trauma emergency medicine

Best Case Ever 62 Penetrating Upper Airway Injury Awake Intubation Do’s & Don’ts

If you were faced with stab wound to the neck and had to act fast, would you have a well-thought out plan that you are comfortable with? In this EM Cases Best Case Ever podcast we discuss the do's and don'ts of penetrating upper airway injury awake intubation with airway expert George Kovacs....

Episode 100 Disaster Medicine

As ED docs we’re particularly well suited to take a lead in disaster medicine. We own this. In this EM Cases podcast, with the help of Laurie Mazurik, Daniel Kollek and Joshua Bezanson we will help you become familiar with a general approach to mass casualties, how to handle critical infrastructure disruption in your ED, management of biohazards including airway management, chemical hazards including decontamination and finally evacuation principles in the case of a natural disaster...

Best Case Ever 60 What we can learn from Prehospital Trauma Management

In this EM Cases podcast Dr. Joel Lockwood tells his Best Case Ever of a prehospital trauma resuscitation, bringing to light the challenges faced by EMS with the complicated trauma patient. He discusses the importance of checklists, practice and simulation to help streamline the process, offloading some cognitive burden, prepare the team, reduce the change of errors, improve efficiency and etch actions into each team member's muscle memory.

Episode 95 Pediatric Trauma

Management of the pediatric trauma patient is challenging regardless of where you work. In this EM Cases episode, with the help of two leading pediatric trauma experts, Dr. Sue Beno from Hospital for Sick Children in Toronto and Dr. Faud Alnaji from Children's Hospital of Eastern Ontario in Ottawa we answer such questions as: what are the most important physiologic and anatomic differences between children and adults that are key to managing the trauma patient? How much fluid should be given prior to blood products? What is the role of POCUS in abdominal trauma? Which patients require abdominal CT? How do you clear the pediatric c-spine? Are atropine and fentanyl recommended as pre-induction agents in the pediatric trauma patient? How can the BIG score help us prognosticate? Is tranexamic acid recommended in early pediatric trauma like it is in adults? Is the Pediatric Trauma Score helpful in deciding which patients should be transferred to a trauma center? and many more...

Best Case Ever 55 Pediatric Cerebral Herniation

In anticipation of the upcoming EM Cases main episode on Pediatric Polytrauma Dr. Suzanne Beno, Co-director of the Trauma Program at the Hospital for Sick Children in Toronto, tells her Best Case Ever of a child who suffers a severe traumatic head injury with signs of raised intracranial pressure and cerebral herniation. She discusses the importance of being vigilant when presented with classic patterns of injury, the use of hypertonic saline, crisis resource management and shared decision making with consultants...

Episode 91 Occult Knee Injuries Pearls and Pitfalls

There are a whole slew of very important occult knee injuries - those that have a normal or near normal x-ray – that can cause serious morbidity if you miss them, and for the catchall soft tissue injuries there are some subtleties in diagnosis and management that will make a real difference to our patients. Arun Sayal and Hossein Mehdian answer questions such as: When should we suspect a spontaneously reduced knee dislocation? Do all patients suspected of a spontaneous knee dislocation require a CT angiogram to rule out vascular injury? Which patients with a low energy mechanism are at risk for knee dislocation and vascular complications? How can you increase the accuracy of the active straight leg raise in assessing for quadriceps and patella tendon rupture? What is an easy way to identify patella baja and patella alta on a knee x-ray? What are the indications for ultrasound of the knee? What are the true indications for a knee immobilizer and how can knee immobilizers kill our patients? and many more...

Best Case Ever 54 Missed Fracture and Apologizing to Patients

In anticipation of EM Cases Episode 91 Knee Injuries Pearls and Pitfalls Dr. Arun Sayal, creator of the CASTED course, tells his Best Case Ever concerning missed fractures and apologizing to patients. Dr. Sayal reminds us of two basic concepts that are all too often skipped over in our assessment of minor injuries and the effect of apologizing to the patient when you've missed a fracture...

By | 2017-01-17T10:35:54+00:00 January 17th, 2017|Categories: Best Case Ever, EM Cases, Medical Specialty, Trauma|Tags: , , |0 Comments

Episode 83 – 5 Critical Care Controversies from SMACC Dublin

EM Cases Episode 83 - 5 Critical Care Controversies from SMACC Dublin: I had the great opportunity to gather some of the brightest minds in Emergency Medicine and Critical Care from around the world (Mark Forrest from U.K., Chris Nickson from Australia, Chris Hicks from Canada and Scott Weingart from U.S.) at the SMACC Dublin Conference and ask them about 5 Critical Care Controversies and concepts: How to best prepare your team for a resuscitation Optimum fluid management in sepsis Direct vs. video laryngoscopy as first line tool for endotracheal intubation Early vs. late trauma intubation Whether or not to attempt a thoracotomy in non-trauma centres The discussion that ensued was enlightening...

CritCases 3 – GSW to the Chest

EM Cases CritCases 3 - GSW to the chest in a rural setting. In this CritCases we discuss preparation for penetrating trauma in a rural setting, the ABC score, massive transfusion protocol, clamshell thoracotomy, trauma intubation and more. The Case... You are the transport physician on call. A 50-year old male with a history of depression allegedly shot himself in the chest with a rifle. A bystander called 911. The local paramedics are en route and the air transport team is activated with a plan to rendezvous at the nearest hospital, Janus General, which is 90 minutes by ground from the nearest tertiary care centre. You contact the rural hospital for a status update but all they can tell you is that his GCS is 14 and he has a GSW to the central chest.

BEEM Cases 1 – Pediatric Minor Head Injury

Dr. Andrew Worster and the BEEM (Best Evidence in Emergency  Medicine) group from McMaster University has teamed up with EM Cases, Justin Morgenstern (@First10EM) and Rory Spiegel (@EMNerd_) to bring you a blog that blends the BEEM critical appraisals in a case-based, interactive, practice-changing format. In each post we choose the most important literature on a given topic and run through a case, learning how to apply evidence based medicine to our practice. Welcome to BEEM Cases! And here's BEEM Cases 1 - Pediatric Minor Head Injury...    Written by Justin Morgenstern (@First10EM), edited by Anton Helman (@EMCases), adapted from the BEEM Course, Jan 2016   Pediatric Minor Head Injury - Decision Rules, Isolated LOC & Strict Rest The Case... With seconds left in the game, Melissa, an 11 year old girl, drives hard to the basket for a layup. She gets knocked to the ground, and doesn’t see the winning shot pass through the net, because it appeared as though she briefly lost consciousness. She quickly gets back up and celebrates with her friends, but after the celebrations, her parents bring her to your community emergency department to get checked. You confirm that she [...]