Trauma Care Conference Telford 2013. St.Emlyn’s on tour.

OK folks, a really quick post 5 days…., yes 5 days before I am due to speak in Telford at the 2013 Trauma Care conference. I’ve been given the topic of ‘The top ten trauma papers of 2012-present and I’m talking in the emergency medicine stream. I’ve got half an hour to get through ten papers which I hope can make a difference to practice. It seems to me that this type of talk is increasingly common at conferences and I think it does have merits, but there are also risks from too much data, presented too quickly and with only a superficial analysis. All suggestions welcome on avoiding these pitfalls!

So, I’ve been out to twitter with requests for papers that meet the following criteria. I’ve also been through all the blogs that I think cover trauma in some way or another……, including the following listed on slide number 3, and I will be extolling the benefits of FOAM when tasked with these talks. Without colleagues and other blog sites this would have been a Herculean task so thanks to those below and many others who have put the work in over the last year.

Friends in FOAM

In some ways this is a rather tricky task, and a bit sad really, there are nowhere near as many papers as I had hoped to find, though perhaps I’ve missed something really important somewhere!
However, there is still time to change the selection! What else should be in the mix for this year? Remember it should ideally be something that makes a difference to practice so please, have a peek and tell me if you agree or disagree, I’d love to hear your suggestions.

selection flowchart
None of these papers are perfect (I know this), but all are worthy of a read. Hopefuly they will get people thinking and in some cases changing practice for the benefit of patients.

 

  1. Radiological evaluation of alternative sites for needle decompression of tension pneumothorax (old news, or wrong question?)
  2. Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma. (enough to abandon the resus room CXR?)
  3. Epidemiology of out of hospital pediatric cardiac arrests due to trauma.(why we shouldn’t give up)
  4. Morphine and ketamine is superior to morphine alone for out-of-hospital trauma analgesia – a randomized controlled trial.(all talks should have a mention of Ketamine #lessonslearnedatSMACC2013)
  5. Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study (please use TXA)
  6. A critical reappraisal of the ATLS classification of hypovolaemic shock: Does it really reflect clinical reality? (Ha! evidence of what I’ve said for years – dogmalysis)
  7. Effect of tranexamic acid on mortality in patients with traumatic bleeding: prespecified analysis of data from randomised controlled trial (no seriously…….you MUST do this).
  8. Impact of emergency medical helicopter transport directly to a university hospital trauma center on mortality of severe blunt trauma patients until discharge (Helo boys love it – but is it true?)
  9. Resuscitation with hydroxyethyl starch improves renal function and lactate clearance in penetrating trauma in a randomized controlled study: the FIRST trial (Fluids in Resuscitation of Severe Trauma). (Oooo, after the sepsis trials will this be believed?)
  10. Preoxygenation and prevention of desaturation during emergency airway management.(do it tomorrow!)

Now I am quite unsure about 2 of these papers. Although they are interesting I have some concerns so if there are some better ones out there, let me know (can you guess which two?).PNX decompression

Plain films in resus?ped arrest outcomes in traumaMorphine vs KetamineMATTERs trialhelo outcomesFIRST trialDSI 1

 

CRASH 2 subanalysisATLS classification resuscitation

Posted by Simon Carley

Professor Simon Carley MB ChB, PGDip, DipIMC (RCS Ed), FRCS (Ed)(1998), FHEA, FAcadMed, FRCEM, MPhil, MD, PhD is Creator, Webmaster, owner and Editor in Chief of the St Emlyn’s blog and podcast. He is Professor of Emergency Medicine at Manchester Metropolitan University and a Consultant in adult and paediatric Emergency Medicine at Manchester Foundation Trust. He is co-founder of BestBets, St.Emlyns and the MSc in emergency medicine at Manchester Metropolitan University. He is an Education Associate with the General Medical Council and is an Associate Editor for the Emergency Medicine Journal. His research interests include diagnostics, MedEd, Major incidents & Evidence based Emergency Medicine. He is verified on twitter as @EMManchester

  1. Hi Simon,
    I won’t be at the trauma conference on Friday, which is a shame. I’m sure what ever you say your presentation will be very useful.
    Mentioning FOAM would be brilliant as I got the feeling on Monday when I was there not many people have heard of it – commenting on how Twitter helped you prepare could be enlightening for some.
    With lots of information being given out, people may find it useful to have one place to visit to access your presentation and the slides you talk about. As far as I know, Trauma Care don’t put presentations on their websites. The presentations are filmed, and released a few weeks after the conference – last year they were about £20/ DVD.

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  2. You may also check this one along with the 1st article. Epub on Injury Journal. Almost same results. Published almost same time. http://www.ncbi.nlm.nih.gov/pubmed/23116647

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  3. prevention – not cure. being the fence at the top of the cliff rather than the ambulance at the bottom

    Some joker did a nice study on using roadkill recipes as a gimmick to highlight wildlife-vehcile collisions as cause of road trauma, with public education of safe driving making a difference.

    There’s a PK on it, over at SMACC – “recipes from disaster”

    http://lifeinthefastlane.com/2013/01/another-six-smaccers/

    Don;t forget the importance of good primary health care – and some left-field thinking from us rural docs in Oz…

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Thanks so much for following. Viva la #FOAMed

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