennis Kim

Critical Care Scenarios

Dennis Kim ( @traumaicurounds ), associate professor of Clinical Surgery at UCLA and medical director of the Harbor-UCLA Medical Center SICU, as well as host of the Trauma ICU Rounds podcast.

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Data Cafe Insights: 2023 ESO Trauma Index Overview

ESO

Surgical Repair of Hip Fractures: Demonstrating effective care prioritization, 94% of older adults with hip fractures were moved to the operating room within 24 hours. This rapid intervention reduced complications and highlights the need for maintaining and improving such protocols.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

Disposition: Consider ICU for many patients, especially if any signs of instability or repeatedly requiring blood products. All patients typically require admission for a new spontaneous retroperitoneal hematoma for monitoring and decisions regarding when or if to restart anticoagulation. Mortality can varies between 5-20%.

EMS 74
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Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. 2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? Paper: Owyang CG, et al.

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Case Report: EMS Says Flail Chest, But Is It?

ACEP Now

On hospital day 2, he was taken to the operating room for surgical rib fixation. The trauma team placed a pigtail catheter in the right chest cavity to decompress the pneumothorax and the patient was admitted to the surgical intensive care unit. The patient continued to have an oxygen requirement and significant pain.

EMS 52