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Purpose: Rib fractures occur in approximately 10% of patients with traumatic injury.They are associated with a greater injury burden especially when coupled with head, extremity, abdominal, and blunt cardiac injury.Mortality rates increase with the number of ...

Cervical Spine Evaluation and Management Purpose: Although cervical spine injuries are relatively uncommon among all trauma patients presenting to emergency departments (approximately 1-3%), cervical spine fractures and associated spinal cord or blunt cerebro...

Management of Traumatic Brain Injury  This document provides an overview of considerations and guidelines that are important in the evaluation and management of patients with traumatic brain injury (TBI). It is not intended to be used a rigid set of treatment...

Management of Blunt Extra – Cranial Carotid and Vertebral Artery Injury in Adults (BCVI)   PURPOSE: To define guidelines in caring for the trauma patient with diagnosis of blunt extra – cranial carotid and vertebral artery injuries (BCVI)   GUIDELINE: ...

Purpose: Provide guidance on the initial evaluation and management of patients sustaining frostbite injuries as well as recommendations regarding wound care and soft tissue management. Background/definitions: Frostbite is the tissue damage resulting f...

mBIG guidelines apply only to adult trauma patients (18 yrs and older). Pediatric trauma patients (less than 18 yrs of age) are excluded from these guidelines and neurosurgical consultation should be obtained for any intracranial hemorrhage. Modified Brain In...

Purpose: Provide a brief overview of the classification of burns, initial resuscitation and management, as well as guidelines on triage.  Classification of Burn Injuries: First Degree Burn (superficial)  Involves only the epidermis (no penetration into...

Purpose Provide guidance on the administration of thrombolytic therapy (t-PA) for the purpose of improving tissue perfusion in the management of severe frostbite injuries.  Background/Definitions Frostbite is the tissue damage resulting from exposure ...

Purpose To provide guidance on safe practices to perform percutaneous tracheostomy in the operating room and ICU settings.  Preprocedural Planning Indications for tracheostomy at the discretion of the attending surgical intensivist. The procedure should ...

Purpose Identify patients who would benefit from early femoral arterial access and describe the process facilitating early femoral arterial access. Background Hemorrhage is the leading cause of preventable death in trauma patients.  Decision making regardin...

Not Indicated: In general, VTE prophylaxis at discharge is not indicated for the following injuries: isolated upper extremity fractures (i.e. clavicle, humerus, elbow, forearm) non-operative isolated pelvic fractures (i.e. pubic rami, sacral ala)  ...

Not Indicated: In general, VTE prophylaxis at discharge is not indicated for the following injuries: isolated upper extremity fractures (i.e. clavicle, humerus, elbow, forearm) non-operative isolated pelvic fractures (i.e. pubic rami, sacral ala)  ...

Purpose Establish a unified guideline for the diagnosis and treatment of new-onset atrial fibrillation (AF) in Acute Care Surgery patients.  Background/Definitions Primary AF: AF with no precipitating cause Secondary AF: AF precipitated by a secondar...

Purpose To provide guidance on safe practices to perform percutaneous tracheostomy in the operating room and ICU settings.  Preprocedural Planning Indications for tracheostomy at the discretion of the attending surgical intensivist. The procedure should ...

Purpose Establish a unified guideline for the diagnosis and treatment of atrial fibrillation (AF) in Acute Care Surgery patients.  Background/Definitions Primary AF: AF with no precipitating cause Secondary AF: AF precipitated by a secondary or rever...

Nebraska Medicine Policy Number: MS 29  Purpose To give an accurate and complete description required to establish a diagnosis of breath death/Death by Neurological Criteria (BD/DNC), and to describe the roles and responsibilities of various clinicians and s...

Purpose: ·         To Identify which patients can appropriately be transferred to Bellevue Medical Center (BMC) who have sustained an isolated fractures requiring total or partial joint replacement Background/definitions: ·         Lack of OR availability...

Purpose: The implementation of a whole blood program at Nebraska Medicine is designed to optimize our resuscitation practices for the hemorrhaging trauma patient. Whole blood, specifically Low Titer O Whole Blood (LTOWB) immediately delivers a balanced produc...