Emergency medicine journal : EMJ
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The early administration of tranexamic acid is recognised as significantly reducing mortality in traumatically injured patients with major haemorrhage, typically given via intravenous or intramuscular routes. In the context of mass casualty events, there may exist multiple traumatically injured casualties that would benefit from tranexamic acid, however, it's administration may be delayed through the need to establish intravenous access. Additionally, if the initial assessment of the traumatically injured casualty is undertaken by an individual who cannot administer intravenous or intramuscular medications, time to administration will be further delayed. This concepts paper seeks to discuss the potential for utilising oral tranexamic acid, in the context of mass casualty events, as an alternative administration route.
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Point-of-care ultrasound (POCUS) can potentially be used in the triage of patients with elbow injuries. However, the diagnostic accuracy of POCUS performed by non-radiologists for the exclusion of elbow fractures is yet unknown. This study aimed to investigate the diagnostic potential of POCUS of the posterior fatpad performed by non-radiologists in the workup of adult patients presenting with elbow injuries. ⋯ POCUS of the posterior fatpad is a promising adjunct to physical examination to determine the need for further diagnostic studies in the triage of patients with elbow injuries. Sensitivity after a limited training is high, but not perfect, and can likely further be improved with additional training.