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…
ED Critical Care Conference: Sept 2013 The Curious Case of AMS with an (initially) Normal CT Head presented by Dr. Andy Grock Case: 24 yo M, no pmhx presents AMS s/p assault. MRI shows Diffuse Axonal Injury. TBI Discussion Severity by GCS Mild >13 Moderate >9 and <12 Severe <8 Read more…
Here’s Dr. Youn with today’s Morning Report! Lateral Canthotomy/Cantholysis Emergent concern: retinal ischemia, optic nerve compression Indications: Acute orbital compartment syndrome – usually 2/2 traumatic retrobulbar hemorrhage Decreased visual acuity IOP > 40 mmHg (normal range: 10-20) Proptosis APD Contraindication: Globe rupture (teardrop pupil, positive Seidel Read more…
Today’s Morning Report is courtesy of Dr. Melton! Case: A 53 YOM BIBEMS in cervical spine precautions after being rear-ended in a motor vehicle collision. He complains of mild lateral neck pain from the seatbelt and tingling in his right arm, no midline tenderness, exam also remarkable for ecchymosis over Read more…
First Morning Report of the new academic year is presented by Dr. Aluisio! Tranexamic Acid (TXA) What: Synthetic amino acid derivative of lysine that inhibits fibrinolysis by competitively inhibiting plasminogen (a TPI that prevents fibrin degradation). How: 1000 mg in 100cc NS over 10 minutes followed by Read more…
Thanks to Dr. Desmond for today’s Morning Report! Pediatric Thoracic Trauma Thoracic trauma in children is relatively uncommon. Usually from high force injuries such as falls or motor vehicle accidents (75%) and is usually blunt. When in isolation, mortality rate is low, however it TRIPLES when accompanied by head Read more…
Thanks to Dr. McMillan for today’s Morning Report! Here’s the case: Female passenger of MVC presents with abdominal pain. Home pregnancy test just positive. Trauma in Pregnancy: Both blunt and penetrating a significant cause of maternal injury. Maternal Physiologic Changes Plasma volume increase (normal hematocrit of 31-35% 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…
Here’s Dr. Kazzi with today’s Morning Report! Blunt Cardiac Injury Right heart most common site of BCI. MVCs and sports injuries are most common. Types of Injury: a) Myocardial contusion b) Chamber rupture (if free wall do not make it to ED, but other VSD / ASD may 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…