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In my last post, I reviewed a huge systematic review and meta-analysis of the use of tranexamic acid (TXA) by all medical disciplines using it. There were more than 125,000 cases included, and the incidence of thrombotic complications in TXA vs non-TXA patients was exactly the same, at about 2%.
Our orthopedic surgery colleagues have been using TXA to reduce blee...
I’ve visited several hundred trauma centers over the past 25 years, and recently I’ve begun to appreciate that there are two tribes when it comes to the use of tranexamic acid: the TXA believers and the TXA hesitant.
There have been several large studies that suggest a survival benefit from major hemorrhage, particularly when given soon after injury (CRASH-2, M...
Okay, time for the answer. This 12-year-old crashed his moped, taking handlebar to the mid-epigastrium. Over the next 3 days, he felt progressively worse and finally couldn’t keep food down.
Mom brought him to the ED. The child appeared ill, and had a WBC count of 18,000. The abdomen was firm, with involuntary guarding throughout and a hint of peritonitis. The diagnosi...
Here’s one from my old-timer collection of actual celluloid x-rays! If I give you the history, I will probably give away the diagnosis. So let’s see if you can do it without.
This xray is a classic for a specific trauma surgical injury. Give it your best shot! Here’s a hint to focus your attention: look at the thoracoabdomen, not the pelvis.
Blunt thoracic aortic injury (BTAI) is one of those high-acuity, low-occurrence events that trauma professionals cannot afford to miss. These injuries are a ticking time bomb that is just waiting to blow up your patient.
Diagnostic techniques have evolved over the years. Back in the old days (before CT angiography), we always performed a screening chest x-ray and used ...