The August newsletter is now available! Click the image below or the link at the bottom to download. This month’s topic is trauma centers.
In this issue you’ll find articles on:
- The value of trauma center care
- Benefit of transport to a trauma center
- Going from Level II to Level I
- Financial triage – the wallet biopsy
- Is there a shortage of on-call specialists
- Why do trauma patients get readmitted?
Subscribers had the newsletter emailed to them last weekend. If you want to subscribe (and download back issues), click here.
Download the newsletter here!
Thursday, September 5 – 8am to noon Central time (1-5pm GMT)
Conference details here!
Link to the live web stream here!
This conference is less than 24 hours away! It is designed to provide high quality trauma education for physicians, nurses, and paramedics in a fast paced and innovative format.
- You think you know… – why we still believe trauma myths and how to bust them
- Dislocated hip reduction techniques
- Field amputation: indications, challenges, techniques
- Finger thoracostomy – from Scott Weingart!
- Burn size estimation
- Nursing considerations in burn patients
- Keeping rare but critical knowledge fresh
- Intraosseous tips
- Disruptive innovation in education
- Curbside consults – we ask specialists the questions you always with you had
All of this, delivered in short, easy to digest presentations and videos!
For those of you unable to attend the live event at the Minnesota History Center in St. Paul, join our live web stream. Submit questions or comments to the presenters in real time via #TETNG13 on Twitter. See you there!
Link to the live web stream here!
Practice guidelines from the Brain Trauma Foundation recommend placement of an ICP monitor in trauma patients with GCS<8 and any type of intracranial hemorrhage. Some rural trauma centers may not have immediate access to a neurosurgeon for this procedure, and geography and/or weather may preclude transferring the patient. What to do?
Well, one person is guaranteed to be available at any trauma center. The trauma surgeon. Six years of data regarding placement of bolt type ICP monitors by appropriately trained and credentialed trauma surgeons or neurosurgeons was reviewed. The study was actually carried out at a Level I center, where both specialties were available. A total of 407 cases were studied.
Here are the interesting factoids:
- Patients tended to be young (average 41 years), and male (of course)
- About one third were falls and one third were motor vehicle crashes
- Trauma surgeons placed 71% of the ICP bolts, neurosurgeons 29%
- Complication rates were low and not significantly different (2.5% for surgeons, 0.8% for neurosurgeons)
Bottom line: This study is intriguing, and I know a few centers in the US and many abroad already allow surgeons to place ICP monitors. However, this study is too small and underpowered to reach a definitive conclusion. A much larger, multicenter trial is warranted, although it will be difficult to carry out. In the meantime, if your hospital needs this resouirce, consider training your trauma surgeons for the procedure. But be sure to monitor complications and outcomes very carefully via your trauma PI process!
Reference: Placement of intracranial bolt monitors by trauma surgeons – a 6 year review. AAST 2013 Paper 20.
The August issue of Trauma MedEd is ready to go! Subscribers will receive it tonight. This issue is devoted to trauma centers.
Included are articles on:
- The value of trauma centers
- Benefits of transport to trauma centers
- The “wallet biopsy” and trauma care
- The shortage of on-call specialists
- And more!
As mentioned above, subscribers will get the issue delivered tonight to their preferred email address. It will be available to everybody else later this week on the blog.
Check out back issues, and subscribe now! Get it first by clicking here!