Trauma Archives - EMOttawa

ROTEM in Trauma: Blood is thicker with Wine – Part 1

by Richard Hoang | Sep 24, 2020 | Critical Care, Featured, Grand Round Summaries, Trauma

In this post, we’ll discuss viscoelastic hemostatic assays (VHAs), namely ROTEM (Rotational Thromboelastometry), and how we can use this tool to enhance the care of traumatically injured patients. This is the first in a two-part series. This part reviews the Evidence...

Hypothermia Part 2: Prognostication and Protocols

by Mark McKinney | Mar 12, 2020 | Featured, Grand Round Summaries, Resuscitation, Trauma

Here we present part two on our series on hypothermia. For more on the assessment, resuscitation, and management of the hypothermic patient, see part one. Prognostication of cardiac arrest in hypothermia Indicators of cardiac arrest before cooling (Brown 2012) Major...

Hypothermia: Keeping your cool when it gets cold

by Mark McKinney | Mar 5, 2020 | Featured, Grand Round Summaries, Resuscitation, Trauma

Hypothermia results in slightly over one hundred deaths per year in Canada; typically as a result of primary hypothermia, frostbite and other cold exposure injuries (Toronto Public Health, 2014). In the United States, this is estimated at 1500 deaths annually...

Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock: A Randomized Clinical Trial

by Hans Rosenberg | Feb 3, 2020 | Full Article, Journal Club, Trauma

Methodology: 4/5 Usefulness: 2/5 Sims CA, et al. JAMA Surg. 2019 Aug 28. Question and Methods: Single-centre, double-blind, randomized control trial to determine whether low-dose vasopressin decreases the need for blood product transfusion in trauma patients with...

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial.

by Hans Rosenberg | Dec 16, 2019 | Full Article, Journal Club, Neurosurgery, Resuscitation, Trauma

Methodology Score: 3/5 Usefulness Score: 3/5 Cooper DJ, et al. JAMA. 2018;320(21):2211-2220. doi:10.1001/jama.2018.17075 Question/Methods: This study was done to determine the effectiveness of early prophylactic hypothermia compared with normothermic management of...

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomized, placebo-controlled trial

by Hans Rosenberg | Dec 9, 2019 | Full Article, Neurosurgery, Trauma

Methodology: 3.5/5 Usefulness: 3.5/5 The CRASH-3 trial collaborators. The Lancet. 2019 Oct 14. Online First Editorial: CRASH-3: a win for patients with traumatic brain injury Question and Methods: Multi-centre, randomized, placebo-controlled trial looking at whether...

$Three week versus six week immobilisation for stable Weber B type ankle fractures: randomised, multicentre, non-inferiority clinical trial$

Three week versus six week immobilisation for stable Weber B type ankle fractures: randomised, multicentre, non-inferiority clinical trial

by Hans Rosenberg | Dec 2, 2019 | Journal Club, Orthopedics, Orthopedics, Trauma

Methodology: 4/5 Usefulness: 3.5/5 Kortekangas T, et al. BMJ. 2019 Jan 23;364:k5432 Question and Methods: This is a pragmatic, randomized, controlled trial to determine if 3 weeks of immobilization (in cast or orthosis) is non-inferior to usual treatment (6 weeks cast...

Crashing through the snow, reviewing the CRASH-3 trial

by Krishan Yadav | Nov 7, 2019 | Featured, Journal Club, Trauma

Dr. Krishan Yadav is an FRCPC Emergency Medicine Physician with a Masters in Clinical Epidemiology, and here he helps to provide some great insights and opinions into the recently published CRASH-3 trial. Tranexamic Acid (TXA) TXA is an inexpensive and readily...

Extreme Ownership: How to Own the Trauma Bay and Lead High-Stakes Resuscitations

by Richard Hoang | Oct 17, 2019 | Featured, Trauma, Uncategorized

In this post, we’re going to do something a little different. Instead of reviewing a specific Emergency Medicine topic, we’re going to discuss Leadership – How to lead your team and make things happen during a high-stakes resuscitation. As the Leadership principles...

Minor Blunt Thoracic Trauma in the Emergency Department: Sensitivity and Specificity of Chest Ultralow-Dose Computed Tomography Compared With Conventional Radiography

by Hans Rosenberg | Sep 30, 2019 | Journal Club, Radiology, Trauma

Methodology: 2/5 Usefulness: 2.5/5 Macri F, Greffier J, Khasanova E, Claret PG, Bastide S, Larbi A, Bobbia X, Pereira FR, de la Coussaye JE, Beregi JP. Ann Emerg Med. 2019 Jun;73(6):665-670. Question and Methods: This 160-patient pilot study prospectively compared...

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