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Article of the Week

How Vigilant is our Care AFTER Grandma's Been Run Over By a Reindeer?

This week’s article examines “failure to rescue” (FTR) and highlights how often such events occur among our geriatric trauma patients, a group already at high risk due to age and comorbidities.

Not surprisingly, the authors found that seniors at the highest risk for FTR were those with more severe injuries, over age 85, and insured through public programs like Medicare or Medicaid. Levels II and III trauma centers had significantly higher FTR rates than Level I centers, highlighting how resources, staffing, education, experience, and specialty support influence outcomes in older adults.

For bedside trauma nurses, these findings emphasize the importance of early complication detection, quick escalation, and effective communication among teams—especially when caring for geriatric patients who can deteriorate rapidly.

Click the link to view the article or watch a short AI-generated article summary (6 min 33 sec).

O’Connor B, Nasef H, Kumar S, et al. Understanding Failure to Rescue in Geriatric Trauma: A National Analysis of Predictors and Outcomes. Journal of Trauma Nursing. 2025:10.1097.

Trauma Happenings

How is the Primary Survey "The Same But Different" for Geriatric Trauma Patients?

This excellent review from Trauma System News explains how the primary survey is SORT OF the same for our injured geriatric patients and details how the ABCDE steps remain consistent but must be adapted to meet the unique needs of older adults.

Additionally, the author argues for adding an “F” for FRAILTY to the ABCDE framework to better reflect the increased vulnerability of our geriatric patients. Read more at the link below.

TEP Anniversary Year

Some anniversaries mark significant milestone years. Such is the case for TCAR Education Programs in 2026. In March, we’ll celebrate our 15th year of providing top-quality trauma education to nurses. To commemorate the occasion, TEP will be introducing several significant changes throughout 2026. Stay tuned for details as we unveil these innovations!

All is S'well: Vasogenic vs. Cytotoxic Edema

What’s the difference between vasogenic and cytotoxic edema, and why is it important? Vasogenic edema involves a problem with blood vessels, which become more permeable, allowing proteins and water to leak into the interstitial space. This condition can occur with burns, sepsis, or as part of any inflammatory response. Although not ideal, vasogenic edema will resolve as the vessels return to their normal state.

However, in cytotoxic edema (cyto = cell, toxic = poisonous), the cell membrane fails either due to direct injury (such as crushing, tearing, or poisoning) or because the sodium-potassium pump malfunctions, usually due to ATP depletion from ischemia or hypoperfusion. Pump failure allows sodium and water to enter the cells, leading to intracellular swelling. Unfortunately, these damaged cells are often dead or dying, so the prognosis for their recovery is poor.

This difference in the TYPE of edema often explains why one patient with increased ICP responds well to interventions, while another shows little improvement. We may reverse leaky vessels, but we can’t revive dead cells.

TCAR Education Programs
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