In the appropriate environment, selective nonoperative management of penetrating abdominal solid organ injuries has a high success rate and a low complication rate.

Preventable or potentially preventable deaths are rare but do occur at an academic Level I trauma center. Delay in treatment and error in judgment are the leading causes of preventable and potentially preventable deaths.

The incidence of TBI coagulopathy in SHI is high, especially in penetrating injuries. Independent risk factors for coagulopathy in isolated head injuries include GCS score of or=16, hypotension upon admission, cerebral edema, subarachnoid hemorrhage, and midline shift. The development of TBI coagulopathy is associated with longer ICU length of stay and an almost 10-fold increased risk of death.

No abstract

Patients with any head injury (mild, moderate, or severe) should undergo a repeat head CT after neurologic deterioration, because it leads to intervention in over one-third of patients. Routine repeat head CT is indicated for patients with a GCS score < or =8, as results might lead to intervention without neurologic change.

Elevated TnI is frequently observed after severe TBI. The level of TnI correlates with the severity of head injury and is an independent predictor of adverse outcomes. BB therapy is associated with a survival advantage in TBI patients with elevated cTnI.

The presence of an IHC program significantly improves consent and conversion rates for organ donation. An IHC program should be considered as a viable option to bridge the gap between organ supply and organ demand.

No abstract