Emergency Treatment of Epidural Hematoma: Case Report

Reyna, Troy M.; Madauss, William C.

doi:10.1093/milmed/146.7.504

Cited by 2 publications

(2 citation statements)

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“…In their articles, neurosurgeons frequently comment on the need for drainage to be done by nonneurosurgeons in emergency conditions 23,25,34,44,45 . In the case reports written by EPs, it was often the neurosurgeon who advised the procedure be performed 37,46 . The media has reported several cases of EPs saving patients’ lives with household drills, but these were all decisions made in counsel with neurosurgeons 47–49 .…”

Section: Discussionmentioning

confidence: 99%

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Local Skull Trephination Before Transfer Is Associated With Favorable Outcomes in Cerebral Herniation from Epidural Hematoma

Nelson

2011

Academic Emergency Medicine

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Objectives: The patient with epidural hematoma and cerebral herniation has a good prognosis with immediate drainage, but a poor prognosis with delay to decompression. Such patients who present to nonneurosurgical hospitals are commonly transferred without drainage to the nearest neurosurgical center. This practice has never been demonstrated to be the safest approach to treating these patients. A significant minority of emergency physicians (EPs) have advised and taught bedside burr hole drainage or skull trephination before transfer for herniating patients. The objective of this study was to assess the effect of nonneurosurgeon drainage on neurologic outcome in patients with cerebral herniation from epidural hematoma.Methods: A structured literature review was performed using EMBASE, the Cochrane Library, and the Emergency Medicine Abstracts database.

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Section: Discussionmentioning

confidence: 99%

“…Even without training, it has been learned in real time, by reading a faxed report from the neurosurgeon 37 . It has also been performed by nonphysicians, such as in the case where this was done by a dentist who used his dental drill 46 . As a specialty, however, we must ask that the procedure be learned well in advance.…”

Section: Discussionmentioning

confidence: 99%