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Management of Severe Head Injury

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61. Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury. Full Text available with Trip Pro

Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury. Attention-deficit hyperactivity disorder (ADHD) and head injury (including traumatic brain injury (TBI)) manifest in high levels across prison samples and guidance from the National Institute for Health and Care Excellence notes that people with acquired brain injury may have increased prevalence of ADHD. We aimed to examine the association of ADHD with TBI and the impact (...) of the association upon health-related quality of life (HRQoL) and service use among imprisoned adults.An observational study was performed in 2011-2013, at Porterfield Prison, Inverness, United Kingdom (UK). The all male sample included 390 adult prison inmates with capacity to consent and no history of moderate or severe intellectual disability. Head injury was measured with a series of self-reported questions, addressing history of hits to the head: frequency, severity, loss of consciousness (LOC

2018 BMC Psychiatry

62. Risk reduction and management of delirium

term is valid until 31 March 2020 and is applicable to guidance produced using the processes described in SIGN 50: a guideline developer’s handbook, 2015 edition (www.sign.ac.uk/assets/sign50_2015.pdf). More information on accreditation can be viewed at www.nice.org.uk/accreditationRisk reduction and management of delirium A national clinical guideline March 2019 Scottish Intercollegiate Guidelines NetworkScottish Intercollegiate Guidelines Network Gyle Square, 1 South Gyle Crescent Edinburgh EH12 (...) solely to alcohol and illicit substances use. It also excludes delirium in children. 1.2.2 Common comorbidities Common comorbidities which have been considered when reviewing the evidence for this guideline are: • critical illness • dementia • depression • frailty • head injury • learning disability • Parkinson’s disease • cerebrovascular disease. 1.2.3 Definitions The International Classification of Diseases, version 10 (ICD-10) defines delirium as, “An aetiologically nonspecific organic cerebral

2019 SIGN

63. Guidelines for diagnosing and managing pediatric concussion

group. These guidelines also do not apply to children/adolescents who have moderate-to-severe closed head injuries, moderate-to-severe developmental delays, neurological disorders, penetrating brain injuries or brain damage from other causes, such as injuries at birth or in infancy. General Directions for Clinical Use We expect that children/adolescents who have sustained a head injury will visit a health care professional soon after the incident for a primary assessment. In this scenario, health (...) , outcomes, and quality of life of those who have sustained a neurotrauma injury. The Foundation receives its funding from the Government of Ontario. © Ontario Neurotrauma Foundation, 2014 Ontario Neurotrauma Foundation 90 Eglinton Street East Toronto ON M4P 2Y3 Tel: 416 422 2228 Fax: 416 422 1240 Email: info@onf.org Questions, changes and errata: info@onf.org Cover image: courtesy of Dr. Mike Evans Chapter: Using These Guidelines Guidelines for Diagnosing and Managing Pediatric Concussion 1 Tipsheet

2019 CPG Infobase

64. Observation is unnecessary following a normal CT brain in warfarinised head injuries: an update

for ethical reasons, or routinely before discharge. Clinical follow-up though to elicit clinically important outcomes. Warfarin users more aware of risks and so more likely to present with less severe mechanisms of injury In-hospital mortality after immediate TICH (warfarin group) 8/37 (21.6%) [95% CI 9.8-38.2] Neurosurgical intervention after immediate TICH (warfarin group) 5/37 (13.5%) [95% CI 4.5-28.8] DICH (TICH within 2/52 after initially normal CT in absence of further head trauma (warfarin group) 4 (...) here, but the larger studies described should reassure us as to the very low risk of DICH, particularly with an initial INR Editor Comment aOR, adjusted OR; AUC, area under the curve; CTB, CT brain; DICH, delayed intracranial haemorrhage; ED, emergency department; FFP, fresh frozen plasma; GCS, Glasgow Coma Score; ICU, intensive care unit; INR, International Normalised Ratio; ISS, injury severity score; LOC, loss of consciousness; LOS, length of stay; MHI, minor head injury; MOI, mechanism

2014 BestBETS

65. Coagulopathy as a risk factor in warfarinised head injury patients

reduce ICH progression and improve mortality. Therefore, both the clinical picture and the INR have not shown to be effective at ruling out ICH in the asymptomatic WHI patient. It is, nevertheless, an important investigation in this setting, as an early check has been shown to allow rapid time to reversal of the INR with ICH. Importantly, Nishijima et al (2013) and Rendell and Batchelor (2013) found that there was no ‘low-risk group’ of warfarinised head injury patients safely managed without CT (...) ; PPV = positive predictive value; NPV = negative predictive value; GCS = Glasgow coma score; LOC = loss of consciousness; RR = relative risk; LOS = length of stay; WHI = warfarinised head injury; ISS = injury severity score; MOI = mechanism of injury; DICH = delayed intracranial haemorrhage; FFP = fresh frozen plasma; TICH = traumatic intracranial haemorrhage; IQR = interquartile range. Clinical Bottom Line With the low-risk patient, the level of coagulopathy does not seem to confer an obvious

2014 BestBETS

66. Managing behavioural and mental health outcomes following a traumatic brain injury

and symptoms of a TBI, specifically a SRC, often dissipate to the point of clinical recovery within several weeks after injury, the long-term behavioural effects of childhood head trauma are misunderstood. 1,4,5 These effects may not present themselves until later in life, perhaps effecting the quality of life well into adulthood. 1,2,4,5 As healthcare providers in sports medicine, we must continue to evolve our practice regarding mental and behavioural health by exploring all aspects of the patient (...) Managing behavioural and mental health outcomes following a traumatic brain injury Managing behavioural and mental health outcomes following a traumatic brain injury | BJSM blog - social media's leading SEM voice by By Sadie R. Morway, Zachary K. Winkelmann , Kenneth E. Games It is crucial to examine the long-term effects following a traumatic brain injury (TBI) in sports medicine. This is especially important for children given the sensitive development of the brain during childhood

2018 British Journal of Sports Medicine Blog

67. Broad Validation Study of a Management Algorithm Mild Head Injury in Children

Title: Multicenter Prospective Broad Validation of a Management Algorithm Mild Head Injury in Children Actual Study Start Date : November 16, 2015 Actual Primary Completion Date : August 2018 Actual Study Completion Date : September 2018 Resource links provided by the National Library of Medicine related topics: Groups and Cohorts Go to Outcome Measures Go to Primary Outcome Measures : Number of patients with clinically severe intracranial injury and classified at risk (top and middle) according (...) Broad Validation Study of a Management Algorithm Mild Head Injury in Children Broad Validation Study of a Management Algorithm Mild Head Injury in Children - 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

2015 Clinical Trials

68. S100 Biomarker in the Acute Management of Mild Head Injuries

. By enrolling a large consecutive sample of patients the investigators are validating this new guideline. Emergency department assessment data is combined with long-term outcome parameters and blood-based biomarkers of neurotrauma. The main aims of the study are: the validation of the Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults the examination of novel blood-based biomarkers of acute brain injury that correlate with the radiological severity (...) S100 Biomarker in the Acute Management of Mild Head Injuries S100 Biomarker in the Acute Management of Mild Head Injuries - 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. S100 Biomarker in the Acute

2015 Clinical Trials

69. Early enteral nutrition supplemented with probiotics improved the clinical outcomes in patients with severe head injury

Early enteral nutrition supplemented with probiotics improved the clinical outcomes in patients with severe head injury Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence (...) to account for anticipated heterogeneity. ">Effect models Example: Heterogeneity will be assessed using the (residual) I2 and adjusted R2 statistics. ">Heterogeneity For further guidance please refer to the and to pre-clinical meta-analysis. Example: Whenever a control group serves more than one experimental group, we will correct the total number of control animals in the meta-analysis by dividing the number of animals in the control group by the number of treatment groups served. Where applicable, Holm

2017 PROSPERO

70. Severity-dependent differences in early management of thoracic trauma in severely injured patients - Analysis based on the TraumaRegister DGU®. Full Text available with Trip Pro

of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management. This may help to anticipate necessary treatment for chest injuries.Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, determined Injury Severity Score ≥ 16, and documentation from European trauma centers were analyzed. Isolated brain injury and severe head injury (Abbreviated Injury ScaleHead ≥ 4) led to patient exclusion (...) Severity-dependent differences in early management of thoracic trauma in severely injured patients - Analysis based on the TraumaRegister DGU®. Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups

2017 Scandinavian journal of trauma, resuscitation and emergency medicine

71. Splenic Injury, Blunt, Selective Nonoperative Management of

in adults with injuries to the liver continue to support nonoperative management in hemodynamically stable adults, but questions still exist about efficacy, patient selection, and details of management. [4–8] These questions include the following: Are the 2003 recommendations still valid? Is nonoperative management appropriate for all hemodynamically stable adults regardless of severity of solid-organ injury or presence of associated injuries? What role should angiography and other adjunctive therapies (...) after blunt abdominal trauma should be taken urgently for laparotomy. Level 2 A routine laparotomy is not indicated in the hemodynamically stable patient without peritonitis presenting with an isolated splenic injury. The severity of splenic injury (as suggested by CT grade or degree of hemoperitoneum), neurologic status, age >55 and/or the presence of associated injuries are not contraindications to a trial of nonoperative management in a hemodynamically stable patient. In the hemodynamically

2012 Eastern Association for the Surgery of Trauma

72. Hepatic Injury, Blunt, Selective Nonoperative Management of

with blunt hepatic trauma at most of the US trauma centers, with reported success rates ranging from 82% to 100%. [8][10–14] Some have even voiced that operative management of hepatic trauma leads to increased hepatic hemorrhage and may lead to unnecessary interventions with an increased incidence of iatrogenic complications. [2][3] Factors previously thought to completely preclude nonoperative management of hepatic injuries include hepatic injury grade, head injury, injury severity score, degree (...) , patient selection, and details of management. [2][6–9] These questions include as follows: Are the 2003 recommendations still valid? Is nonoperative management appropriate for all hemodynamically stable adults regardless of the severity of solid-organ injury or presence of associated injuries? What role should angiography and other adjunctive therapies play in nonoperative management? Is the risk of missing a hollow viscous injury a deterrent to nonoperative management? What is the best way

2012 Eastern Association for the Surgery of Trauma

73. Should stimulants be administered to manage difficulties with attention, hyperactivity and impulsivity following paediatric acquired brain injury?

of traumatic brain injury. Brain Inj 1988;2:273–90. Clark E, Baker BK, Gardner MK, et al. Effectiveness of stimulant drug treatment for attention problems – a look at head injured children. Sch Psychol Int 1990;11:227–34. Plenger PM, Dixon CE, Castillo RM, et al. Subacute methylphenidate treatment for moderate to moderately severe traumatic brain injury: a preliminary double-blind placebo-controlled study. Arch Phys Med Rehabil 1996;77:536–40 Mahalick DM, Carmel PW, Greenberg JP, et al. Psychopharmacologic (...) Should stimulants be administered to manage difficulties with attention, hyperactivity and impulsivity following paediatric acquired brain injury? BestBets: Should stimulants be administered to manage difficulties with attention, hyperactivity and impulsivity following paediatric acquired brain injury? Should stimulants be administered to manage difficulties with attention, hyperactivity and impulsivity following paediatric acquired brain injury? Report By: David W Harvey, Matthew Morrall

2012 BestBETS

74. Glaucoma: diagnosis and management

Glaucoma: diagnosis and management Glaucoma: diagnosis and management Glaucoma: diagnosis and management NICE guideline Published: 1 November 2017 nice.org.uk/guidance/ng81 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising (...) a visual field defect or IOP of Glaucoma: diagnosis and management (NG81) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 4124 mmHg or more, unless clinical circumstances indicate urgent or emergency referral is needed. [2017] [2017] 1.1.5 Refer for further investigation and diagnosis of COAG and related conditions, after considering repeat measures as in recommendation 1.1.4, if: there is optic nerve head damage

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

75. Cerebral palsy in under 25s: assessment and management

and management (NG62) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 46children with cerebral palsy born after 35 weeks: attributed to a perinatal hypoxic–ischaemic injury: 20% not attributed to a perinatal hypoxic–ischaemic injury: 12%. 1.2.7 Recognise that for cerebral palsy associated with a perinatal hypoxic–ischaemic injury: the extent of long-term functional impairment is often related to the severity (...) Cerebral palsy in under 25s: assessment and management Cerebr Cerebral palsy in under 25s: assessment al palsy in under 25s: assessment and management and management NICE guideline Published: 25 January 2017 nice.org.uk/guidance/ng62 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

76. Pre-Trauma Center Management of Intracranial Pressure in Severe Pediatric Traumatic Brain Injury. (Abstract)

Pre-Trauma Center Management of Intracranial Pressure in Severe Pediatric Traumatic Brain Injury. Pre-trauma center care is a critical component in severe pediatric traumatic brain injury (TBI). For geographically large trauma catchment areas, optimizing increased intracranial pressure (ICP) management may potentially improve outcomes. This retrospective study examined ICP management in nontrauma centers and during interfacility transport to the trauma center.Charts from a pediatric level I (...) -five patients (74%) had increased ICP upon admission at trauma center, 48% experienced ICPs greater than 20 cm H2O within 12 hours of admission, 12% required an urgent craniotomy, and 16% had herniation syndromes on neuroimaging. Pre-trauma center ICP management included osmotherapy and head-of-bed elevation. Sixty-four percent of patients with increased ICP at trauma center admission received pre-trauma center ICP management.Early increased ICP is a common presentation of severe pediatric TBI

2016 Pediatric Emergency Care

77. Guidelines on Supraventricular Tachycardia (for the management of patients with) Full Text available with Trip Pro

and electrophysiological procedures. The ESC published management Guidelines for supraventricular tachycardias (SVTs) in 2003 ; corresponding US guidelines have also been published, the most recent being in 2015. There is a need to provide expert recommendations for professionals participating in the care of patients presenting with SVT. In addition, several associated conditions where SVTs may coexist need to be explained in more detail. To address this topic, a Task Force was convened by the ESC, with the remit (...) by agreement of the expert panel after thorough deliberation. The document was peer-reviewed by official external reviewers. The strengths of the recommendations and levels of evidence of particular management options were weighed and graded according to predefined scales, as outlined above in Tables and , respectively. Overall, these Guidelines include evidence and expert opinions from several countries. The pharmacological and non-pharmacological antiarrhythmic approaches discussed may therefore include

2019 European Society of Cardiology

78. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

Assessment of pulmonary embolism severity and the risk of early death 18 5.1 Clinical parameters of pulmonary embolism severity 18 5.2 Imaging of right ventricular size and function 18 5.2.1 Echocardiography 18 5.2.2 Computed tomographic pulmonary angiography 19 5.3 Laboratory biomarkers 19 5.3.1 Markers of myocardial injury 19 5.3.2 Markers of right ventricular dysfunction 19 5.3.3 Other laboratory biomarkers 19 5.4 Combined parameters and scores for assessment of pulmonary embolism severity 20 5.5 (...) for high-risk PE (Section 6.1). A dedicated management algorithm is proposed for high-risk PE ( Supplementary Figure ). NOACs are recommended as the first choice for anticoagulation treatment in a patient eligible for NOACs; VKAs are an alternative to NOACs. The risk-adjusted management algorithm ( Figure ) was revised to take into consideration clinical PE severity, aggravating conditions/comorbidity, and the presence of RV dysfunction. Chronic treatment after the first 3 months Risk factors for VTE

2019 European Society of Cardiology

79. Management of Poisoning

It is estimated that 350,000 people died worldwide from unintentional poisoning in 2002. 1 In Singapore, injuries (including poisoning) ranked as the ? fth leading cause of death and the leading cause of hospitalisation from 2007 to 2009. The pattern of poisoning has changed as the public is now exposed to other new drugs and chemicals. New antidotes and therapies have also been developed for the management of such poisoning, and are now available to health professionals. The Ministry of Health released its (...) and should be avoided unless necessary (pg 101). Grade D, Level 3 D If intubation and mechanical ventilation is necessary for severe obtundation, hypotension, hypoventilation or severe metabolic acidosis, ensure appropriately high minute ventilation and maintain alkalemia (via serial blood gas analysis) with serum pH 7.50-7.55 (pg 101). Grade D, Level 4 D Consider haemodialysis for patients who require intubation (pg 102). Grade D, Level 412 D Pulmonary oedema and acute lung injury may occur and should

2020 Ministry of Health, Singapore

80. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Full Text available with Trip Pro

is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website ( ). Drs. Weiss and Peters served as arbiters for conflict interest management and adjudication throughout the guidelines process following standard operating procedures set forth by Society of Critical Care Medicine (SCCM) and endorsed by European Society of Intensive Care Medicine. Dr. Weiss participates in Pediatric Acute Lung Injury (...) the chairs, co-chairs, methodologists, and group heads, as well as within subgroups, served as an integral part of the guideline development process. Methods: The panel consisted of six subgroups: recognition and management of infection , hemodynamics and resuscitation, ventilation, endocrine and metabolic therapies, adjunctive therapies, and research priorities. We conducted a systematic review for each Population, Intervention, Control, and Outcomes question to identify the best available evidence

2020 Society of Critical Care Medicine

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