Scribd
Upload
34 views2 pages

Pearls Trauma

This document provides pearls on traumatic disorders including that trauma is the number one cause of death ages 1-44, orotracheal intubation is preferred even with suspected c-spine injury, and most aortic disruptions from blunt trauma occur just distal to the left subclavian artery.

Uploaded by

hsbaconga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
34 views2 pages

Pearls Trauma

This document provides pearls on traumatic disorders including that trauma is the number one cause of death ages 1-44, orotracheal intubation is preferred even with suspected c-spine injury, and most aortic disruptions from blunt trauma occur just distal to the left subclavian artery.

Uploaded by

hsbaconga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Traumatic Disorders: Pearls

 Trauma is the number one cause of death in ages between 1 and 44 years old

 Orotracheal intubation (with in-line immobilization) is the procedure of choice (even with suspected C-spine
injury)

 Most reliable method of assuring endotracheal intubation is visualizing the tube pass through the cords

 Elderly patients, athletes, and those on rate controlling medications may not develop tachycardia

 A narrowed pulse pressure suggests significant blood loss and use of compensatory mechanisms

 Class III shock is the first class in which there is a drop in the systolic blood pressure below 90 mmHg

 The hallmark of neurogenic shock is hypotension with normal heart rate or bradycardia, and lack of
vasoconstriction on exam

 Normal urine output in adults is 0.5cc/kg/hour

 20% of patients with intra-abdominal injuries with significant mechanisms of injury have benign abdominal exams

 Most common site (90%) of aortic disruption due to blunt trauma is just distal to left SCA at ligamentum
arteriosum

 Diaphragmatic injuries are more commonly (80%) diagnosed on the left

 Stab wounds most commonly involve the liver (40%), small bowel (30%), diaphragm (20%), and colon (15%)

 The most commonly injured organs in blunt trauma are spleen (40-55%), liver (35-45%), and retroperitoneal
hematoma (15%)

 Thoracic trauma accounts for 25% of civilian trauma deaths

 Most common site of aortic disruption due to blunt trauma is just distal to left SCA at ligamentum arteriosum
(90%)

 Anticipate mechanical ventilation of a patient with a pulmonary contusion if the contusion is >28% of lung volume
(by CXR) or more than one lobe is involved

 Fractures of middle third of the clavicle are most common (80%)

 Most common facial fracture is nasal bone, then mandible

 30% of blowout orbital fractures have associated ocular injuries

 Approximately 80% of GU injuries involve kidney, 10% involve bladder

 If platysma muscle is violated in neck trauma, injury to deep structures should be suspected

American Academy of Emergency Medicine


Written Board Review Course 2020 – Pearls
Copyright © 2020 American Academy of Emergency Medicine, Inc. (AAEM). All Rights Reserved.
Any reproduction or duplication is strictly prohibited without prior permission from AAEM.
Traumatic Disorders: Pearls

 Fluorescein staining may show “waterfall” of unstained aqueous fluid from the wound of penetrating globe
trauma (Seidel test)

 Auricular hematomas can result in necrosis of the underlying cartilage & “cauliflower ear” deformity

 Industrial sprayers and other high pressure equipment may cause serious injuries with minimal exam findings

 Head injury is the most common cause of death in pediatric trauma

 Falls are the most common cause of injury in patients over 65 years old.

 Upright CXR shows as little as 200–300cc as blunting of costophrenic angles.

 90% of renal injuries from blunt trauma are contusions

 Always evaluate the GU system in a retrograde fashion

 Renal imaging in adult blunt trauma is indicated if gross hematuria or unexplained shock with microscopic
hematuria is present

 Organisms specific to animal bite include


o Human Bite – Eikenella corrodens
o Cat Bite – Pasteurella multocida
o Dog Bite – Capnocytophaga canimorsus

 Corneal Burns
o Acids  coagulation necrosis, shallower burns
o Alkalis  liquefaction necrosis, deeper burns

 80% of intra-ocular foreign bodies enter eye through the cornea

 Domestic violence: leading cause of injury to women (15-44 y/o), 30-50% due to partner violence

 Bicycle handlebar: think intramural duodenal hematoma or pancreatic injury

 Pediatric ETT size = Age/4 + 3 (cuffed)

American Academy of Emergency Medicine


Written Board Review Course 2020 – Pearls
Copyright © 2020 American Academy of Emergency Medicine, Inc. (AAEM). All Rights Reserved.
Any reproduction or duplication is strictly prohibited without prior permission from AAEM.

You might also like