J Emerg Med
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Randomized Controlled Trial
A Randomized Controlled Trial using iTClamp, Direct Pressure, and Balloon Catheter Tamponade to Control Neck Hemorrhage in a Perfused Human Cadaver Model.
Penetrating neck wounds are common in the civilian and military realms. Whether high or low velocity, they carry a substantial morbidity and mortality rate. ⋯ The iTClamp and BCT were associated with significantly less fluid loss than DMP in a perfused cadaver model. The iTClamp required significantly less time to apply than the BCT. Both the iTClamp and the BCT were more effective than simple DMP. The iTClamp offers an additional option for managing hard-to-control bleeding in the neck.
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Randomized Controlled Trial
The Impact of Head of Bed Elevation on Optic Nerve Sheath Diameter in Cervical Collar Applied Healthy Volunteers.
Guidelines recommend placing a cervical collar (c-collar) until spinal injury is excluded. Previous studies have shown that c-collar placement increases intracranial pressure (ICP), which can worsen outcomes for trauma patients who are at risk of increased ICP. Head of bed elevation (HBE) has been found to decrease ICP. However, there is no consensus in the literature for the optimal degree of HBE to decrease ICP. ⋯ Our results show that c-collar increases ONSD in healthy volunteers. Elevating the head of the bed 30 and 45° for 20 min decreased ONSD to baseline values.