article thumbnail

Ep 164 Cardiogenic Shock Simplified

Emergency Medicine Cases

What are the best strategies to efficiently get the patient in cardiogenic shock to definitive care, whether that be the cath lab or the operating room? How can we best pick up occult cardiogenic shock before it floured shock kicks in? Which patients with acute heart are safe to send home in general?

article thumbnail

EM@3AM: Retroperitoneal Hematoma

EMDocs

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 74
professionals

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Episode 35: When to operate in trauma with Dennis Kim

Critical Care Scenarios

Takeaway lessons * Trauma patients who are hypotensive or otherwise unstable should be assumed to be bleeding, bleeding, bleeding until proven otherwise, and should have a very low threshold to proceed directly to the operating room for exploration.* pneumatically), then definitively addressed by Orthopedics at their convenience.

article thumbnail

Case Report: EMS Says Flail Chest, But Is It?

ACEP Now

The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). On hospital day 2, he was taken to the operating room for surgical rib fixation.

EMS 52
article thumbnail

EZ-IO® Emergency Burr Hole for Epidural Hematoma

Handtevy

The standard care in North America for post-traumatic EDH involves decompressive craniotomy or trepanation via a burr hole, typically performed in an operating room by neurosurgery teams. 2) The EZ-IO® device may be a temporizing and lifesaving intervention until definitive neurosurgical care can be obtained.

article thumbnail

Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

Figure 1: The Young-Burgess classification of pelvic ring fractures (source: [link] 3 It is paramount to differentiate the definitions of “hemodynamically unstable” and “mechanically unstable” pelvic fractures. For a broader overview of pelvic trauma, please review Dr. Lupez’s 2017 article here: [link].

ED 54
article thumbnail

SGEM#205: Twist & Shout – Testicular Torsion

The Skeptics' Guide to EM

Might his examination be enough to convince the urologists to take him straight to the operating room without a preceding diagnostic ultrasound? Ultrasound imaging of the scrotum is the gold standard for diagnosis of testicular torsion, however can lead to delays in definitive care.