Here is the summary of the journal club for tomorrows session;
- Tourniquet use - probably beneficial, although there are some adverse effects such as nerve injury, ischaemia and reperfusion injury and compartment syndrome.
- Resuscitative thoracotomy - beneficial in penetrating thoracic trauma, probably beneficial in blunt trauma with signs of life, no benefit in blunt trauma with no signs of life.
- FLUSH study - use saline flush with cardiac ultrasound to confirm CVC line placement.
- Tranexemic acid - no benefit in patients with traumatic brain injury.
- Peri-shock pauses in CPR - limiting time off the chest during CPR improves outcomes in OHCA.
- Paediatric cannula's - high failure rate. Need to look at better ways of securing lines in kids. Avoid antecubital lines as these have a higher failure rate.
- Traumatic upper limb amputations - have an aggressive algorithmic approach to these injuries. These patients need to be transported to a major trauma centre for definitive management.
- Thoracolumbar Spine Clearance - use a clinical decision rule to clear the spine. If you are unable to clear the spine, recommended imaging should be CT scan.