The World Health Organization trauma checklist versus Trauma Team Time-out: A perspective.

Time-out protocols have reportedly improved team dynamics and patients' safety in various clinical settings - particularly in the operating room. In 2016, the World Health Organization (WHO) introduced a Trauma Care checklist, which outlines steps to follow immediately after the primary and secondary surveys and prior to the team leaving the patient. The WHO Trauma Care checklist's main perceived benefit is the prompting of clinicians to complete trauma admissions as per evidence-based guidelines. The WHO Trauma Care checklist, while likely to be successful in reducing errors of omission related to hospital admission, may be limited in its ability to reduce errors that occur in the initial 30 min of trauma reception - when most of the life-saving decisions are made. To address this limitation a Trauma Team Time-out protocol is proposed for initial trauma resuscitation, targeting the critical first 30 min of hospital reception.

Clinical use of a neuronavigation system in hemangioblastoma resection of posterior cranial fossa.

The aim of this study was to retrospectively evaluate the effectiveness of the Stryker Leibinger neuronavigation system in surgical resection of hemangioblastomas of the posterior fossa. The study included 16 cases of solid hemangioblastoma of posterior cranial fossa treated since we began using Stryker Leibinger neuronavigation system-assisted microneurosurgery in 2003. These cases were compared on the basis of time, blood loss, and complications to 19 similar cases of solid hemangioblastoma that underwent conventional microneurosurgical resection prior to 2003. All patients in the experimental (neuronavigation-assisted) group underwent surgical resection without complications while the control groups' resections all involved blood loss related to the longer operation time. Neuronavigation also resulted in a clear field of surgical vision and clear lesion boundaries, making it easier to remove lesions and reduce accidental injury of adjacent normal structures. The application of navigation technology is very valuable for solid hemangioblastoma operations not only by shortening operative time, thereby significantly reducing operative blood loss, but also by making surgical excision easier, reducing damage to adjacent normal structures, and decreasing surgical complications and mortality.

Efficacy of subdural saline injection during surgery for acute epidural haematomas.

PRIMARY OBJECTIVE: The purpose of this study was to investigate the efficacy of subdural space saline injection surgery in the management of large acute epidural haematomas (EDHs). METHODS AND PROCEDURES: Over a period of 6 years, the authors employed the technique of subdural space saline injection to facilitate elevation of dura after evacuation of supratentorial epidural haematomas. MAIN OUTCOMES AND RESULTS. Eighty patients with supratentorial epidural haematomas underwent the procedure. Infusion of saline in the subdural space not only helps elevation of the dura, facilitate haemostasis and application of suspension stitches during operation, it also avoids ICP fluctuations during the operations. Post-operative CT scans showed rapid disappearance of saline and reposition of cerebral structure. No patient required re-operation for residual haematoma. CONCLUSIONS: Subdural saline injection is an effective operative technique in the management of large epidural haematoma.