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Cervical Spine Evaluation and Management
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
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...
Intracranial Hypertension Management Algorithm
Management of Blunt Cerebrovascular Injuries (BCVI)
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: ...
Guidelines for the Initial Management of Frostbite
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...
Modified Brain Injury Guidelines (mBIG)
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...
Initial Management of Burns
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...
Thrombolytic Therapy for the Management of Severe Frostbite
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 ...
Percutaneous Tracheostomy Protocol
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 ...
Early Femoral Arterial Line Placement for Trauma
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...
Orthopedic Trauma Discharge VTE Prophylaxis
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) ...
Orthopedic Trauma Discharge VTE Prophylaxis
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) ...
Evaluation and Management of Atrial Fibrillation
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...
Percutaneous Tracheostomy Protocol
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 ...
Evaluation and Management of Atrial Fibrillation
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 Brain Death Criteria
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...
Isolated Orthopedic Transfers to Bellevue Medical Center Requiring Joint Replacement
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...
Whole Blood Usage in Trauma
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...
Trauma Team Activation (TTA) Criteria
LEVEL 3 trauma team includes: Trauma attending Emergency medicine (EM) attending and resident PGY 4 or 5 surgical resident when available in house Junior surgical or EM residents on trauma service Trauma advanced practice providers (APP) Anesthes...
Trauma Patient Admission Criteria
Trauma patients can be complex with multiple injuries requiring various management strategies, interventions, and care. As a result, determining the appropriate level of care for admission can be challenging. The following represents a list of criteria/conditi...