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Cardiac tamponade. Aortic Dissection. Blunt cardiac injury. Cardiac Tamponade Blood fills pericardial sac Increasing pressure on myocardium -> Decreased preload Decreased preload -> Hypotension -> Death Clinical exam shows Beck’s Triad Hypotension Muffled heart sounds Jugular venous distension (JVD) Diagnosed during FAST exam (subxiphoid view) Treat with pericardiocentesis Bedside thoracotomy if patient loses pulse Aortic […]

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Step 1: Perform ATLS Primary Survey (B- Breathing) Signs of respiratory distress/injury Shortness of breath Hypoxemia Tracheal deviation Diminished breath sounds Step 2: Consider Performing Bedside Tube Thoracostomy Insert at 5th intercostal space just anterior to mid-axillary line Step 3: Imaging Start with portable bedside chest x-ray Pneumothorax can also be diagnosed by thoracic ultrasound […]

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The hardest question… Should you get a CTA? Blunt Trauma of Neck Obtain CTA if… Patient has neurologic deficit Numbness Weakness Visual changes Patient sustained forceful impact to the neck Patient has fracture Basilar skull Facial bones Cervical spine Penetrating Trauma of the Neck Go to OR if patient is unstable Go to OR if […]

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Step 1: Protect the Spine Apply cervical collar Step 2: Apply NEXUS Criteria Use the “SPINE” mnemonic Spinal midline tenderness Painful distracting injury Intoxication Neurologic deficit Encephalopathy Step 3: If Patient Has None of the NEXUS Criteria… You Are Done! Step 4: If Patient Has Positive NEXUS Criteria… Obtain CT scan of the cervical scan […]