Trauma case conference, plus some AI evaluation
Presentation for the University of Wisconsin - Madison, Department of Emergency Medicine Residency case conference. Ostensibly, the theme was trauma, however after an excellent joint trauma conference last week, I used part of this session to cover my approach to evaluating predictive AI models.
(As always, details are educational, and cases are composites rather than identifiable real patients.)
What we covered
1) When is an ED thoracotomy indicated?
2) Pediatric hematuria after blunt trauma, CT or observation?
3) How do you evaluate a predictive model that fires alerts?
Slides
Link to download presentation.
ED thoracotomy supplemental videos and resources
Clamshell Approach
Traumatic Effusions (second half)
Resuscitative thoracotomy: step-by-step procedure
Tray setup and practical logistics
Selected references (as cited in the deck)
ED thoracotomy
- Burlew CC, et al. Western Trauma Association critical decisions in trauma, resuscitative thoracotomy. J Trauma Acute Care Surg. 2012. doi:10.1097/TA.0b013e318270d2df
- Seamon MJ, et al. An evidence-based approach to patient selection for emergency department thoracotomy. J Trauma Acute Care Surg. 2015. doi:10.1097/TA.0000000000000648
- Dewey EN, et al. Resuscitative thoracotomy, what you need to know. J Trauma Acute Care Surg. 2025. doi:10.1097/TA.0000000000004803
- Simms ER, et al. Bilateral anterior thoracotomy (clamshell incision) is the ideal emergency thoracotomy incision, an anatomic study. World J Surg. 2013. doi:10.1007/s00268-013-1961-5
- Tacoma Trauma Trust. ED thoracotomy guidelines (2016). PDF
Traumatic hematuria and renal injury
- Coccolini F, et al. Kidney and uro-trauma, WSES-AAST guidelines. World J Emerg Surg. 2019. doi:10.1186/s13017-019-0274-x
- Hosein PJ, et al. Coming Together, a review of the American Association for the Surgery of Trauma’s updated kidney injury scale. AJR. 2019. doi:10.2214/AJR.19.21486
- Hagedorn JC, et al. Pediatric blunt renal trauma practice management guidelines, collaboration between EAST and the Pediatric Trauma Society. J Trauma Acute Care Surg. 2019. doi:10.1097/TA.0000000000002209
- UW Emergency Radiology. AAST kidney injury scale reference. Link
Predictive AI model evaluation
- Wong A, et al. External validation of a widely implemented proprietary sepsis prediction model in hospitalized patients. JAMA Intern Med. 2021. doi:10.1001/jamainternmed.2021.2626
- Tarabichi S, et al. Improving timeliness of antibiotic administration using a provider and pharmacist facing sepsis early warning system in the emergency department setting. Crit Care Med. 2022. doi:10.1097/CCM.0000000000005267
Cheers,
Erkin
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