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Simple Blood Test To Detect Mild Brain Injury?


FREDERICK, Md. — The Army says it has discovered a simple blood test that can diagnose mild traumatic brain damage [TBI] or concussion, a hard-to-detect injury that can affect young athletes, infants with “shaken baby syndrome” and combat troops.

“This is huge,” said Gen. Peter Chiarelli, the Army vice chief of staff.

Yes, it is, if it pans out. There’s so little actual information in this that it’s hard to get excited about it, but let’s say they’ve isolated a “brain injury” protein.

First, it would have uses outside traumatic brain injury (TBI), though that in and of itself might be useful. I don’t want to poo-pooh this test for TBI, but there are already rules for returning to contact sports (and combat has to be the ultimate in contact activities), so what’s the purpose here? (I forsee more Purple Hearts, which is fine.)

Stroke? TIA? Seizure? Pseudotumor cerebri, as a strain indicator? What if this is the test that allows us to diagnose meningitis without doing lumbar punctures? I’m all in on that front. Let’s hope this pans out, for all our sakes.

*This blog post was originally published at GruntDoc*

Why Not To Drop Your Baby On His Head

Exaggeration, drama, and histrionics are very much the rule of thumb in the ER.  Someone comes in and claims they were stabbed with an eight-inch butcher’s knife, and the police later bring in the actual weapon, and it turns out to be a three-inch penknife.  Someone claims to have taken a whole bottle of tylenol, but their serum levels turn out to be nowhere near the toxic level (or even zero).  A patient reports to you that their last pneumonia was so bad their doctor didn’t think they’d pull through, but you check the records and see they weren’t even in the ICU.  (The sole exception to this rule, of course, is the stated alcohol intake, which is usually about half to a third the actual alcohol intake.) Read more »

*This blog post was originally published at Movin' Meat*

Trauma Victims In South Africa: Triaging The Dead

I noticed my use of the phrase ‘call it’ a few times recently. It is something I saw on American TV and not at all something that is common in my neck of the woods. The sort of scene that you would get in gray’s when the junior doctor is pumping the chest shouting ‘I will not let you die, dammit!’ while the senior doctors stand one side and instruct him to ‘call it!’ is pretty foreign to our way of doing things. I even got ragged a bit for using the phrase at all. I thought I’d relate a story from days gone by that illustrates this point.

It was the time of the taxi wars. Now taxis in our country are nothing like you might be thinking. They are fleets of mini-buses, quite often owned by people of questionable legal character. Occasionally rival groups try to take each other out (I mentioned this before here). But roughly at the turn of the millennium there was outright war. When the war came to Pretoria we saw quite a few of the victims, but neurosurgery got the most. A friend of mine was rotating through neurosurgery and this story came from him.

There had been a contact between two different taxi organisations. The casualties were streaming in. The neurosurgeon and my friend, his trusty lackey, were overworked and I think it had affected their sense of humour. So while they were getting another gunshot head ready for surgery and heard another four were en route, they were not amused. When the ambulances arrived the neurosurgeon said he wanted to go out and triage them in the ambulances before they were unloaded. And this is what they did.

The neurosurgeon looked at each patient in turn. The first three he told them to send into casualties for his attention. But the fourth…he took one look at the fourth and exclaimed;

“Vat hom weg! hierdie een is gefok!*”

My colleague laughed the next day when the newspapers reported: “On arrival at the hospital, one taxi driver was declared dead by the neurosurgeon on duty.” Fortunately they did not quote him verbatim.

*take him away! this one is f#@ked!

*This blog post was originally published at other things amanzi*

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