More emphasis is given to the use of warmed IVF and blood. Saphenous vein cutdown for immediate large-bore IV access in the event of failed peripheral access is no longer taught. Instead, the use of cordis-type introducers is encouraged, with the femoral site preferred over subclavian or internal jugular sites. The pediatric Broselow tape system is introduced. The term myocardial contusion, an ambiguous term to many, is replaced by the term blunt cardiac injury.
Vaginal exam is emphasized in appropriate major trauma settings.
CT is defined as the test of choice in GU evaluation for gross hematuria in the setting of trauma. Management of traumatic head injury is updated to reflect current literature and neurosurgical trauma guidelines. Routine hyperventilation is discouraged and prophylactic anticonvulsants are recommended for the initial week only. For closed spinal trauma, the use of methylprednisolone in North American sites only is recommended. This would be a good issue to discuss on the E-Med forum.