Role of Serial Phlebotomy in the Management of Blunt Solid Organ Injury in Adults.

Background: The management of blunt spleen and liver trauma has become increasingly nonoperative. There is no consensus on timing or duration of serial hemoglobin and hematocrit monitoring in this patient population.

Objective: This study examined the clinical utility of serial hemoglobin and hematocrit monitoring.

Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury: Approved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023).

This 2023 Clinical Policy from the American College of Emergency Physicians is an update of the 2008 “Clinical Policy: Neuroimaging and Decisionmaking in Adult Mild Traumatic Brain Injury in the Acute Setting.” A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following questions: 1) In the adult emergency department patient presenting with minor head injury, are there clinical decision tools to identify patients who do not require a head computed tomography? 2) In the adult emergency department patient presenting with minor head injury, a normal baseline neurologic examination, and taking an anticoagulant or antiplatelet medication, is discharge safe after a single head computed tomography? and 3) In the adult emergency department patient diagnosed with mild traumatic brain injury or concussion, are there clinical decision tools or factors to identify patients requiring follow-up care for postconcussive syndrome or to identify patients with delayed sequelae after emergency department discharge? Evidence was graded and recommendations were made based on the strength of the available data. Widespread and consistent implementation of evidence-based clinical recommendations is warranted to improve patient care.

Reducing Inpatient Falls Through Simulations With Symptom Burden Devices.

Background: In-hospital patient falls are a persistent problem in health care, resulting in increased length of stay and nonreimbursable charges.

Local Problem: Although fall prevention programs have decreased inpatient fall rates, our hospital averages 30 falls per month.

Methods: This was a quality improvement project, including a simulation and debriefing.

Feasibility assessment for use of Rh-positive blood products during emergency resuscitation in the North Texas trauma population.

The purpose of this study was to evaluate the extent to which a blood bank policy aimed at decreasing the risk of hemolytic disease of the fetus and newborn (HDFN) by limiting emergency-release blood to Rh-negative blood products is effective. We conducted a retrospective review of the trauma registry for all trauma patients evaluated at our level II trauma center. Patients who received blood products within 4 h of arrival were included.