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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

Patients may arrive with other concomitant injuries such as head or spine injuries and may be critically ill. Imaging CT scan of the abdomen and pelvis with IV contrast or CT angiogram of the abdomen is the imaging modality of choice. Majority of RPH will stabilize on their own and not require intervention. Mortality can varies between 5-20%.

EMS 74
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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.* Operative prep for exploratory laparotomy is usually from the chin to the knees.

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

ACEP Now

His vital signs were within normal limits except for a respiratory rate of 23 with a room air pulse oxygen in the upper 90s. 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).

EMS 52
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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. Introduction The pelvic ring is made up of the bony ilium, ischium, pubis, and sacrum, which are held together with ligaments.

ED 54
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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.