Diagnose on Sight: Shortness of Breath

shortness of breathCase: 55-year-old restrained driver is reporting severe shortness of breath and right sided chest pain after a high-speed motor vehicle collision. Her respiratory rate is 26 breaths/min and her oxygen saturation is 96% on a 15-liter non-rebreather. She has decreased breath sounds on the right, epigastric tenderness, and an abdominal seatbelt sign. What is the diagnosis?

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By |2016-12-22T19:21:45-08:00Jan 18, 2016|Diagnose on Sight, Trauma|

AIR-Pro Series: Trauma (2015)

Below we have listed our selection of the 6 highest quality blog posts related to 4 advanced level questions on trauma topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions:

  1. When to give tranexamic acid in the trauma patient
  2. The pregnant trauma patient
  3. Transfusions in the trauma patient
  4. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

In this module, we have 6 AIR-Pro’s and we did not include any honorable mentions to prevent redundancy of the topics covered. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net.

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Trick of the Trade: Dermal Avulsion Injuries 2.0

Take a shortened, piece of rubber tourniquet and encircle the finger, then clamp it with a needle driver.This year I published a Novel, Simple Method for Achieving Hemostasis of Fingertip Dermal Avulsion Injuries in the Journal of Emergency Medicine 1  a technique I’ve used in my local ED for several years. In brief, this involves achieving hemostasis over a fingertip skin avulsion by using a tourniquet followed by tissue adhesive glue. After bringing the technique to press and sharing this video, I’ve received great tips from peers and subsequently refined it with some additional ideas.  Thus I present for the first time on ALiEM: Dermal Avulsion Injuries 2.0.

 

 

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NEXUS Chest CT Decision Instruments in Blunt Trauma

ct_cat_scanner_angled_400_wht_5332One of the five 2014 American College of Surgeons’ Choosing Wisely recommendations is to avoid routing whole-body CT imaging of trauma patents, also known as the ‘pan-CT’. Until now, no validated decision instrument existed to help guide clinicians decide whether to obtain a chest CT in the setting of blunt trauma. This month, Dr. Robert Rodriguez and the multi-institutional NEXUS Chest CT research team published a paper describing the derivation and validation of 2 decision instruments in PLOS Medicine [1].

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By |2019-01-28T21:43:56-08:00Oct 13, 2015|Radiology, Trauma|

60-Second Soapbox: New podcast series featuring Drs. Lin, Riddell, Shaikh

aliem_soapboxWe are excited to announce our new podcast series, 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 whole minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. Don’t worry if your are microphone-shy. We will carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!

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Rib Fractures in Older Adults – What’s the Big Deal?

Fall Risk Bracelet And Wooden CaneBlunt chest trauma from falls or motor vehicle collisions are a common reason for ED visits and a common source of rib fractures. While many patients with rib fractures can be discharged home with oral analgesics and an incentive spirometer, certain patients are at much higher risk for morbidity and mortality. This post will look at which patients are at risk, what factors predict increased mortality, and inpatient interventions that can reduce mortality, with a focus on the risks in older adults.

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By |2016-11-11T19:37:08-08:00Jun 3, 2015|Geriatrics, Trauma|

A cost-effective, two-layer wound closure task trainer

Buried SuturePerforming a two layer wound closure can be a challenging procedure in the Emergency Department for clinicians with limited wound care experience. Challenges include suture choice, suture placement, and the technique of burying the knot in the deep layer of the wound, and the availability of ready ‘volunteers’ with complex wounds willing to let novices practice on them. Commercially available suture models are expensive, and can be cumbersome to store, and difficult to obtain in a timely manner to provide the learner with opportunities to practice prior to wound repair on a patient in the department.

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