Thromboelastography and Rotational Thromboelastometry in Bleeding Patients with Coagulopathy: Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

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Assessment of the immediate need for specific blood product transfusions in acutely bleeding patients is challenging. Clinical assessment and commonly used coagulation tests are inaccurate and time-consuming. The goal of […]

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A Multiyear Cross-sectional Study of Guideline Adherence for the Timeliness of Opioid Administration in Children With Sickle Cell Pain Crisis.

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The National Heart, Lung, and Blood Institute evidence-based guidelines for timeliness of opioid administration for sickle cell disease (SCD) pain crises recommend an initial opioid within 1 hour of arrival, […]

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The management of occult hemothorax in adults with thoracic trauma: a systematic review and meta-analysis.

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Hemothorax is a common sequelae following thoracic trauma and is associated with significant morbidity and mortality. Current guidelines recommend all traumatic hemothoraces be considered for drainage with tube thoracostomy (TT), […]

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The management of occult hemothorax in adults with thoracic trauma: a systematic review and meta-analysis.

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Hemothorax is a common sequelae following thoracic trauma and is associated with significant morbidity and mortality. Current guidelines recommend all traumatic hemothoraces be considered for drainage with tube thoracostomy (TT), […]

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Emergency care provided to refugee children in Europe: RefuNET: a cross-sectional survey study.

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Refugee children and young people have complex healthcare needs. However, issues related to acute healthcare provision for refugee children across Europe remain unexplored. This study aimed to describe the urgent […]

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Risk of significant traumatic brain injury in adults with minor head injury taking direct oral anticoagulants: a cohort study and updated meta-analysis.

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Patients taking direct oral anticoagulants (DOACs) commonly undergo CT head imaging after minor head injury, regardless of symptoms or signs. However, the risk of intracranial haemorrhage (ICH) in such patients […]

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Use of Fibrinogen Concentrate for Trauma-Related Bleeding: A Systematic-Review and Meta-Analysis.

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Trauma-induced coagulopathy contributes to significant morbidity and mortality in patients who experience trauma-related bleeding.To synthesize the evidence supporting the efficacy and safety of preemptive and goal-directed fibrinogen concentrate (FC) in […]

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Computed Tomography Angiography in the “No Zone” Approach Era for Penetrating Neck Trauma: A Systematic Review.

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Penetrating neck trauma continues to present a diagnostic dilemma. Practice guidelines advocate the use of computed tomography angiography (CTA) for suspected vascular or aero-digestive injuries in all neck zones. There […]

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Variation in CT use for paediatric head injuries across different types of emergency departments in Australia and New Zealand.

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CT of the brain (CTB) for paediatric head injury is used less frequently at tertiary paediatric emergency departments (EDs) in Australia and New Zealand than in North America. In preparation […]

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Outcomes and Implications of a Single Brain Death Exam Policy on Organ Donation Outcomes at a High-volume Trauma Center.

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Despite current neurological guidelines that a single brain death examination (SBDE) is sufficient to determine brain death, a vast majority of hospitals still utilize a two-brain death examination (TBDE) policy […]

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Esmolol in the management of pre-hospital refractory ventricular fibrillation: A systematic review and meta-analysis.

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Esmolol has been proposed as a viable adjunctive therapy for pre-hospital refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT).We performed a systematic review and meta-analysis to assess the effectiveness of esmolol on […]

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Isolated Low-Grade Solid Organ Injuries in Children Following Blunt Abdominal Trauma: Is It Time to Consider Discharge from the Emergency Department?

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Acute intervention for solid organ injury (SOI) is rare in hemodynamically stable children. Pediatric guidelines recommend admission with follow-up labs, even for low-grade injuries.Datasets from two large multi-center prospective observational […]

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A review of guidelines on anticoagulation reversal across different clinical scenarios – Is there a general consensus?

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Anticoagulation is key to the treatment/prevention of thromboembolic events. The primary complication of anticoagulation is serious or life-threatening hemorrhage, which may necessitate prompt anticoagulation reversal; this could also be required […]

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Relationship between the Injury Severity Score and the need for life-saving interventions in trauma patients in the UK.

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Major trauma is the third leading cause of avoidable mortality in the UK. Defining which patients require care in a major trauma centre is a critical component of developing, evaluating […]

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Extracorporeal membrane oxygenation use in Trauma Quality Improvement Program centers: Temporal trends and future directions.

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Increased clinical experience and the decreased need for systemic anticoagulation have renewed interest in the use of extracorporeal membrane oxygenation (ECMO) for posttraumatic respiratory and cardiopulmonary failure. The objectives of […]

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Reliability of the visio-vestibular examination for concussion among providers in a pediatric emergency department.

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Visio-vestibular examination (VVE) deficits are common following pediatric concussion. Guidelines recommend assessing these deficits on all potentially concussed youth given their diagnostic and prognostic value, however test psychometrics of the […]

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Value-based syncope evaluation and management: Perspectives of health care professionals on readiness, barriers and enablers.

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Syncope is a common condition seen in the emergency department. Given the multitude of etiologies, research exists on the evaluation and management of syncope. Yet, physicians’ approach to patients with […]

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Intranasal ketamine for acute pain management in children: A systematic review and meta-analysis.

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To assess the efficacy and safety of intranasal analgesic-dose ketamine as compared to intranasal fentanyl for pediatric acute pain.A systematic review and meta-analysis was performed following the PRISMA guidelines. We […]

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Early Prediction of Acute Kidney Injury in the Emergency Department With Machine-Learning Methods Applied to Electronic Health Record Data.

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Acute kidney injury occurs commonly and is a leading cause of prolonged hospitalization, development and progression of chronic kidney disease, and death. Early acute kidney injury treatment can improve outcomes. […]

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Isolated Rib Cage Fractures in the Elderly: Do All Patients Belong to the Intensive Care Unit? A retrospective nationwide analysis.

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Western Trauma Association guidelines recommend admitting patients≥65 years old with>2 rib fractures diagnosed by chest radiograph (CXR) to the intensive care unit (ICU). Increased use of computed tomography (CT) has […]

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Do Early Non-Steroidal Anti-Inflammatory Drugs for Analgesia Worsen Acute Kidney Injury in Critically Ill Trauma Patients? An Inverse Probability of Treatment Weighted Analysis.

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Administration of NSAIDs for acute post-traumatic analgesia is increasing in popularity as an alternative to opioids despite reservations regarding its potential impact on the development of acute kidney injury (AKI). […]

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Valproic Acid Decreases Resuscitation Requirements After Hemorrhage in a Prolonged Damage Control Resuscitation Model.

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Hemorrhage is the leading cause of preventable death in trauma. Future military conflicts are likely to be in austere environments, where prolonged damage control resuscitation (p-DCR) may be required for […]

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Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Thoracic Trauma in the Setting of Platelet Dysfunction: A Translational Swine Study.

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In patients with non-compressible torso hemorrhage (NCTH), antiplatelet medications may lead to worse outcomes. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may potentially stabilize these patients, but currently major […]

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Outcome of Immediate Versus Early Antibiotics in Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis.

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Debate exists about the mortality benefit of administering antibiotics within either 1 or 3 hours of sepsis onset. We performed this meta-analysis to analyze the effect of immediate (0 to […]

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BLUNT CEREBROVASCULAR INJURY – THE CASE FOR UNIVERSAL SCREENING.

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Adult blunt trauma activations from 7/2017 through 8/2019 underwent full-body CT scan including CTA neck with a 128-slice CT scanner. We calculated sensitivity, specificity, positive predictive value (PPV), negative predictive […]

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LIQUID PLASMA: A SOLUTION TO OPTIMIZING EARLY AND BALANCED PLASMA RESUSCITATION IN MASSIVE TRANSFUSION.

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Early and balanced resuscitation for traumatic hemorrhagic shock is associated with decreased mortality, making timely plasma administration imperative. However, fresh frozen plasma (FFP) thaw time can delay administration, and the […]

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