Trauma Archives - The Emergency Medical Minute

Trauma

Podcast 809: Achilles Tendon Rupture

Contributor: Aaron Lessen, MD Educational Pearls: Achilles tendon rupture usually presents in younger, healthy patients after a sports injury Patients typically present complaining of an abrupt onset ankle pain after feeling a “pop” Pain can be localized to posterior ankle and patient’s lack the ability to plantarflex Achilles rupture is a clinical diagnosis and does…

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Podcast 807: Ring Removal Tricks

Contributor: Jared Scott, MD Educational Pearls: If a patient is in significant pain, a digital block can be helpful. Pain management alone may allow for manual ring removal.  Ring cutters and trauma shears with specialized ring cutters can be attempted but will destroy the ring and some materials may be resistant to cutting.  2 alternative…

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Beating the Odds, Twice

A Shocking Adverse Effect Chief Complaint: Defibrillator shock HPI: 50-year-old biologic male who identifies as a female presented after reportedly being shocked by her defibrillator 5 times before calling EMS, EMS noted that they witnessed 1 shock. They also noted that blood pressure was in the low 100s and heart rate was between 200-260 before…

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Podcast 798: Digit Reimplantation

Contributor: Aaron Lessen, MD Educational Pearls: Multiple factors affect if a digit can be reattached including: location of digit injury, mechanism of injury, duration since injury, preservation mechanism.  Recommended preservation is via indirect cooling. This is accomplished by wrapping the amputated digit piece in saline soaked gauze, placing the wrapped piece in a waterproof bag…

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Podcast 786: Smiling Death

Contributor: Nick Hatch, MD Educational Pearls: “Smiling Death” describes the prehospital phenomenon of a person who is happy to be extricated from an extended period of crush injury, but dies suddenly soon after the rescue.   Smiling Death is caused by Crush Syndrome. Crush Syndrome begins when large areas of tissue are damaged by compression and…

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Podcast 779: Pulse Pressure in Trauma

Contributor: Aaron Lessen, MD Educational Pearls: Pulse pressure is the difference between the systolic and diastolic blood pressure, normal is about 40 A narrow pulse pressure is generally thought of as less than 30 mmHg which may signal peripheral vasoconstriction in response to lower blood volumes 2020 study examined hypotension and narrow pulse pressure in…

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Podcast 746: Elderly Head Trauma on Anticoagulation

Contributor: Aaron Lessen, MD Educational Pearls: Biggest study to date examined new protocol for repeat head CT in anticoagulated elderly patients with head trauma and an initial negative head CT 0.5%-6% of patients in this category will get a delayed ICH and this can occur up to a week out from initial injury 18% of…

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High Stakes

high stakes Chief Complaint: Chest pain and shortness of breath HPI 37-year-old male reports about 36 hours ago he was on a bicycle riding approximately 20 miles an hour when he went over the handlebars and impaled his left shoulder with a tent pole that was planted into the ground. At that time, it went…

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Podcast 737: TBI Outcomes

Contributor: Aaron Lessen, MD Educational Pearls: Study evaluating patient outcomes after traumatic brain injury (TBI) over 1 year Trial followed patients with severe TBI (GCS 3-8) and moderate TBI (GCS 9-12) At 1 year out ½ of the severe TBI group were able to be independent for at least 8 hours per day; ⅔ were…

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Podcast 692: Pelvic Fractures

Contributor: Peter Bakes, MD Educational Pearls: Pelvis is comprised of the iliac, ischium, and sacrum Three mechanisms for pelvic fractures by Young-Burgess Classification Anterior-posterior compression causing open-book pelvic fractures that can be complicated by retroperitoneal bleeding or urethral injury Lateral compression causing rami fractures Vertical sheer causing offset of sacroiliac joint or sacrum Mechanically stable…

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