Trauma
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Pediatric Abdominal Ultrasound: A Comprehensive Guide to Making the Diagnosis — Part I
Ultrasound is rapidly evolving as the ideal imaging modality for many common pediatric complaints. This two-part series reviews the select applications of ultrasound, reviewing the basic techniques, indications, and limitations for each exam.
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Cervical Spinal Injury
Although spinal injuries are uncommon, they should be considered when children have sustained head or neck trauma or multiple severe injuries. Children with severe or multisystem trauma are more likely to suffer a spinal injury. Thus, emergency department providers should have a lower threshold to immobilize and image such patients to prevent morbidity and mortality. This article reviews the most common pediatric spinal fractures and injuries and optimal management practices.
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Tranexamic Acid in Trauma
Tranexamic acid or TXA is a potent antifibrinolytic that has the potential to decrease clot breakdown and reduce bleeding in trauma patients. Studies have shown that the use of TXA in trauma patients improves overall survival, although these studies have been discounted as not being relevant to trauma care as practiced in well-resourced countries. Thus, the adoption of TXA into trauma protocols in U.S. centers has been slow and controversial. Further studies are needed to answer questions about which patient populations can benefit most from TXA and how it should be used in highly developed and well-resourced trauma systems and centers.
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Updates in Pediatric Trauma, Part I
MONOGRAPH: New advances in diagnostic evaluation and treatment for the No. 1 cause of death and disability in children and adolescents.
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Misplaced NG tubes a major patient safety risk
Misplaced nasogastric and percutaneous endoscopic gastrostomy tubes pose a serious threat to patient safety and a liability risk for hospitals. New technology might improve the detection of misplaced tubes.
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Penetrating Thoracic Trauma
Trauma continues to be a significant cause of morbidity and mortality. Accidental death remained the fifth most common cause of death for all ages in 2009. Thoracic injuries reportedly have been involved in up to 75% of all deaths related to trauma and may be directly responsible in up to 25% of these deaths. -
Pharmacology Watch: HPV Vaccine Now Recommended for Males
In this issue: New recommendations for HPV vaccine; guidelines for treatment of essential tremor; updates on smoking cessation drugs; and FDA actions. -
Abstract & Commentary: Academic ICU Attending Workload: Potential Effects on Teaching, Patient Care, and Workforce Stability
This article reports findings of a task force set up by the Society of Critical Care Medicine in 2008 to study intensivist workforce issues in the face of the ongoing increase in ICU beds and numbers of critically ill patients. -
Clinical Briefs in Primary Care supplement
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Abstract & Commentary: Hospital Organizational Characteristics Associated with Use of Daily Sedation Interruption in Mechanically Ventilated Patients
Miller and colleagues conducted a survey of daily interruption of sedation (DIS) in U.S. hospitals and sought to determine whether organizational features were associated with DIS use. The survey was mailed to a stratified random sample of non-federal U.S. acute-care hospitals with more than 50 beds.