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EM@3AM: Amniotic Fluid Embolism

EMDocs

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. She had a precipitous delivery while the ambulance was pulling in. We’ll keep it short, while you keep that EM brain sharp. The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. RR 28, SpO2 89% on 6L NC.

EMS 111
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Penetrating chest trauma

Don't Forget the Bubbles

Grabbing a pristine white table napkin to apply pressure to the wound, Ranulf’s class teacher and expedition leader called the ambulance as chaos descended on the restaurant. Tarquin screamed and pulled the knife straight back out, but blood started to spurt from the decent-sized incision he had accidentally made. The trauma call goes out.

E-9-1-1 139
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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

Ali, a 12-year-old male, is pre-alerted by ambulance to ED. The pre-alert from the ambulance states his GCS is 12 (E3V4M5), moving all 4 limbs with an obvious large haematoma to the back of his head. Trauma is the most significant contributor to childhood mortality, with the mechanism changing with maturity and social development.

E-9-1-1 59