Discover and read the best of Twitter Threads about #MorningPaper
Most recents (3)
1/🧵 This #Trauma #MorningPaper is a retrospective study of 284 cases of traumatic cardiac arrest (TCA) in Sweden, mostly men with mean age of 38. Are our attempts always futile? @SMHMajorTrauma @nottsurgeon @ShehanHett @karimbrohi @londonsdrcosmo @e1v1m1
sjtrem.biomedcentral.com/articles/10.11…
sjtrem.biomedcentral.com/articles/10.11…
2/ The study region has no #REBOA or prehospital resus thoracotomy services. 90.1% of TCA were prehospital with 64.8% from blunt injuries. Only 6.7% had shockable rhythm.
29.9% survived to ICU with mean days on ventilator of 3d. Only 10% survived to 30 days (GOS 3 or 4 mostly).
29.9% survived to ICU with mean days on ventilator of 3d. Only 10% survived to 30 days (GOS 3 or 4 mostly).
3/ In-hospital TCA had a much higher chance of survival (42.9% vs 7.0%) - but remember there is no prehospital thoracotomy/aortic compression/REBOA services, therefore I'm not sure how applicable this data is if setup were different. @viseshsankaran @traumakhan @WilsonMSJ 
1/🧵 Congratulations to @IIHDrBirmingham @MarkHeadache @DrMollan for their publication. Thanks @aswinchari for flagging this up as a #MorningPaper. #IIH #CSF @neuro_at_ic @e1v1m1 @markhwilson @AhmedToma13 @PaedNeurosurg @Samuel_Jeffery
link.springer.com/article/10.100…
link.springer.com/article/10.100…
2/ This 9-year prospective observational study included 490 #IIH patients in @uhbtrust with 98% being female (F:M was 53:1) with mean BMI 38, as defined by papilloedema (Frisen grade >0) in at least one eye. 67.1% required multiple hospital visits. 87% were treated medically.
3/ Medical treatment most commonly used included acetazolamide (27%) and topiramate (9%). #IIH relapse occured in only 3.7%. Ocular outcome mirrored reduction in ganglion cell layer (GCL) vol, perimetric mean deviation (PMD) and retinal nerve fibre layet (RNFL) on OCT.
Case study as #MorningPaper to start off the week. 27y cyclist vs car, GCS 15, CSF rhinorrhoea. CT attached. What are the steps of your management plan? What kind of injuries are you seeing?
My decision here: Lumbar drain initially for yeh CSF leak, Pneumovax but not antibiotics. Lefort III fracture and mandibular needs surgery so planned to cranialise frontal sinus at the same setting. Consent included fascia lata and calvarial grafts, just in case. 1/🧵
2/ #Submental intubation to gain better oral access: cut down onto inferior border of mandible, blunt dissection with artery clip through floor of mouth, dilators and then deliver ETT submetally and reconnect.
