Haney Mallemat, MD
54-year old male presents with finger laceration after catching his wedding band on metal scaffolding above his head. He now reports significant pain at his left fourth digit with skin avulsion and decreased range of motion. What's the diagnosis and what should you do next?
Following a severe brain injury the goal of the clinician is to prevent secondary brain injury. This entails increasing oxygen delivery to the brain by preventing hypoxia and increasing cerebral perfusion. Hyperosmolar therapy, including mannitol and hypertonic saline, is often used to decrease ICP.
When patients present to the Emergency Department with acute upper GI bleeding, the natural inclination is to quickly pull the transfusion trigger. However, a 2013 study gives us pause: