Evidence-based articles on management of trauma in the emergency department
Dr. Reisman presents today’s Morning Report! What is the evidence for pre-hospital spinal immobilization of trauma patients? Routine spinal immobilization in trauma patients: What are the advantages and disadvantages? S. Abram, C. Bulstrode The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 1 August Read more…
We recently had a case of pediatric GU injury after blunt trauma. This inspired me to write a piece on GU injuries. Enjoy! Most GU injuries are a result of blunt trauma. Up to 10% of patients in the ED with abdominal trauma will have GU injuries. They are Read more…
Recently, I reviewed a pediatric spinal trauma case. The recommendation for steroids was the most controversial part of the case. One service recommended it, another didn’t. One service from another hospital where the patient was to be transferred recommended it, but another service at the same hospital adamantly was opposed Read more…
“Life is tough enough without having someone kick you from the inside.”—Rita Rudner Thankfully, these teeny kicks don’t cause trauma!! Critical illness, including trauma, actually affects less than 1% of all pregnancies in the US. However, this patient population can be exceedingly complicated due to the plethora of physiologic alterations Read more…
ED thoracotomies were introduced into medicine circa 1900, with endless debate and controversy to follow. It’s a procedure that no doubt can save a patient’s life, as without this “last ditch” effort, mortality would be 100% in a trauma patient left in cardiac arrest. Survival outcomes have been quoted anywhere Read more…
We’re always talking about reducing health care costs. One of the ways major ways to reduce costs is to stop ordering unnecessary tests. Let’s talk about CT scans for a minute. CT scans can cost anywhere from $300-1500 per scan of the body part for your patient, with CT head Read more…
(A Review on Chest Tubes in the Trauma Patient ) Indications for Chest Tube Placement in Trauma Patients Pneumothorax (simple, tension) Hemothorax Esophageal rupture with gastric leak into pleural space Traumatic arrest (bilateral chest tubes) Quick Caveat: Detecting a traumatic pneumothorax in blunt chest trauma: Ultrasound vs Supine AP CXR- ULTRASOUND Read more…
E-FAST. What do the letters stand for? Extended Focused Assessment with Sonography for Trauma (as opposed to FAST- Focused Assessment with Sonography for Trauma) How is E-FAST different than the FAST? There are 4 anatomical spaces examined in the FAST: Hepatorenal space (Morison’s Pouch), Splenorenal space, Rectovesicular space (Pouch of Read more…
Pelvic fracture + Hemodynamic Instability = YIKES…read below. Hemodynamically unstable pelvic fractures have mortality rates upwards of 45-50%. Death in the first 24 hours is generally from acute blood loss. These injuries need to be taken seriously; immediate and urgent resuscitation and stabilization is warranted. The main points in managing Read more…
Its time for our next installment of Trauma Drama. I think its time to get into discrete injuries. The first one I want to talk about is blunt neck trauma. The reason I chose this one is that penetrating neck trauma gets all of the attention and gets people excited. Read more…