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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?

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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 73
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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.

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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
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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.

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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.

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How To Manage Tracheo-Innominate Fistula

ACEP Now

Tracheo-innominate fistula (TIF) is an unusual and frequently lethal complication of such definitive airway placement. 15 Definitive Treatment Definitive treatment of TIF has traditionally involved median sternotomy and ligation of the innominate artery. He has had a tracheostomy for approximately 15 months since his injury.

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