Trauma

Podcast #61: Permissive Hypotension

Run Time: 5 minutes Author: Dr. Martin O’Bryan Educational Pearls: Although ATLS indicates that you should be providing fluids and blood to hypotensive trauma patients to increase blood pressure, the patient has a higher risk of mortality with higher blood pressure. The increase in mortality is due to the dilution of the blood and the…

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Podcast #47: Broken Penis

Run Time: 2 minutes Author: Dr. Erik Verzemnieks Educational Pearls: During an erection the corpus cavanosum fills with blood, when enough stress is placed on the penis during an erection the surrounding tissue can rupture. A broken penis most often occurs during intercourse in the “reverse cowgirl” position. This condition requires surgical repair of the…

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Podcast #43: Dental Injuries

Run Time: 7 minutes Author: Dr. Eric Miller Educational Pearls: There are three types of dental fractures or Ellis fractures. Ellis I is through the enamel, Ellis II is into the dentin, and Ellis III is into the nerve pulp of the tooth. For fractures, any bleeding should be controlled and the tooth should be completely…

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Podcast #37: Aortic Rupture

Run Time: 4 minutes Author: Dr. Jared Scott Educational Pearls: The number first most common reason for sudden death after a motor vehicle accident is head injury, the second is traumatic aortic rupture. Due to the increased pressure of blood in the aorta, a rupture leads to rapid exsanguination. The most common location for a traumatic aortic…

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Podcast #34: Hard Signs for Vascular Injury

Run Time: 1 minute Author: Dr. Nicholas Hatch Educational Pearls: Hard signs of vascular injury include: loss of pulses, severe arterial bleeding, active uncontrolled hemorrhaging, rapidly expanding pulsatile hematoma, and palpable thrill or bruit. Patient with these signs and suspected injury needs to be moved to the operating room ASAP. Soft signs of vascular injury include:…

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Podcast #29: Management of Stingray Injuries

Run Time: 3 minutes Author: Dr. Eric Miller Educational Pearls: Do not urinate on the stingray envenomation site – does not work for jellyfish either. First, wash the wound thoroughly with warm, not hot, water to denature the proteins in the venom. Second, care for the penetration wound and explore for a foreign body with…

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Podcast #20: REBOA

Run Time: 1 minute Author: Dr. John Winkler Educational Pearls: REBOA stands for Resuscitative Endovascular Balloon Occlusion of the Aorta. The balloon is often placed via femoral artery and placed in the aorta at the level of the heart to increase perfusion to the brain in trauma. Significantly less invasive than a thoracotomy and has less…

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Podcast #12: TXA in the ED

Run Time: 3 minutes Author: Dr. Nicholas Hatch Educational Pearls: TXA is short for tranexamic acid. Most often use in the ED is with severe bleeding or problematic bleeding associated with trauma. Crash II trial determined the benefit of TXA is only applicable for about three hours after a trauma. Typical dosing is 1 gram in…

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Podcast #6: Trauma in Pregnancy/Perimortem C-section

Run Time: 15 minutes Author: Dr. Donald Stader Educational Pearls: Trauma ABCs change in pregnancy. A: Progesterone dilates to blood vessels in the nose and the back of the throat changing the airway in pregnant women, causes intubation to be more difficult because of increased redundant tissue. B: Pregnant women desaturate very quickly because of metabolic…

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