daily lows were measured at USGS streamflow-gaging station 08041500 Village Creek near Kountze, Tex., which has more than 70 years of record. Many other USGS streamflow-gaging stations in Texas started the 2011 water year with normal streamflow but by the end of the water year were flowing at near-record lows. Panhandle (fig. 1). Relatively few perennial streams exist in western Texas, and no USGS streamflow-gaging stations in that part of the State have complete streamflow record for the periods 1951-56 and 2011. Streamflows at stations on the Colorado, Brazos, and Trinity Rivers are regulated and not discussed in this report.

To the Editor:According to the World Health Organization, guidelines are systematically developed evidence-based statements to assist providers, recipients, and other stakeholders to make informed decisions about appropriate health interventions. The target audience for guidelines are clinicians with a general expertise, but without specific advanced knowledge for a certain condition.The recently published fourth edition of the Brain Trauma Foundation (BTF) Guidelines 1,2 fails to reach this aim, for several reasons. First, the literature upon which this new edition was based was only updated until 2013 (Appendix D). 1 This way, the 2016 BTF guidelines do not take into account the most recent evidence. Second, the guidelines stick to absolute thresholds for blood pressure, intracranial pressure (ICP), and cerebral perfusion pressure (CPP). For example, in the case of ICP, the previous recommendation that "Treatment should be initiated with ICP thresholds above 20 mm Hg" has been modified to "Treating ICP above 22 mm Hg is recommended because values above this level are associated with increased mortality" (level II B). Formulated this way, this recommendation seems to suggest that our patient is safe when his ICP is 21, but that 23 mm Hg should trigger aggressive therapy. Obviously, this is absurd, for several reasons. First, in reality, small and clinically negligible measurement errors of ±2 mm Hg occur frequently, 3 but could be enough to move a reading below/over the threshold. Second, we should never forget that the observational studies upon which the association between an ICP of 20 or 22 and outcome were based have been done in patients in whom ICP was already treated. Third, the ICP-time burden or "dose of ICP" is probably a more relevant predictor for outcome. Indeed, the higher the ICP, the shorter the time it can be tolerated. 4 Moreover, the actual ICP threshold is flexible between and within patients, and depends on age, CPP, and whether cerebrovascular autoregulatory function is active or not. 4 Finally, interventional studies where very aggressive treatments, such as surgical decompression, 5 were applied very early, as soon as the ICP crossed the 20 mm Hg threshold even briefly, have demonstrated harm rather than benefit.As Sackett wrote, 6 "Evidence-based medicine is not 'cookbook' medicine. Because it requires a bottom-up approach that integrates the best external evidence with individual clinical expertise and patients' choice, it cannot result in slavish, cookbook approaches to individual patient care." The BTF Guidelines 1,2 have simplified a complex story into a sterile dogma. We know that ICP values lower than 10 to 15 mm Hg are probably not dangerous and that ICPs higher than 25 to 30 are worrisome and require immediate aggressive intervention. Nevertheless, a huge area of uncertainty exists between these 2 extremes. Clinicians have to deal with these uncertainties daily, like ancient sailors sailing between Scylla and Charybdis deciding between low and high thresholds, integrating clinic...

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Severe flooding occurred near the Austin metropolitan area in central Texas September 7–14, 2010, because of heavy rainfall associated with Tropical Storm Hermine. The U.S. Geological Survey, in cooperation with the Upper Brushy Creek Water Control and Improvement District, determined rainfall amounts and annual exceedance probabilities for rainfall resulting in flooding in Bell, Williamson, and Travis counties in central Texas during September 2010. We documented peak streamflows and the annual exceedance probabilities for peak streamflows recorded at several streamflow-gaging stations in the study area. The 24-hour rainfall total exceeded 12 inches at some locations, with one report of 14.57 inches at Lake Georgetown. Rainfall probabilities were estimated using previously published depth-duration frequency maps for Texas. At 4 sites in Williamson County, the 24-hour rainfall had an annual exceedance probability of 0.002. Streamflow measurement data and flood-peak data from U.S. Geological Survey surface-water monitoring stations (streamflow and reservoir gaging stations) are presented, along with a comparison of September 2010 flood peaks to previous known maximums in the periods of record. Annual exceedance probabilities for peak streamflow were computed for 20 streamflow-gaging stations based on an analysis of streamflow-gaging station records. The annual exceedance probability was 0.03 for the September 2010 peak streamflow at the Geological Survey’s streamflow-gaging stations 08104700 North Fork San Gabriel River near Georgetown, Texas, and 08154700 Bull Creek at Loop 360 near Austin, Texas. The annual exceedance probability was 0.02 for the peak streamflow for Geological Survey´s streamflow-gaging station 08104500 Little River near Little River, Texas. The lack of similarity in the annual exceedance probabilities computed for precipitation and streamflow might be attributed to the small areal extent of the heaviest rainfall over these and the other gaged watersheds. Citation: Winters KE. 2012. Floods in Central Texas, September 7–14, 2010. Texas Water Journal. 3(1):14-25. Available from: https://doi.org/10.21423/twj.v3i1.3292.

Suggested citation:Wehmeyer, L.L., Winters, K.E., and Ockerman, D.J., 2013, A preliminary assessment of streamflow gains and losses for selected stream reaches in the lower Guadalupe River Basin, Texas, 2010-12: U.S. Geological Survey Scientific Investigations Report 2013-5209, 30 p., http://dx.doi.org/10.3133/20135209. For more information on the USGS-the Federal source for science about the Earth, its natural and living resources, natural hazards, and the environment, visit http://www.usgs.gov or call 1-888-ASK-USGS.For an overview of USGS information products, including maps, imagery, and publications, visit http://www.usgs.gov/pubprodTo order this and other USGS information products, visit http://store.usgs.gov Any use of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the U.S. Government.Although this information product, for the most part, is in the public domain, it also may contain copyrighted materials as noted in the text. Permission to reproduce copyrighted items must be secured from the copyright owner. AbstractThe U.S.