Emergency Department Thoracotomy. EAST guideline – Update 2015

This guideline has been endorsed by EAST and uses Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology a framework recently adopted by EAST.

Since its first formal description nearly 50 years ago, emergency department thoracotomy (EDT) has remained among the most polarizing and controversial procedures that physicians perform. When treating moribund trauma victims presenting in extremis, clinicians are forced to make immediate life-or-death decisions for their patients—decisions that attempt to balance the last chance of survival with the risk of salvaging patients with severe anoxic encephalopathy or exposing health care providers to blood-borne pathogens. Limited salvage rates in conjunction with considerable potential risks associated with EDT have been central to the controversy. These reported outcomes have led to a more discriminating focus on patients most likely to benefit from the heroic procedure while limiting unnecessary risk. A selective approach to the performance of EDT based on the presence or absence of several predictors of survival has thus emerged. The primary objective of this article is to provide clear evidence-based recommendations for the physician facing the most common presenting clinical scenarios after critical injury. These recommendations are meant to provide an evidence-based framework from which clinicians can make rapid decisions regarding further resuscitation with EDT or futility.

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Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction.


Existing trials studying the use of Gastrografin for management of adhesive small bowel obstruction (SBO) are limited by methodological flaws and small sample sizes. We compared institutional protocols with and without Gastrografin (GG), hypothesizing that a SBO management protocol utilizing GG is associated with lesser rates of exploration, shorter length of stay, and fewer complications. (altro…)

Current Therapy of Trauma and Surgical Critical Care

Juan A. Asensio, Donald D. Trunkey
Mosby/Elsevier, 2008 – Medical785 pages

Here’s a unified evidence-based approach to problems encountered in trauma and critical care surgical situations. Comprehensive and concise, it is ideal for a quick overview before entering the operating room or ICU, or as a review for board certification or recertification.

    • Be prepared for the unexpected with practical, concise coverage of major surgical problems in trauma and critical care.


    • Get expert practical and up-to-date guidance on ventilator management, damage control, noninvasive techniques, imaging, infection control, dealing with mass casualties, treating injuries induced by chemical and biological agents, and much more.


  • Find the information you need quickly and easily through numerous illustrations, key points boxes, algorithms, and tables.

Guidelines update

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2016

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ObjectiveTo provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.”

DesignA consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development.