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The Third Law Of Trauma

The Trauma Pro

They occasionally crash when we think everything is going so well. Like go to CT, do some more stuff in the ED because that BP cuff just has to be wrong, or call interventional radiology and wait for 45 minutes. And the only place with the proper tools to do that is an operating room. But sometimes it’s for the worse.

Radiology 201
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Updated: How To Detect Bucket Handle Injuries With CT

The Trauma Pro

But without a more convincing exam, it is difficult to convince yourself to operate immediately on these patients. With newer scanners, radiologists are better able to detect subtle areas of hypoperfusion as well. If the exam worsens, operate. Radiology 265(3):678–693, 2012. PMID: 35830194; PMCID: PMC9280606.

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Preperitoneal Packing Vs Angioembolization: Part 1

The Trauma Pro

Unfortunately, it’s generally not feasible to operatively fix the pelvis acutely, and external fixation has limited impact on ongoing hemorrhage. If the patient can be stabilized to some degree, interventional radiology can be very helpful. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures 147
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How Good is Ultrasound at Diagnosing PTA?

RebelEM

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage.

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ToxCard: Iron

EMDocs

5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Radiology in the management of acute iron poisoning. 9 Typical dose: Polyethylene glycol (Go-Lytely ) 25 mL/kg/hr in small children and 1.5-2 2 L/hr in adults. doi: 10.1097/PEC.0b013e3182302604.

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The Electronic Trauma Flow Sheet: What Does(n’t) Work – Part 1

The Trauma Pro

This stream of information continues after the patient leaves the trauma bay for CT, imaging, interventional radiology, operating room, ICU, or floor bed. During chart reviews, I have seen numerous examples of fluids, vital signs, and drug administration recorded well after the patient has been declared dead!

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emDOCs Revamp: Esophageal Perforation

EMDocs

ECG – May show tachycardia or rate related ST depressions Laboratory evaluation: CBC w/ differential – may reveal leukocytosis with left shift CMP, Lipase – can reveal alternative intra-abdominal diagnoses as well as show findings of end-organ hypoperfusion (elevated serum creatinine, transaminitis, etc.)