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Management of Severe Head Injury

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21. Retrospective Analysis of a Population of Patients With With Severe Traumatic Head Injury and Woken Early

Retrospective Analysis of a Population of Patients With With Severe Traumatic Head Injury and Woken Early Retrospective Analysis of a Population of Patients With With Severe Traumatic Head Injury and Woken Early - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Retrospective Analysis of a Population of Patients With With Severe Traumatic Head Injury and Woken Early (PRECOCE TC) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03293420 Recruitment Status : Completed First Posted : September 26, 2017 Last

2017 Clinical Trials

22. Head Injury

. A victim may sustain a significant head injury without loss of consciousness or loss of memory (amnesia). Therefore, loss of consciousness or memory loss should not be used to define the severity of a head injury or to guide management. 1 The initial first aid for a victim with head injury includes assessing and managing the airway and breathing, whilst caring for the neck until expert help arrives. There is insufficient evidence to support or refute the use by first aiders of simplified concussion (...) if the victim has a reported or witnessed injury, has signs of injury to the head or face such as bruises or bleeding, or is found in a confused or unconscious state. A victim may have a brain injury without external signs of injury to the head or face. Serious problems may not be obvious for several hours after the initial injury. 3 Management • Call an ambulance if there has been a loss of consciousness or altered consciousness at any time, no matter how brief. • A victim who has sustained a head injury

2016 Australian Resuscitation Council

23. Management of Blunt Force Bladder Injuries

the evaluation and management of blunt force bladder injuries (Fig. 7). Several recommendations are made. The need for initial CT cystography after trauma depends on characteristics of the trauma itself but is not recommended in patients without gross hematuria. In general, patients with intraperitoneal bladder ruptures should undergo operative repair, while this is not routinely necessary in those with extraperitoneal ruptures, unless the injury is complex. The need for follow-up cystography after bladder (...) Management of Blunt Force Bladder Injuries Blunt Force Bladder Injuries Management of - Practice Management Guideline Search » Blunt Force Bladder Injuries Management of Published 2019 Citation: Authors Yeung, Lawrence L., MD; McDonald, Amy A., MD; Como, John J., MD, MPH; Robinson, Bryce, MD; Knight, Jennifer, MD; Person, Michael A., MD; Lee, Jane K., MD; Dahm, Philipp, MD, MHSc Author Information From the Department of Urology (L.L.Y.), College of Medicine, University of Florida, Gainesville

2019 Eastern Association for the Surgery of Trauma

24. Management of Rotator Cuff Injuries

Management of Rotator Cuff Injuries View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 1 MANAGEMENT OF ROTATOR CUFF INJURIES CLINICAL PRACTICE GUIDELINE Adopted by the American Academy of Orthopaedic Surgeons Board of Directors March 11, 2019 Endorsed by: Please cite this guideline as: American Academy of Orthopaedic Surgeons. Management of Rotator Cuff Injuries Clinical Practice Guideline. https://www.aaos.org/rotatorcuffinjuriescpg Published (...) March 11, 2019 View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 2 Disclaimer This Clinical Practice Guideline was developed by an AAOS physician volunteer Clinical Practice Guideline development group based on a systematic review of the current scientific and clinical information and accepted approaches to management of rotator cuff injuries. This clinical practice guideline is not intended to be a fixed protocol, as some patients may require more

2019 American Academy of Orthopaedic Surgeons

25. Physiologic Predictors of Severe Injury: Systematic Review

Physiologic Predictors of Severe Injury: Systematic Review Comparative Effectiveness Review Number 205 Physiologic Predictors of Severe Injury: Systematic Review e Comparative Effectiveness Review Number 205 Physiologic Predictors of Severe Injury: Systematic Review Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00009-I Prepared by: Pacific Northwest Evidence-based (...) using assistive technology may not be able to fully access information in this report. For assistance contact epc@ahrq.hhs.gov. Suggested citation: Totten AM, Cheney TP, O'Neil ME, Newgard CD, Daya M, Fu R, Wasson N, Hart EL, Chou R. Physiologic Predictors of Severe Injury: Systematic Review. Comparative Effectiveness Review No. 205. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 18-EHC008-EF. Rockville, MD: Agency

2018 Effective Health Care Program (AHRQ)

26. Sir Hugh Cairns and World War II British advances in head injury management, diffuse brain injury, and concussion: an Oxford tale. (PubMed)

Sir Hugh Cairns and World War II British advances in head injury management, diffuse brain injury, and concussion: an Oxford tale. The authors trace the Oxford, England, roots of World War II (WWII)-related advances in head injury management, the biomechanics of concussion and brain injury, and postwar delineation of pathological findings in severe concussion and diffuse brain injury in man. The prominent figure in these developments was the charismatic and innovative Harvey Cushing-trained (...) Hospital for Head Injuries. During this time Cairns also trained the first full-time female neurosurgeon. Pivotal in supporting animal research demonstrating the critical role of acceleration in the causation of concussion, Cairns recruited the physicist Hylas Holbourn, whose research implicated rotary acceleration and shear strains as particularly damaging. Cairns' work in military medicine and head injury remain highly influential in efforts to mitigate and manage brain injury.

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2016 Journal of Neurosurgery

27. Pre-hospital intubation of people with serious head injuries by inexperienced staff linked to increased death rate

interval [CI] 0.78 to 2.33) when compared to no intubation or intubation on arrival in hospital. Pre-hospital intubation by providers with limited experience was associated with significantly higher risk of mortality (OR 2.33, 95% CI 1.61 to 3.38). When it was performed by an experienced provider it was not associated with increased mortality (OR 0.75, 95% CI 0.52 to 1.08). What does current guidance say on this issue? NICE recommends that pre-hospital management of serious head injuries treats (...) of bias, were pooled in a meta-analysis. The review looked only at “severe” traumatic brain injury, defined as a score of nine or less on the 15-point scale Glasgow Coma Scale accompanied by evidence of head injury. The age of participants in the included studies was 14 years or more; trials looking specifically at children were excluded. This review followed good practice for conducting systematic reviews, but many studies underlying the review were conducted in the US where paramedic standards

2018 NIHR Dissemination Centre

28. CRACKCast E041 – Head Injury

CRACKCast E041 – Head Injury CRACKCast E041 - Head Injury - CanadiEM CRACKCast E041 – Head Injury In , by Chris Lipp September 19, 2016 This episode of CRACKCast covers Rosen’s Chapter 041, Head Injury. This episode covers a spectrum of head injuries seen in the emergency department along with appropriate management. Shownotes – Rosen’s in Perspective Most common causes of head injury: falls, MVC’s Leading cause of death for people < 25 yrs old There may be no external indicators on someone (...) and Cerebral Edema Congestive brain swelling Increased intracranial blood volume due to hyperemia caused by vasodilation needed to maintain increased metabolic needs of damaged brain tissue after head injury Cerebral edema Absolute increase in cerebral water content Diffuse cerebral edema may occur with a head injury, but does NOT correlate with the severity of head injury 3 findings: loss of sulci, loss of grey-white interface and collapsed ventricles Vasogenic edema Failure of the BBB endothelial

2016 CandiEM

29. Pre-hospital intubation of people with serious head injuries by inexperienced staff linked to increased death rate

interval [CI] 0.78 to 2.33) when compared to no intubation or intubation on arrival in hospital. Pre-hospital intubation by providers with limited experience was associated with significantly higher risk of mortality (OR 2.33, 95% CI 1.61 to 3.38). When it was performed by an experienced provider it was not associated with increased mortality (OR 0.75, 95% CI 0.52 to 1.08). What does current guidance say on this issue? NICE recommends that pre-hospital management of serious head injuries treats (...) of bias, were pooled in a meta-analysis. The review looked only at “severe” traumatic brain injury, defined as a score of nine or less on the 15-point scale Glasgow Coma Scale accompanied by evidence of head injury. The age of participants in the included studies was 14 years or more; trials looking specifically at children were excluded. This review followed good practice for conducting systematic reviews, but many studies underlying the review were conducted in the US where paramedic standards

2018 NIHR Dissemination Centre

30. Management of Perceived Devastating Brain Injury

there is an emerging realisation that severe brain injury takes a long time to achieve maximal outcome, and the typical assessment of outcome at hospital discharge, or even at six months may underestimate the quality of survival, particularly in patients who have undergone extremely aggressive management 26 . Finally, societal expectations of what is accepted as a ‘life worth living’ are constantly being recalibrated, and many patients who are severely disabled express satisfaction with quality of life 27-29 (...) injuries. Journal of the Intensive Care Society 2016;:1–7. 2. Chamoun RB, Robertson CS, Gopinath SP . Outcome in patients with blunt head trauma and a Glasgow Coma Scale score of 3 at presentation. Journal of Neurosurgery 2009;111(4):683–7. 3. Souter MJ, Blissitt PA, Blosser S, et al. Recommendations for the Critical Care Management of Devastating Brain Injury: Prognostication, Psychosocial, and Ethical Management. Neurocrit Care 2015;23(1):4–13. 4. Manara AR, Thomas I. Outcomes of the first full year

2018 Intensive Care Society

31. Relationship between injury severity, random blood glucose and management outcome in a cohort of Nigerian patients with head injury (PubMed)

Relationship between injury severity, random blood glucose and management outcome in a cohort of Nigerian patients with head injury This study was designed to evaluate the relationship between injury severity, admission Random Blood Glucose [RBG] and management outcome in a cohort of Nigerian patients with Head Injury [HI].RBG was determined at admission, twenty four hours as well as seventy two hours after admission in patients with head injury. Severity of injury was graded using Glasgow Coma (...) in 25% of the patients, moderate disability occurred in 30.1% and good outcome occurred in 35.8%. Hyperglycaemia occurred in one patient each in mild and severe head injuries and in two patients with moderate head injury. All the patients with hyperglycaemia had favourable outcome.Random blood glucose of ≥ 11.1 mmol/l was not common at admission in head injured patients in this cohort of patients and the value was not associated with severe injury or poor outcome.

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2015 Journal of neurosciences in rural practice

32. Hyperglycemia: A Predictor of Death in Severe Head Injury Patients (PubMed)

Hyperglycemia: A Predictor of Death in Severe Head Injury Patients Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU).This prospective study included adults with traumatic (...) mortality rate in head injury patients, and comprehensive treatment of hyperglycemia can improve the outcome of severe head injury patients.

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2016 Clinical medicine insights. Endocrinology and diabetes

33. Computed Tomography Perfusion in Patients With Severe Head Injury

Computed Tomography Perfusion in Patients With Severe Head Injury Computed Tomography Perfusion in Patients With Severe Head Injury - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Computed Tomography (...) Perfusion in Patients With Severe Head Injury The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02756585 Recruitment Status : Unknown Verified April 2016 by Jai Shankar, Nova Scotia Health Authority. Recruitment status was: Not yet recruiting First Posted : April 29, 2016 Last Update Posted : April 29

2016 Clinical Trials

34. Clinical Practice Guideline for the Management of Communication and Swallowing Disorders following Paediatric Traumatic Brain Injury

Children’s Hospital, VictoriaClinical Practice Guideline for the Management of Communication and Swallowing Disorders following Paediatric Traumatic Brain Injury 10 Plain English Summary Traumatic brain injury (TBI) is a leading cause of disability, affecting approximately 765 1 to 2008 2 per 100 000 Australian children each year. Its effects are vast and include speech, language and swallowing disorders. These disorders are more likely to affect children with moderate and severe TBI. This guideline (...) speech, language and swallowing that is specific to the child to support recovery. • Information about factors that predict speech, language and swallowing disorders is limited. Factors that might be considered include extent, severity and site of injury, cranial nerve involvement, cognition, and ventilation period. Executive Summary This guideline provides evidence-based recommendations (EBRs) and consensus-based recommendations (CBRs) for the management of speech, language and swallowing disorders

2017 Clinical Practice Guidelines Portal

35. Management of Suspected Spinal Injury

cord injury are: • a motor vehicle, motor cycle or bicycle incident as an occupant, rider, or pedestrian • an industrial accident (i.e. workplace) • a dive or jump into shallow water or water with obstacles or being "dumped" in the surf • a sporting accident (e.g. rugby, falling from a horse) • a fall from greater than a standing height (e.g. ladder, roof) • falls in the elderly population • a significant blow to the head • a severe penetrating wound (e.g. gunshot). The symptoms and signs (...) the limbs (paralysis) • nausea • headache or dizziness • altered or absent skin sensation. 2.2 Signs Signs of spinal injury include: • head or neck in an abnormal position • signs of an associated head injury • altered conscious state • breathing difficulties • shock • change in muscle tone, either flaccid or stiff • loss of function in limbs • loss of bladder or bowel control • priapism (erection in males). ANZCOR Guideline 9.1.6 January 2016 Page 3 of 6 3 Management The priorities of management

2016 Australian Resuscitation Council

36. Mild Head Injury Home Management

Severe Weakness or loss of feeling in arm or leg Confusion or strange behavior Eye changes One pupil larger than the other ( ) Peculiar eye movements ( , saccades) Slow pulse (<50/minute) or rapid pulse (>110/minute) Unusual breathing pattern or bowel IV. References Bengtzen, Novak and Chesnutt (2016) Crit Dec Emerg Med 30(5): 3-10 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Mild Head Injury Home Management." Click (...) Mild Head Injury Home Management Mild Head Injury Home Management Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Mild Head Injury

2018 FP Notebook

37. Management of Mild Head Injury

Management of Mild Head Injury Management of Mild Head Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Management of Mild Head (...) Injury Management of Mild Head Injury Aka: Management of Mild Head Injury , Mild Traumatic Brain Injury , MTBI , Minor Head Injury , Mild Head Injury , Mild Head Trauma From Related Chapters II. Epidemiology Mild Traumatic Brain Injury (MTBI) accounts for 75% of the 1.7 Million people in U.S. who suffer TBI annually III. Criteria : 13-15 (at two hours) Loss of consciousness may have occurred with injury Awake and oriented with normal ination IV. History See Time and mechanism of injury Loss

2018 FP Notebook

38. The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics. (PubMed)

The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics. The utility of advanced prehospital interventions for severe blunt traumatic brain injury (BTI) remains controversial. Of all trauma patient subgroups it has been anticipated that this patient group would most benefit from advanced prehospital interventions as hypoxia and hypotension (...) have been demonstrated to be associated with poor outcomes and these factors may be amenable to prehospital intervention. Supporting evidence is largely lacking however. In particular the efficacy of early anaesthesia/muscle relaxant assisted intubation has proved difficult to substantiate.This article describes the design and protocol of the Head Injury Retrieval Trial (HIRT) which is a randomised controlled single centre trial of physician prehospital care (delivering advanced interventions

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2013 Scandinavian journal of trauma, resuscitation and emergency medicine

39. The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics. (PubMed)

The study protocol for the Head Injury Retrieval Trial (HIRT): a single centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics. The utility of advanced prehospital interventions for severe blunt traumatic brain injury (BTI) remains controversial. Of all trauma patient subgroups it has been anticipated that this patient group would most benefit from advanced prehospital interventions as hypoxia and hypotension (...) have been demonstrated to be associated with poor outcomes and these factors may be amenable to prehospital intervention. Supporting evidence is largely lacking however. In particular the efficacy of early anaesthesia/muscle relaxant assisted intubation has proved difficult to substantiate.This article describes the design and protocol of the Head Injury Retrieval Trial (HIRT) which is a randomised controlled single centre trial of physician prehospital care (delivering advanced interventions

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2013 Scandinavian journal of trauma, resuscitation and emergency medicine

40. The role of Hyperbaric oxygen therapy in the prevention and management of radiation induced complications of the head and neck - a systematic review of literature. (PubMed)

The role of Hyperbaric oxygen therapy in the prevention and management of radiation induced complications of the head and neck - a systematic review of literature. Radiation therapy for the treatment of head and neck cancer can injure normal tissues and have devastating side effects. Hyperbaric oxygen (HBO) is known to reduce the severity of radiation-induced injury by promoting wound healing. While most of the research in literature has focused on its efficacy in osteonecrosis, HBO has other (...) proven benefits as well. The aim of this review was to identify the various benefits of hyperbaric oxygen therapy in patients who have undergone radiation for head and neck cancer. An electronic database search was carried out to identify relevant articles and selected articles were reviewed in detail. The quality of evidence for each benefit, including preserving salivary gland function, preventing osteonecrosis, dental implant success, and overall quality of life, was evaluated. Evidence showed

2017 Journal of stomatology, oral and maxillofacial surgery

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