Implementation of a novel daily performance improvement checklist (PIC) improves alcohol screening and intervention compliance in trauma.

Introduction: Screening, brief intervention, and referral to treatment (SBIRT) has demonstrated up to 50% reduction in alcohol-related traumatic injury and is mandated by the American College of Surgeons for trauma center accreditation. While SBIRT effectiveness has been previously investigated, optimal implementation in the trauma setting has not. We sought to improve SBIRT compliance through integration of screening into a performance improvement checklist (PIC) deployed during morning report.

Evaluating Clinical Reasoning in Undergraduate Medical Education: The Value of a Virtual Oral Assessment.

Background: Oral assessments are essential components of board certification in numerous fields, as they provide insight into problem-solving capacity and clinical reasoning. The development of clinical reasoning often begins in undergraduate medical education and remains a challenge to assess.

Objective: We developed a pilot oral assessment to evaluate medical student oral presentations and systematically assess clinical reasoning.

Triphasic response of pituitary stalk injury following TBI: a relevant yet uncommonly recognised endocrine phenomenon.

The triphasic response of pituitary stalk injury has previously been described in a minority of patients following intracranial surgery, however, this phenomenon can also occur after traumatic brain injury. We present the case of a 20-year-old male who experienced the triphasic response of pituitary stalk injury (central diabetes insipidus, syndrome of inappropriate antidiuretic hormone and central diabetes insipidus again) after striking his head on a concrete curb. His history and presentation highlight the importance of recognising the distinctive symptoms of each individual stage of pituitary stalk injury, and using the appropriate diagnostic tools and therapies to guide further management.

Delayed versus Immediate Cord Clamping in Preterm Infants.

Background: The preferred timing of umbilical-cord clamping in preterm infants is unclear.

Methods: We randomly assigned fetuses from women who were expected to deliver before 30 weeks of gestation to either immediate clamping of the umbilical cord (≤10 seconds after delivery) or delayed clamping (≥60 seconds after delivery). The primary composite outcome was death or major morbidity (defined as severe brain injury on postnatal ultrasonography, severe retinopathy of prematurity, necrotizing enterocolitis, or late-onset sepsis) by 36 weeks of postmenstrual age.