Trauma and Emergency Medicine

Proximal humerus fracture with simultaneous shoulder dislocation in children is a rare occurrence, with few reported cases. This systematic review of case reports aimed to document the outcomes of different treatment methods. A comprehensive literature search from 1980 to 2024 included case reports on traumatic shoulder fracture-dislocation in children. Eighteen studies were included, with a mean followup of 1.5 years. The cases comprised 7 boys and 11 girls, aged between 11 months and 16 years (median 6 years). The cases were divided into two groups based on epiphysealinvolvement.

Chronic pain conditions constitute the primary reason for seeking healthcare, the development of related disability and addiction, and the highest driver of healthcare costs. Chronic temporomandibular, jaw and orofacial pain after acute jaw sprain/strain can be prevented if prompt and appropriate treatment in an emergency or urgent care clinic is provided using a jaw sprain/strain clinical protocol immediately after onset to begin the healing and recovery process. 

The tongue is a complex muscular organ essential for speech, taste, chewing and swallowing [1]. Tongue injuries range in severity from minor lacerations to complete amputation. The most common location is anterior dorsum as a result of falls, seizures, self-mutilation, electroconvulsive therapy or child abuse [1,2]. 

Necrotizing enterocolitis (NEC) is one of the most common serious acquired diseases of the gastrointestinal tract, both in full-term and premature infants. Studies show that the incidence of NEC among newborns is 2.4 per 1000 children. It was found that NEC in premature newborns occurs 12 times more often than in full-term patients [1].

Posttraumatic stress disorder (PTSD) is a highly debilitating psychiatric condition that develops in a subset of individuals following a traumatic event, such as a threat of death, serious injury or sexual assault. Over the past two decades, substantial body of research has focused on key neural regions and circuits that play a role in pathogenesis and maintenance of PTSD symptoms. More specifically, hyper-activation of amygdala, insula, and dorsal anterior cingulate cortex, as well as hypo-activation in ventral medial prefrontal cortex and altered function of hippocampus have been repeatedly reported.

Anesthetic recovery can be a critical period since neurocognitive problems such as agitation and delirium are often seen during the early recovery phase. We recently demonstrated that an α2-adrenergic agonist dexmedetomidine-induced unconsciousness and accompanying brain dynamics changes were completely and instantly reversed by the α2-adrenergic antagonist in the nonhuman primate model.

Multiple species obtain repetitive head collisions throughout the course of their lifetimes with minimal neurologic deficit. Nature has allowed the unique development of multiple protective mechanisms to help prevent neurotrauma. In this review, we examine the concept of rapid brain movement within the skull ‘Slosh’ and what nature teaches on how to prevent this from occurring.

As of 2024, adults aged 65 and older account for over 10% of the global population, nearly double the 1974 figure and still rising. In the island of Puerto Rico, the proportion of older adults has increased greatly, from approximately 13% of the population being over 65 years in 2014, to 24.6% of the population in 2024. 

Sleep Paralysis (SP) is a complex and multifaceted phenomenon situated at the intersection of neurobiology, psychiatry, genetics, and cultural belief systems. This study offers a comprehensive investigation into SP, integrating findings from neurophysiological, psychological, and sociocultural domains. Neurobiological evidence highlights disruptions during the rapid eye movement (REM) sleep cycle—specifically the persistence of REM atonia into wakefulness—as a core mechanism underlying SP, often accompanied by vivid hallucinations and sensory distortions.

It is my hope that the title of this commentary makes you curious—why is it important as a professional in an emergency medicine setting to know about such a difficult and aversive topic? You might be asking: haven’t we as a society been inundated enough with disclosures and information about other forms of sexual abuse and sexploitation, perpetrated by celebrities, clergy, teachers, military colleagues, and sometimes by relatives? Haven’t we had enough and why do we need to know more?

Securing a definitive airway in maxillofacial trauma is paramount yet challenging due to anatomical disruption, hemorrhage, and trismus. Conventional orotracheal or nasotracheal intubation can be contraindicated or hazardous. Submental intubation (SMI) has emerged as a effective and safe alternative to tracheostomy, providing unobstructed surgical access without the associated long-term morbidity.

Traumatic brain injury (TBI) poses a significant global health challenge, where secondary injury processes driven by oxidative stress and metabolic crisis are key determinants of poor neurological outcomes, yet lack effective treatments. This review synthesizes emerging evidence on a novel neuroprotective pathway—the thioredoxin-1 (Trx1)–ataxia-telangiectasia mutated (ATM)–pentose phosphate pathway (PPP) axis. 

Background: Silver Trauma refers to the specialized approach in managing trauma in patients over the age of 65. The use of Silver Trauma frameworks can have positive outcomes across all measurable domains in healthcare. Our paper aimed to assess factors that positively and negatively influence length of stay (LOS), functional outcomes on discharge as evidenced by discharge destination (DD), and readmission rates.

Background: Traumatic bereavement frequently combines grief-specific separation distress with trauma-related intrusions, avoidance, and dysregulation. A subgroup of patients develops persistent impairment consistent with prolonged grief disorder (PGD).This commentary outlines the clinical rationale and conceptual foundations of a manualized group program for bereavement after traumatic loss, integrating psychotherapeutic structure with art-based containment strategies.

Background: Traumatic cardiac arrest during prolonged extrication presents significant physiologic challenges. While prehospital care traditionally relies on emergency medical services personnel, select systems deploy hospital-based teams capable of delivering advanced anesthetic and resuscitative interventions at the scene.