The role of the emergency pharmacist in trauma resuscitation

Journal of Pharmacy Practice

Volumn 24, Issue 2, 2011, Pages 146-159

  Scarponcini, Thomas R ^a   Edwards, Christopher J ^b   Rudis, Maria I ^a   Jasiak, Karalea D ^c   Hays, Daniel P ^b  

^a MAYO CLINIC   (United States)

^b UNIVERSITY OF ARIZONA MEDICAL CENTER   (United States)

^c UNIVERSITY OF ARIZONA   (United States)

Author keywords

emergency; pharmacist; pharmacotherapy; resuscitation; trauma

Indexed keywords

ACETYLSALICYLIC ACID; ADRENALIN; ANTIBIOTIC AGENT; ATROPINE; CLOPIDOGREL; DOPAMINE; ETIRACETAM; ETOMIDATE; FENTANYL; FOSPHENYTOIN SODIUM; FRESH FROZEN PLASMA; KETAMINE; LIDOCAINE; METHYLPREDNISOLONE; MIDAZOLAM; NORADRENALIN; PANCURONIUM; PHENYLEPHRINE; PHENYTOIN; PHYTOMENADIONE; PROPOFOL; RECOMBINANT BLOOD CLOTTING FACTOR 7A; ROCURONIUM; SUXAMETHONIUM; TETANUS ANTIBODY; THIOPENTAL; UNINDEXED DRUG; VALPROIC ACID; VECURONIUM; WARFARIN;

ABDOMINAL INJURY; ADRENAL INSUFFICIENCY; ADULT RESPIRATORY DISTRESS SYNDROME; AIRWAY; ANESTHESIA INDUCTION; ANTIBIOTIC THERAPY; APNEA; ARTICLE; BITE WOUND; BLEEDING; BRADYCARDIA; BREATHING; CERVICAL SPINE; CIRCULATION; CLINICAL PHARMACY; COMPETITIVE INHIBITION; CONFUSION; CONTINUOUS INFUSION; CORONARY HEMODYNAMICS; CRITICALLY ILL PATIENT; CRUSH TRAUMA; DEBRIDEMENT; DELIRIUM; DIASTOLIC BLOOD PRESSURE; DISABILITY; DRUG CONTRAINDICATION; DRUG DOSE REGIMEN; DRUG DOSE TITRATION; DRUG EFFICACY; DRUG MEGADOSE; DRUG RECEPTOR BINDING; EMERGENCY CARE; EMERGENCY WARD; ENDOTRACHEAL INTUBATION; ENVIRONMENTAL EXPOSURE; FACE INJURY; FACE MASK; FLUID RESUSCITATION; GLASGOW COMA SCALE; HALLUCINATION; HEART RATE; HEART TAMPONADE; HEMORRHAGIC SHOCK; HUMAN; HYPOTENSION; INJURY; INTERNATIONAL NORMALIZED RATIO; INTRACRANIAL PRESSURE; INTRAOCULAR PRESSURE; LOADING DRUG DOSE; LOW DRUG DOSE; MALIGNANT HYPERTHERMIA; MEAN ARTERIAL PRESSURE; MOUTH INJURY; NEUROLOGIC EXAMINATION; NEUROMUSCULAR BLOCKING; OXYGEN DELIVERY DEVICE; OXYGENATION; PERICARDIOCENTESIS; PHARMACIST; POSTTRAUMATIC SEIZURE; PRACTICE GUIDELINE; PREMEDICATION; PSYCHOSIS; RAPID SEQUENCE INDUCTION; RECOMMENDED DRUG DOSE; RESUSCITATION; RISK BENEFIT ANALYSIS; SEDATION; SEIZURE; SIDE EFFECT; SINGLE DRUG DOSE; SPINAL CORD INJURY; STEROID THERAPY; SYNAPTIC TRANSMISSION; SYSTOLIC BLOOD PRESSURE; TETANUS; TETANUS PROPHYLAXIS; TRACHEA INJURY; TRAUMATIC BRAIN INJURY; TREATMENT INDICATION; VACCINATION; WOUND;

EID: 79955563463     PISSN: 08971900     EISSN: 15311937     Source Type: Journal    
DOI: 10.1177/0897190011400550     Document Type: Article

References (101)

1. Kohn LT, Corrigan JM, Donaldson MS To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press ; 2000 :
2. Hafner JW, Jr.,. Belknap SM, Squillante MD, et al. Adverse drug events in emergency department patients. Ann Emerg Med. 2002 ; 39 (3). 258-267 (Pubitemid 34219639)
3. Hospital-Based Emergency Care: At the Breaking Point. Washington, DC: National Academies Press ; 2006 :
4. Leape LL, Cullen DJ, Clapp MD, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. J Am Med Assoc. 1999 ; 282 (3). 267-270 (Pubitemid 29343170)
5. Vernon DD, Furnival RA, Hansen KW, et al. Effect of a pediatric trauma response team on emergency department treatment time and mortality of pediatric trauma victims. Pediatrics. 1999 ; 103 (1). 20-24 (Pubitemid 29281923)
6. Nuss KE, Dietrich AM, Smith GA. Effectiveness of a pediatric trauma team protocol. Ped Emerg Care. 2001 ; 17 (2). 96-100 (Pubitemid 32332584)
7. Brent RJ, Poltorak I. The pharmacist as a trauma team member. Hosp Pharm. 1987 ; 22 (2). 152-155
8. Kelly-Pisciotti SJ, Hays DP, O'Brien TE. Pharmacists enhancing patient safety during trauma resuscitations. American Society of Health-System Pharmacists Midyear Clinical Meeting. 2005 ;:
9. Reynolds SF, Heffner J. Airway management of the critically ill patient: rapid-sequence intubation. Chest. 2005 ; 127 (4). 1397-1412 (Pubitemid 46224307)
10. Robinson N, Clancy M. In patients with head injury undergoing rapid sequence intubation, does pretreatment with intravenous lignocaine/lidocaine lead to an improved neurological outcome? A review of the literature. Emerg Med J. 2001 ; 18 (6). 453-457 (Pubitemid 34071001)
11. Butler J, Jackson R. Towards evidence based emergency medicine: best BETs from Manchester Royal Infirmary. Lignocaine premedication before rapid sequence induction in head injuries. Emerg Med J. 2002 ; 19 (6). 554
12. El-Orbany M, Connolly LA. Rapid sequence induction and intubation: current controversy. Anesth Analg. 2010 ; 110 (5). 1318-1325
13. Chraemmer-Jorgensen B, Hoilund-Carlsen PF, Marving J, et al. Lack of effect of intravenous lidocaine on hemodynamic responses to rapid sequence induction of general anesthesia: a double-blind controlled clinical trial. Anesth Analg. 1986 ; 65 (10). 1037-1041 (Pubitemid 16031308)
14. Danzl D, Vissers RJ Emergency Medicine: A Comprehensive Study Guide. Tintinelli J, ed. New York: McGraw-Hill Medical Publishing ; 2004: 108-118.
15. Vaillancourt C, Kapur AK. Opposition to the use of lidocaine in rapid sequence intubation. Ann Emerg Med. 2007 ; 49 (1). 86-87 (Pubitemid 46039757)
16. Mississauga, Ontario: AstraZeneca Canada Inc. ; 2007 :
17. Fleming B, McCollough M, Henderson HO. Myth: atropine should be administered before succinylcholine for neonatal and pediatric intubation. Can J Emerg Med. 2005 ; 7 (2). 114-117 (Pubitemid 41686198)
18. Fastle RK, Roback MG. Pediatric rapid sequence intubation: incidence of reflex bradycardia and effects of pretreatment with atropine. Ped Emerg Care. 2004 ; 20 (10). 651-655 (Pubitemid 39383226)
19. Zelicof-Paul A, Smith-Lockridge A, Schnadower D, et al. Controversies in rapid sequence intubation in children. Curr Opin Ped. 2005 ; 17 (3). 355-362 (Pubitemid 40791470)
20. Oglesby AJ. Should etomidate be the induction agent of choice for rapid sequence intubation in the emergency department?. Emerg Med J. 2004 ; 21 (6). 655-659 (Pubitemid 39504600)
21. Zed PJ, Abu-Laban RB, Harrison DW. Intubating conditions and hemodynamic effects of etomidate for rapid sequence intubation in the emergency department: an observational cohort study. Acad Emerg Med. 2006 ; 13 (4). 378-383
22. Jabre P, Combes X, Lapostolle F, et al. Etomidate versus ketamine for rapid sequence intubation in acutely ill patients: a multicentre randomised controlled trial. Lancet. 2009 ; 374 (9686). 293-300
23. Moss E, Powell D, Gibson RM, et al. Effect of etomidate on intracranial pressure and cerebral perfusion pressure. Br J Anaesth. 1979 ; 51 (4). 347-352 (Pubitemid 10196061)
24. Modica PA, Tempelhoff R. Intracranial pressure during induction of anaesthesia and tracheal intubation with etomidate-induced EEG burst suppression. Can J Anaesth. 1992 ; 39 (3). 236-241
25. Watt I, Ledingham IM. Mortality amongst multiple trauma patients admitted to an intensive therapy unit. Anaesthesia. 1984 ; 39 (10). 973-981 (Pubitemid 15076641)
26. Hildreth AN, Mejia VA, Maxwell RA, et al. Adrenal suppression following a single dose of etomidate for rapid sequence induction: a prospective randomized study. J Trauma. 2008 ; 65 (3). 573-579
27. Warner KJ, Cuschieri J, Jurkovich GJ, et al. Single-dose etomidate for rapid sequence intubation may impact outcome after severe injury. J Trauma. 2009 ; 67 (1). 45-50
28. Ray DC, McKeown DW. Effect of induction agent on vasopressor and steroid use, and outcome in patients with septic shock. Crit Care. 2007 ; 11 (3). R56
29. Riche FC, Boutron CM, Valleur P, et al. Adrenal response in patients with septic shock of abdominal origin: relationship to survival. Intens Care Med. 2007 ; 33 (10). 1761-1766 (Pubitemid 47476653)
30. Hohl CM, Kelly-Smith CH, Yeung TC, et al. The effect of a bolus dose of etomidate on cortisol levels, mortality, and health services utilization: a systematic review. Ann Emerg Med. 2010 ; 56 (2). 105-113 e5
31. Nasr NF, Nasr IF, Ghaly B Emergency Medicine Procedures. EF Riechman RR Simon, ed. New York: McGraw-Hill Medical Publishing ; 2004: 19-39.
32. Sehdev RS, Symmons DA, Kindl K. Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emerg Med Australas. 2006 ; 18 (1). 37-44
33. Urwin SC, Menon DK. Comparative tolerability of sedative agents in head-injured adults. Drug Saf. 2004 ; 27 (2). 107-133 (Pubitemid 38186953)
34. White PF. Comparative evaluation of intravenous agents for rapid sequence induction - thiopental, ketamine, and midazolam. Anesthesiology. 1982 ; 57 (4). 279-284 (Pubitemid 12031856)
35. Qureshi AI, Suarez JI, Bhardwaj A, et al. Use of hypertonic (3%) saline/acetate infusion in the treatment of cerebral edema: Effect on intracranial pressure and lateral displacement of the brain. Crit Care Med. 1998 ; 26 (3). 440-446 (Pubitemid 28141476)
36. Jensen S, Schou-Olesen A, Huttel MS. Use of midazolam as an induction agent: comparison with thiopentone. Br J Anaesth. 1982 ; 54 (6). 605-607 (Pubitemid 12076981)
37. Reves JG, Fragen RJ, Vinik HR, et al. Midazolam: pharmacology and uses. Anesthesiology. 1985 ; 62 (3). 310-324 (Pubitemid 15101882)
38. Choi YF, Wong TW, Lau CC. Midazolam is more likely to cause hypotension than etomidate in emergency department rapid sequence intubation. Emerg Med J. 2004 ; 21 (6). 700-702 (Pubitemid 39504610)
39. Sagarin MJ, Barton ED, Sakles JC, et al. Underdosing of midazolam in emergency endotracheal intubation. Acad Emerg Med. 2003 ; 10 (4). 329-338 (Pubitemid 36437790)
40. Wilbur K, Zed PJ. Is propofol an optimal agent for procedural sedation and rapid sequence intubation in the emergency department?. Can J Emerg Med. 2001 ; 3 (4). 302-310 (Pubitemid 33815589)
41. Angelini G, Ketzler JT, Coursin DB. Use of propofol and other nonbenzodiazepine sedatives in the intensive care unit. Crit Care Clin. 2001 ; 17 (4). 863-880 (Pubitemid 33101685)
42. Los Angeles, CA: Abraxis Bioscience, Inc. ; 2007 :
43. Miller RD, Katzung BG Basic and Clinical Pharmacology. 9 th ed Katzung BG Bertram G, ed. New York: McGraw-Hill Medical Publishing: ; 2001: 451-452.
44. Laurin EG, Sakles JC, Panacek EA, et al. A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients. Acad Emerg Med. 2000 ; 7 (12). 1362-1369
45. Clancy M, Halford S, Walls R, et al. In patients with head injuries who undergo rapid sequence intubation using succinylcholine, does pretreatment with a competitive neuromuscular blocking agent improve outcome? A literature review. Emerg Med J. 2001 ; 18 (5). 373-375 (Pubitemid 34070968)
46. Mallon WK, Keim SM, Shoenberger JM, et al. Rocuronium vs. succinylcholine in the emergency department: a critical appraisal. J Emerg Med. 2009 ; 37 (2). 183-188
47. Naguib M, Samarkandi AH, El-Din ME, et al. The dose of succinylcholine required for excellent endotracheal intubating conditions. Anesth Analg. 2006 ; 102 (1). 151-155 (Pubitemid 43038299)
48. Magorian T, Flannery KB, Miller RD. Comparison of rocuronium, succinylcholine, and vecuronium for rapid-sequence induction of anesthesia in adult patients. Anesthesiology. 1993 ; 79 (5). 913-918 (Pubitemid 23339048)
49. Sluga M, Ummenhofer W, Studer W, et al. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: a prospective, randomized trial in emergent cases. Anesth Analg. 2005 ; 101 (5). 1356-1361 (Pubitemid 41531871)
50. Larsen PB, Hansen EG, Jacobsen LS, et al. Intubation conditions after rocuronium or succinylcholine for rapid sequence induction with alfentanil and propofol in the emergency patient. Eur J Anaesthesiol. 2005 ; 22 (10). 748-753 (Pubitemid 41391650)
51. Andrews JI, Kumar N, van den Brom, RH, et al. A large simple randomized trial of rocuronium versus succinylcholine in rapid-sequence induction of anaesthesia along with propofol. Acta Anaesthesiol Scand. 1999 ; 43 (1). 4-8 (Pubitemid 29014102)
52. Perry JJ, Lee JS, Sillberg VA, et al. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev.. 2008 ; (2) :
53. Payen JF, Chanques G, Mantz J, et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospective multicenter patient-based study. Anesthesiology. 2007 ; 106 (4). 687-695 (Pubitemid 46555612)
54. Kendrick DB, Monroe KW, Bernard DW, et al. Sedation after intubation using etomidate and a long-acting neuromuscular blocker. Ped Emerg Care. 2009 ; 25 (6). 393-396
55. Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002 ; 30 (1). 119-141 (Pubitemid 34112188)
56. Sandiumenge Camps A, Sanchez-Izquierdo Riera JA, Toral Vazquez D, et al. Midazolam and 2% propofol in long-term sedation of traumatized critically ill patients: efficacy and safety comparison. Crit Care Med. 2000 ; 28 (11). 3612-3619
57. Kauvar DS, Lefering R, Wade CE. Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations. J Trauma. 2006 ; 60 (6 suppl). S3 - S11
58. Ploumis A, Yadlapalli N, Fehlings MG, et al. A systematic review of the evidence supporting a role for vasopressor support in acute SCI. Spinal Cord. 2010 ; 48 (5). 356-362
59. Ivascu FA, Howells GA, Junn FS, et al. Rapid warfarin reversal in anticoagulated patients with traumatic intracranial hemorrhage reduces hemorrhage progression and mortality. J Trauma. 2005 ; 59 (5). 1131-1137
60. Ansell J, Hirsh J, Hylek E, et al. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 ; 133 (6 suppl). 160S - 198S (Pubitemid 351892967)
61. Lubetsky A, Yonath H, Olchovsky D, et al. Comparison of oral vs intravenous phytonadione (vitamin K1) in patients with excessive anticoagulation: a prospective randomized controlled study. Arch Intern Med. 2003 ; 163 (20). 2469-2473 (Pubitemid 37385789)
62. Aguilar MI, Hart RG, Kase CS, et al. Treatment of warfarin-associated intracerebral hemorrhage: literature review and expert opinion. Mayo Clin Proc. 2007 ; 82 (1). 82-92 (Pubitemid 46036324)
63. Morgenstern LB, Hemphill JC, 3rd, Anderson C, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010 ; 41 (9). 2108-2129
64. Fredriksson K, Norrving B, Stromblad LG. Emergency reversal of anticoagulation after intracerebral hemorrhage. Stroke. 1992 ; 23 (7). 972-977
65. Lankiewicz MW, Hays J, Friedman KD, et al. Urgent reversal of warfarin with prothrombin complex concentrate. J Thromb Haemost. 2006 ; 4 (5). 967-970
66. Imberti D, Barillari G, Biasioli C, et al. Prothrombin complex concentrates for urgent anticoagulation reversal in patients with intracranial haemorrhage. Pathophys Haem Thromb. 2008 ; 36 (5). 259-265
67. Bellal J, Amini A, Friese RS, et al Annual Meeting of the American Association for the Surgery of Trauma. Boston, MA: ; 2010 :
68. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. XIII. Antiseizure prophylaxis. J Neurotrauma. 2007 ; 24 (suppl 1). S83 - S86
69. Temkin NR, Dikmen SS, Wilensky AJ, et al. A randomized, double-blind study of phenytoin for the prevention of post-traumatic seizures. New Engl J Med. 1990 ; 323 (8). 497-502 (Pubitemid 20260049)
70. Chang BS, Lowenstein DH. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003 ; 60 (1). 10-16 (Pubitemid 36070636)
71. Eatontown, NJ: West-Ward Pharmaceutical Corporation ; 2006 :
72. Jones KE, Puccio AM, Harshman KJ, et al. Levetiracetam versus phenytoin for seizure prophylaxis in severe traumatic brain injury. Neurosurg Focus. 2008 ; 25 (4). E3
73. Szaflarski JP, Sangha KS, Lindsell CJ, et al. Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis. Neurocrit Care. 2010 ; 12 (2). 165-172
74. Temkin NR, Dikmen SS, Anderson GD, et al. Valproate therapy for prevention of posttraumatic seizures: a randomized trial. J Neurosurg. 1999 ; 91 (4). 593-600 (Pubitemid 30133456)
75. Kortbeek JB, Al Turki SA, Ali J, et al. Advanced trauma life support: the evidence for change. J Trauma. 2008 ; 64 (6). 1638-1650
76. http://www.east.org/tpg/OpenFxUpdate.pdf..
77. Bleck TP. Pharmacology of tetanus. Clin Neuropharmacol. 1986 ; 9 (2). 103-120 (Pubitemid 16111360)
78. Farrar JJ, Yen LM, Cook T, et al. Tetanus. J Neurol Neurosurg Psych. 2000 ; 69 (3). 292-301 (Pubitemid 30636231)
79. Chapter 16..,. http://www.cdc.gov/vaccines/pubs/surv-manual/chpt16- tetanus.pdf..
80. Tetanus and pertussis vaccination coverage among adults ≥ 18 years-United States, 1999 and 2008. MMWR. 2010 ; 59 (40). 1302-1306
81. http://www.immunize.org/acip/acip-2010.asp..
82. Kretsinger K, Broder KR, Cortese MM, et al. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. MMWR Recomm Rep. 2006 ; 55 (RR-17). 1-37
83. Holbrook TL, Galarneau MR, Dye JL, et al. Morphine use after combat injury in Iraq and post-traumatic stress disorder. New Engl J Med. 2010 ; 362 (2). 110-117
84. Miner JR. The surgical stress response, preemptive analgesia, and procedural sedation in the emergency department. Acad Emerg Med. 2008 ; 15 (10). 955-958
85. Silka PA, Roth MM, Geiderman JM. Patterns of analgesic use in trauma patients in the ED. Am J Emerg Med. 2002 ; 20 (4). 298-302 (Pubitemid 34701072)
86. Curtis KM, Henriques HF, Fanciullo G, et al. A fentanyl-based pain management protocol provides early analgesia for adult trauma patients. J Trauma. 2007 ; 63 (4). 819-826 (Pubitemid 350287300)
87. McHale PM, LoVecchio F. Narcotic analgesia in the acute abdomen-a review of prospective trials. Eur J Emerg Med. 2001 ; 8 (2). 131-136
88. Patanwala AE, Hays DP. Pharmacist's activities on a trauma response team in the emergency department. Am J Health Syst Pharm. 2010 ; 67 (18). 1536-1538
89. Bratton SL, Chestnut RM, Ghajar J, et al. Guidelines for the management of severe traumatic brain injury. II. Hyperosmolar therapy. J Neurotrauma. 2007 ; 24 (suppl 1). S14 - S20
90. Rabinstein AA. Treatment of cerebral edema. Neurologist. 2006 ; 12 (2). 59-73
91. Schwarz S, Georgiadis D, Aschoff A, et al. Effects of hypertonic (10%) saline in patients with raised intracranial pressure after stroke. Stroke. 2002 ; 33 (1). 136-140 (Pubitemid 34055759)
92. Al-Rawi PG, Tseng MY, Richards HK, et al. Hypertonic saline in patients with poor-grade subarachnoid hemorrhage improves cerebral blood flow, brain tissue oxygen, and pH. Stroke. 2010 ; 41 (1). 122-128
93. Suarez JI, Qureshi AI, Bhardwaj A, et al. Treatment of refractory intracranial hypertension with 23.4% saline. Crit Care Med. 1998 ; 26 (6). 1118-1122 (Pubitemid 28272866)
94. Cote CJ, Greenhow DE, Marshall BE. The hypotensive response to rapid intravenous administration of hypertonic solutions in man and in the rabbit. Anesthesiology. 1979 ; 50 (1). 30-35 (Pubitemid 9113179)
95. Bracken MB, Shepard MJ, Collins WF, et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. New Engl J Med. 1990 ; 322 (20). 1405-1411 (Pubitemid 20152525)
96. Bracken MB, Shepard MJ, Collins WF, et al. Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data. Results of the second National Acute Spinal Cord Injury Study. J Neurosurg. 1992 ; 76 (1). 23-31
97. Ito Y, Sugimoto Y, Tomioka M, et al. Does high dose methylprednisolone sodium succinate really improve neurological status in patient with acute cervical cord injury? a prospective study about neurological recovery and early complications. Spine. 2009 ; 34 (20). 2121-2124
98. ,. http://www.caep.ca/template.asp?id=6ac5624e27aa4cba8bbcc037ee2d4355..
99. Hugenholtz H, Cass DE, Dvorak MF, et al. High-dose methylprednisolone for acute closed spinal cord injury-only a treatment option. Can J Neurol Sci. 2002 ; 29 (3). 227-235 (Pubitemid 34966317)
100. Hadley MN, Walters BC, Grabb PA, et al. Guidelines for the management of acute cervical spine and spinal cord injuries. Clin Neurosurg. 2002 ; 49: 407-498
101. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 ; 2 (7872). 81-84