This post is not intended to be a comprehensive review of skull fracture types and management, but rather a discussion of two subtypes of skull fracture – open and depressed fractures. I chose this topic because it’s something I saw frequently during my recent elective working in an emergency department in Kumasi, Ghana. In the United States at trauma centers these patients are frequently managed immediately by neurosurgery; however, with few consultants available, I was able to be more involved in the prolonged care of these patients. If faced with these types of severe head/skull injuries in a community hospital, it is important to feel comfortable with the initial management.
Do you routinely recommend rest for your post-concussive pediatric patient? You may reconsider this adivce. This week Dr. Lou Argentine reviewed this clincal question for his critically appraised topic.
Have you cared for a paient dying from traumatic hemorrhagic shock despite maximum resucitation efforts? Dr. Zaffer Qasim from Christiana Care and @emmeddoc joined us for an outstanding talk on the use of REBOA in this patient population.