Stop the Bleed® in medical schools: Early advocacy and promising results.

Objective: We hypothesized that medical students would be empowered by hemorrhage-control training and would support efforts to include Stop the Bleed® (STB) in medical education.

Design: This is a multi-institution survey study. Surveys were administered immediately following and 6 months after the course.

The use of inferior vena cava filters in spine trauma: A nationwide study using the National Trauma Data Bank.

Objective: To determine the prevalence and variation of inferior vena cava filter (IVCF) use in the spine trauma population and evaluate patient and facility level factors associated with their use.

Study Design: Retrospective cohort. Participants/Outcome Measures: Patients with spinal injuries were identified by ICD-9 codes from the National Trauma Data Bank (NTDB), the best validated national trauma database.

Venous Sinus Thrombosis in Blunt Trauma: Incidence and Risk Factors.

Purpose: The aim of our study was to determine the incidence and risk factors of dural venous sinus thrombosis and epidural hemorrhage in the setting of a blunt trauma causing a calvarial fracture crossing a dural venous sinus.

Methods: A retrospective review of 472 blunt trauma patients with calvarial fracture crossing a dural venous sinus was performed. Two hundred ten patients who underwent computed tomography venography were identified and evaluated for the presence of dural venous sinus thrombosis and/or epidural hemorrhage.

Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society.

Introduction: Thoracic trauma is the second most prevalent nonintentional injury in the United States and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma.

Preperitoneal pelvic packing: Technique and outcomes.

Significant pelvic ring fractures are usually secondary to high-energy trauma, and when associated with other life-threatening injuries and hemodynamic instability, result in high mortality rates ranging from 40 to 60%. The major cause of death during the first 24 h after pelvic trauma is attributed to acute blood loss, with later mortality secondary to multisystem organ failure. In a majority of patients, the source of pelvic bleeding is from disruption of the presacral venous plexus and bony fracture sites, while arterial injury is present in only 10-15%.

Pediatric gunshot wound recidivism: Identification of at-risk youth.

Background: Although penetrating injury is the most common reason for pediatric trauma recidivism, there is a paucity of literature specifically looking at this population. The objective of this study was to identify those in the pediatric community at the highest levels of risk for experiencing gunshot wound (GSW) on multiple occasions.

Methods: A retrospective review querying our urban Level I trauma database was performed.

Guidance Document for the Prehospital Use of Tranexamic Acid in Injured Patients.

Tranexamic acid (TXA) is being administered already in many prehospital air and ground systems. Insufficient evidence exists to support or refute the prehospital administration of TXA, and results are pending from several prehospital studies currently in progress. We have created this document to aid agencies and systems in best practices for TXA administration based on currently available best evidence.

Acute splenic syndrome in an African-American male with sickle cell trait on a commercial airplane flight.

Background: Patients with sickle cell trait (SCT) generally suffer few effects of sickle cell disease. Acute splenic syndrome is a rare but well-documented complication of SCT that can present in the setting of low oxygen tension that occurs with major changes in altitude, either by unpressurized air flight or ground travel such as mountain climbing.

Objective: Our objective was to increase emergency physician awareness of the rare diagnosis of altitude-induced splenic infarction in patients with SCT by presenting and reviewing recorded literature.

Presumptive antibiotic use in tube thoracostomy for traumatic hemopneumothorax: an Eastern Association for the Surgery of Trauma practice management guideline.

Background: Antibiotic use in injured patients requiring tube thoracostomy (TT) to reduce the incidence of empyema and pneumonia remains a controversial practice. In 1998, the Eastern Association for the Surgery of Trauma (EAST) developed and published practice management guidelines for the use of presumptive antibiotics in TT for patients who sustained a traumatic hemopneumothorax. The Practice Management Guidelines Committee of EAST has updated the 1998 guidelines to reflect current literature and practice.

Screening for thoracolumbar spinal injuries in blunt trauma: an Eastern Association for the Surgery of Trauma practice management guideline.

Background: Thoracolumbar spine (TLS) injuries have an incidence rate of 5% in blunt trauma patients. The Eastern Association for the Surgery of Trauma published Practice Management Guidelines for the Screening of Thoracolumbar Spine Fracture in 2007. The Practice Management Guidelines Committee was assembled to reevaluate the literature.

Therapeutic hypothermia for treatment of intractable intracranial hypertension after liver transplantation.

A comatose 23-year-old woman with acute liver failure due to an overdose of acetaminophen had indications of intracranial hypertension and underwent liver transplantation. Her level of arousal did not improve, and on postoperative day 1, clinical signs of cerebral herniation became apparent. An intracranial pressure monitor was placed, and intracranial hypertension was documented.

Short simulation training improves objective skills in established advanced practitioners managing emergencies on the ward and surgical intensive care unit.

Background: Several studies evaluating simulation training in intensive care unit (ICU) physicians have demonstrated improvement in leadership and management skills. No study to date has evaluated whether such training is useful in established ICU advanced practitioners (APs). We hypothesized that human patient simulator-based training would improve surgical ICU APs' skills at managing medical crises.