Penetrating injuries of the lung come in two flavors: gunshot and stab. However, the end result for both is the same. They leak. And the leak is either air or blood. Having lower kinetic injury, stab wounds tend not to leak as much. Gunshots, on the other hand, can travel... Read more
Published on: 2020-10-26
Over the years, I’ve commented several times on the “myth” of NSAIDs causing problems with fracture healing. I still hear occasional comments from my orthopedic colleagues cautioning against the use of these drugs in patients who have had fracture repairs. But is it true?  In 2003, several papers brought to light... Read more
Published on: 2020-10-23
The focus of this post is going to be a little different. I’ll be coming up out of the trenches of clinical care, and focusing on trauma systems for a bit. Specifically, I’m going to look at the density of high-level trauma centers in bigger cities. For my non-US readers,... Read more
Published on: 2020-10-21
Intraosseous lines (IO) make life easy. They are quicker to insert, have a higher success rate, and require less experience than a standard IV. And they can be used for pretty much any solution or drug that can be given through an IV. But there are some limitations. They can’t... Read more
Published on: 2020-10-13
This issue is devoted to one of the most undervalued aspects of maintaining your health and career: sleep. This issue covers the basics of sleep, how it impacts trauma professionals, and what to do about sleep problems. Topics covered include: Facts On Fatigue And Sleep Loss Impact on EMS Providers... Read more
Published on: 2020-10-08
Current events are making this classic post even more poignant! The VIP syndrome occurs in healthcare when a celebrity or other well-connected “important” person receives a level of care that the average person does not. This situation was first documented in a paper published in the 1960s which noted that VIP... Read more
Published on: 2020-10-05
Solid organ injury is one of the more common manifestations of blunt abdominal trauma. Most trauma centers have some sort of practice guideline for managing these injuries. Frequently, interventional radiology (IR) and angioembolization (AE) are part of this algorithm, especially when active bleeding is noted on CT scan. So it... Read more
Published on: 2020-09-30
Published on: 2020-09-28
The next issue of Trauma MedEd will be sent out to subscribers this week, and will provide some interesting information on fatigue and sleep loss. Most trauma professionals have at least a little experience with this topic. You may one who provides care on call at night, or work a... Read more
Published on: 2020-09-28
A bucket-handle injury is a relatively uncommon complication of blunt trauma to the abdomen. It only occurs in a few percent of patients, but is much more likely if they have a seat belt sign.  The basic pathology is that the bowel mesentery (small bowel of sigmoid colon) gets pulled... Read more
Published on: 2020-09-25
Trauma professionals are always on the lookout for injuries that can kill you. Thoracic aortic injury from blunt trauma is one of those injuries. Thankfully, it is uncommon, but it can certainly be deadly. One of the screening tests used to detect aortic injury is the old-fashioned chest xray. This... Read more
Published on: 2020-09-23
I love challenging dogma. I spoke last week (virtually) at an excellent event at the Intermountain Medical Center in Utah. One of my talks there addressed trauma myths and dogma. I bring this up because there is an interesting article in the Journal of Trauma this month that questions the... Read more
Published on: 2020-09-21
When is the last time this has happened to you? You are called to the ED for a trauma activation. The patient was involved in a motorcycle crash and is doing fine, but he has a large midline scar on his abdomen. You inquire as to what it is. He... Read more
Published on: 2020-09-14
Okay, so this abstract is a bit more on the touchy-feely side. But it is extremely important because it speaks to the balancing act we all have to perform in order to achieve a satisfying harmony between work and everything else. Older generations of surgeons threw nearly all of their... Read more
Published on: 2020-09-10
The management of blunt spleen injury has evolved significant over the time I’ve been in practice. Initially, the usual formula was: Spleen injury = splenectomy This began to change in the late 1980’s, and beginning in the early 90’s nonoperative management became the rage. We spent the next 10-15 years... Read more
Published on: 2020-09-09