Ebs trauma

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Ebs trauma

  1. 1. Evidence Based SurgeryShinuo LiuDr Andrew Davidson16/08/12 EBS presentation 1
  2. 2. Case50 year old RHD CEO.Tripped over dog. Moderate TBI.Observation + PTAsPut on phenytoin for 1 week. EBS presentation 2
  3. 3. PICOP = in ALL patients with traumatic brain injuryI = prophylactic anticonvulsantsC=O = does it work? Is there a role? EBS presentation 3
  4. 4. Keywords• Traumatic brain injury• Head injury• Brain injury• Anticonvulsant*• Antiepileptic*• Prophyla*• Prevent* EBS presentation 4
  5. 5. MEDLINE EBS presentation 5
  6. 6. EBS presentation 6
  7. 7. SCOPUS EBS presentation 7
  8. 8. EMBASE EBS presentation 8
  9. 9. EBS presentation 9
  10. 10. SummaryProphylactic phenytoin reduces the incidence ofseizure in the first week after injury but notthereafter (?CMZ/PHB/VPA).There is a role in suppression of early seizuresin moderate to severe head injury. EBS presentation 10
  11. 11. Indications (Khan and Banerjee (2010) Int J Emerg Med;3:187–191)• GCS score <10• Cortical contusions• Depressed skull fracture• Subdural haematoma• Epidural haematoma• Intracerebral haematoma• Penetrating head wound EBS presentation 11
  12. 12. Our caseSupported by evidence! EBS presentation 12
  13. 13. EBS presentation 13
  14. 14. EBS presentation 14
  15. 15. EBS presentation 15
  16. 16. EBS presentation 16

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