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Emergency Department Trephination (Burr Hole) for Epidural Hematoma

By Danielle Kowal, BA, and David Ross, DO | on October 13, 2022 | 0 Comment
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Danielle Kowal is a third-year medical student at Rocky Vista University College of Osteopathic Medicine in Parker, Colo.

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ACEP Now: Vol 41 – No 10 – October 2022

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Dr. Ross is an emergency physician and faculty member at Rocky Vista University College of Osteopathic Medicine in Parker, Colo. He is an associate professor and director of the rural and wilderness medicine track. He also teaches in the office of simulation in medicine and surgery (SIMS) at Rocky Vista University.

The authors have no financial conflicts of interest to disclose.

References

  1. Emergency medicine defined key index procedure minimums. Accreditation Council for Graduate Medical Education website. Available at https://www.acgme.org/globalassets/pfassets/programresources/em_key_index_procedure_minimums_103117.pdf. Published November 2017. Accessed September 13, 2022.
  2. Beeson MS, Ankel F, Bhat R, et al. The 2019 model of the clinical practice of emergency medicine. The Journal of Emergency Medicine. 2020;59(1):96-120.
  3. Smith SW, Clark M, Nelson J, et al. Emergency department skull trephination for epidural hematoma in patients who are awake but deteriorate rapidly. J Emerg Med. 2010;39(3):377-383.
  4. Cohen JE, Montero A, Israel ZH. Prognosis and clinical relevance of anisocoria-craniotomy latency for epidural hematoma in comatose patients. J Trauma. 1996;41(1):120-122.
  5. Beffa D. How to perform an emergency Burr Hole procedure. ACEP Now website. https://www.acepnow.com/article/perform-emergency-burr-hole-procedure/. Published December 15, 2017. Accessed September 13, 2022.
  6. Bulters D, Belli A. A prospective study of the time to evacuate acute subdural and extradural haematomas. Anaesthesia. 2009;64(3):277-281.
  7. Nelson JA. Local skull trephination before transfer is associated with favorable outcomes in cerebral herniation from epidural hematoma. Acad Emerg Med. 2011;18(1):78-85.
  8. Leach P, Childs C, Evans J, Johnston N, Protheroe R, King A. Transfer times for patients with extradural and subdural haematomas to neurosurgery in Greater Manchester. British Journal of Neurosurgery. 2007;21(1):11-15.
  9. Uzan M, Yentur E, Murat H, et al. Is it possible to recover from uncal herniation? Analysis of 71 head injured cases. Journal of neurosurgical sciences. 1998;42:89-94. PMID: 9826793.
  10. Price, D. Epidural hematoma management in the ED clinical presentation. Medscape website. https://emedicine.medscape.com/article/824029-clinical. Published February 2, 2022. Accessed September 13, 2022.
  11. O’Sullivan M, Gray W, Buckley T. Non-neurosurgical operative intervention in head-injured patients. British Journal of Neurosurgery. 1990;4:473-478.
  12. Wilson MH, Wise D, Davies G, et al. Emergency burr holes: “How to do it”. Scand J Trauma Resusc Emerg Med. 2012;20(24).

Pages: 1 2 3 4 | Single Page

Topics: Brain HemorrhageBurr Holeepidural hematomaIntracerebral HemorrhageTrephination

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