1.  I recently attended a conference in Minneapolis: "Care Across the Continuum: A Trauma and Critical Care Conference“. I wanted to share my notes…..Toni Trapp, RN

2. Presented by Dr. Martin Birch, Asst. Prof, Dept. of Anesthesiology, Univ of MN

3. Tips:  HAVE A BACK UP PLAN  USE THE BOUGIE  USE THE VIDEO (GLIDESCOPE) Trauma considerations:  full stomach--should avoid RSI  cervical instability--Is there an airway? Remember, a surgical airway is not a failure!  these patients are at high risk for extubation, and may be difficult to re-intubate

4. Take away thoughts: Think about intubation early, BEFORE it becomes emergent. (ie...morbid obese patient, hypotensive, and now is hypoxic on bipap. This is an example of late thinking).

5. Presented by Dr. Reza Khodaverdian, Dept of Cardiothoracic Surgery, HCMC

6. Indications: >or= 3 rib fractures with flail segment, intractable pain and chest wall deformity.

7. Presented by Dr. Scott Chapman, PharmD, Assoc. Prof, Dept of Experimental and Clinical Pharmacology, College of Pharmacy, Univ of MN and North Memorial

8.  Vit K and FFP are currently the primary choice  IV Vit K is the quickest route of reversal (subcut is not a very predictable onset)  PCC-(prothrombin complex concentrate products) amount of factor 7 varies in this product, and the appropriate dosing is still yet to be determined--currently 7units to 50units/kg seems to be effective  studies show that PCC and Vit K have a rapid onset drop in INR but both had rebound INR---need to re-dose  RFVIIa(recombinant factor VIIa)-- after administration, 27 minutes INR from 2.8 down to 1.2, similar onset as PCC, but shows less re-dosing needed than the PCC

9. Presented by Dr. Christopher Johnson, Dir. PICU at St. Cloud Hospital

10. Primary injury=direct injury, and often irreversable Secondary Injury=subsequent injury, preventable and profoundly affected by intervention (ie..prolonged seizure post head injury, uncontrolled ICP, fever control) Goal: optimizing treatment to prevent secondary injury.

11. Presented by Dr. Jeffrey Louie

12. Age guidelines: 6 months old = roll over 9 months old = sit up or pull up 12 months old = walking 18 months old = independent walking Typical injury with stair falls related to age: <4 years old = head > 4 years old = forearm injury, lower extremity injury, and head BE AWARE (red flag!!!!): Trunk injuries are rare!!!, Femur fractures are rare. Start thinking about abuse.