Greetings from the MICU!

[Tipsy McStagger]

Hi everybody! I'm interloping into your forum for some assistance. In the upcoming months we have a day where we will be talking about Trauma and the ED. I'm hoping you all can point me in the direction of some great papers or resources that you think would have significant overlap between a trauma patient and the medical ICU. Something ideally that medicine trained folks will not be familiar with, but that you feel would benefit their education with further knowledge on the subject.

Especially medically managed trauma that you think could perhaps be taken care of in the MICU, but that providers there do not have exposure to or feel comfortable with.

I appreciate your help!

Edit: By means of example I was thinking about some good things to talk about would be chest tube size, coagulopathy and acidosis etc.
1) Does size matter? A prospective analysis of 28-32 versus 36-40 French chest tube size in trauma.
2) The trauma triad of death: hypothermia, acidosis, and coagulopathy.

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[TraumaLlamaMD]

One topic that would be great to consider is management of rib fractures in elderly patients - a MICU in a place with no trauma center is likely to see a lot of these as these patients are often ground level falls and may not be brought to a trauma center.

Epidural analgesia improves outcome after multiple rib fractures - PubMed

The use of epidural analgesia is limited in the trauma population due to numerous exclusion criteria. However, when feasible, epidural analgesia is associated with a decrease in the rate of nosocomial pneumonia and a shorter duration of mechanical ventilation after rib fractures.

www.ncbi.nlm.nih.gov

Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol | Trauma Surgery & Acute Care Open

 

[Tipsy McStagger]

One topic that would be great to consider is management of rib fractures in elderly patients - a MICU in a place with no trauma center is likely to see a lot of these as these patients are often ground level falls and may not be brought to a trauma center.

Epidural analgesia improves outcome after multiple rib fractures - PubMed

The use of epidural analgesia is limited in the trauma population due to numerous exclusion criteria. However, when feasible, epidural analgesia is associated with a decrease in the rate of nosocomial pneumonia and a shorter duration of mechanical ventilation after rib fractures.

www.ncbi.nlm.nih.gov

Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol | Trauma Surgery & Acute Care Open

Solid! Thanks for your help

 

[Dr.LeoSpaceman]

Hi everybody! I'm interloping into your forum for some assistance. In the upcoming months we have a day where we will be talking about Trauma and the ED. I'm hoping you all can point me in the direction of some great papers or resources that you think would have significant overlap between a trauma patient and the medical ICU. Something ideally that medicine trained folks will not be familiar with, but that you feel would benefit their education with further knowledge on the subject.

Especially medically managed trauma that you think could perhaps be taken care of in the MICU, but that providers there do not have exposure to or feel comfortable with.

I appreciate your help!

Edit: By means of example I was thinking about some good things to talk about would be chest tube size, coagulopathy and acidosis etc.
1) Does size matter? A prospective analysis of 28-32 versus 36-40 French chest tube size in trauma.
2) The trauma triad of death: hypothermia, acidosis, and coagulopathy.

I'd also consider something related to massive transfusion/resuscitation. That does have some parallels in MICU care.

Pre-hospital Plasma
1:1:1 Resuscitation
Whole Blood

 

[2010houston]

Going along with what FayIND said, the use of tranexamic acid. CRASH II, WOMAN trials.