Category: Trauma and Environmental

Gunshot Wounds

When most people think about trauma, they think about gunshot wounds. However, not all gunshots come in as a multi system trauma alert. Not all patients have been shot in the chest or belly and need to be rushed to the OR. Much more commonly, we are dealing with gunshot wounds to the extremities. In this episode, we will cover the basic approach to the extremity gunshot wound.

Marathon Medicine

One of the best events you can volunteer for as a medical student is your local marathon. You learn about musculoskeletal injuries, heat injuries, electrolyte emergencies, as well as prepare yourself for the occasional seizure, cardiac arrest, and case of anaphylaxis. You learn procedures like starting IVs, obtaining vitals, and basic wound care. It really is a great place to learn the basics of Emergency Medicine. In this episode, we will discuss marathon related emergencies.

Laceration Evaluation

Laceration Repair is one of your core 3 procedures and is critical to master if you want to get a good SLOE. You have to very carefully consider if the wound should even be repaired at all! Otherwise it might get infected and the patient will have a bad outcome. However, if your presentation is strong, they will let you repair the wound, which will get you great scores on your SLOE.

Abdominal Trauma

Abdominal trauma is probably the most difficult and most subjective type of trauma that you can evaluate. There is no perfect decision criteria that you can use. There is no perfect test. It all comes down to some magical combination of clinical gestalt and objective findings. Sure, we can usually tell when the patient needs to go straight to the OR, and we do have some great tools such as bedside ultrasound. However, none of these work 100% of the time. That is why I always consider three things when thinking through these cases. Mechanism, Exam, and Imaging.

Cardiac Trauma

This week we are continuing our trauma series and talking about cardiac injury. There are 3 big diagnoses in this section that we will cover: cardiac tamponade, aortic dissection, and blunt cardiac injury. All 3 can kill your patient, and all 3 are easy to evaluate for if you know what to look for. We will cover all of these as well as several common pimp questions in this episode.

Thoracic Trauma

Injuries to the chest are one of the most common, most life-threatening, and most important injuries that occur during severe trauma. In this episode we will cover injuries to the lungs with a specific focus on the 3 life threatening diagnoses that must be considered during every case: tension pneumothorax, open pneumothorax, and hemothorax.

Neck Trauma

Today we will be covering neck injury. Specifically, we will cover soft tissue injury of the neck. It can be divided into blunt and penetrating trauma. And because this is where the blood vessels are located, the test of choice for these injuries will be a CT angiogram. We’ll discuss the indications for CTA, when to go straight to the OR, as well as a few other pearls during this week’s episode.

C-Spine Trauma

This episode will overview cervical spine injuries in trauma. First you put the collar on, then you take it off. The tricky part is learning WHEN to take the collar off. You have two options. Option 1 is to use a decision rule called the NEXUS criteria. Option 2 is to get a CT of the cervical spine and then “clear the collar” when the picture returns. Otherwise, the collar stays on until the patient can get follow up with a spine specialist.

Head Trauma

Over the next several weeks we are going to be doing a series of episodes on trauma. Starting today with head trauma. There are lots of critical diagnoses that you cannot miss with head injuries, and you need to order a CT head without contrast if you suspect any of them. One way to help you decided whether to order a CT is by using the Canadian Head CT Rule. We will cover all of this and more in today’s episode.

Trauma Basics

Trauma is easily the most interesting topic in all of emergency medicine. We might not see it quite as much as chest pain and abdominal pain, but trauma is certainly one of the top 10 things you will see most commonly on your clerkship. Today I am going to give you an overview of a course called ATLS- Advanced Trauma Life Support. It is the national standard of care for treating trauma. It’s very easy to understand, just remember your A-B-C-D-Es (Primary Survey) and don’t forget to do a thorough Secondary Survey.

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