The age of patients with TBI is increasing, especially in high income countries, and the median age of patients admitted to the ICU has doubled over the last three decades. Age is clearly a strong outcome predictor in TBI. However, the perception of a universally poor outcome has sometimes led to therapeutic nihilism and less aggressive treatment for older patients. The bleak outcomes that result from this approach reinforce self-fulfilling prophecies of poor prognosis and current prejudices. However, uniform nihilism is unjustified: when older patients are treated in a timely and appropriate manner, favourable outcomes can be achieved in a substantial proportion of patients. However, the high burden of prior comorbidity, pre-injury therapies (such as anticoagulant and antiplatelet therapy), and reduced physiological reserve, not only affect outcome, but modulate physiology and host response, and hence demand changes in management strategies.
Not all Brains are the Same by David Menon
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Peter Brindley interrogates: Liz Crowe: Love, Swearing and Resilience
Phoebe Adams, , The Talks DASsmacc, interrogation, Love, Resilience, swearing, 0
A no-holds barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social...
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The Future of Out-Of-Hospital Cardiac Arrest
Phoebe Adams, , The Talks DASsmacc, Individualized Skilled Resuscitation Academy, 0
There is a huge variation in our outcomes for cardiac arrest patients. Measuring your results makes it possible for...
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Diagnosing critical neuromuscular disease – physical exam findings, ancillary tests
Phoebe Adams, , 2017, The Talks DASsmacc, Neurology; Resuscitation; Emergency Medicine; Neuromuscular; Respiratory Failure; Physical Exam; Neurocritical Care, 0
Neuromuscular diseases are common and include chronic autoimmune disorders such as myasthenia gravis, acute demyelinating disorders like Guillain Barre,...
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Did Nietzsche Know Anything About Critical Illness Survivors? by Margaret Herridge
Phoebe Adams, , The Talks DASsmacc, Critical Illness Survivors, Nietzsche, 0
Traditionally, the focus of critical care has simply been on keeping patients alive. This is not enough, now we...
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How to Fail… Part Two by Martin Bromiley
Phoebe Adams, , The Talks DASsmacc, Failure, 0
Failure is something even the very best regularly experience, in safety critical roles that failure can lead to death...
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Diagnosing a wake-up stroke (look to the future) – imaging, implications on treatment
Phoebe Adams, , 2017, The Talks DASsmacc, DasSMACC, wake up stroke, 0
Diagnosing a wake-up stroke by Fernanda Bellolio
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Endocarditis will also f&*k you up
Phoebe Adams, , 2017, The Talks DASsmacc, ENDOCARDITIS BLOOD CULTURES, 0
Endocarditis has been on the back burner for a while now. It is a disease that is evolving as...
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SMACCForce: Bringing Lessons from MERT back home
Phoebe Adams, , The Talks DASsmacc, MERT, smaccFORCE, 0
Bringing Lessons from MERT back home by Claire Park