Trauma

Various Degrees of Thermal Burns

Hamid Ehsani-Nia, DO^*, Mohammad I Ehsani-Nia, BS^* and John Collins, MD^*

DOI: https://doi.org/10.21980/J8R91WIssue 3:4 No ratings yet.

On exam,there is a large swath of skin with evidence of thermal injury involving the neck, shoulder, chest, and face, including damage to the ear, external nostril, and lips. Burns exhibit varying degrees of severity and total approximately 4.5% of the body surface area. Several areas are charred and insensate to pinprick. The left earlobe is partially burned off. Patient's airway is patent with no evidence of thermal injury or obstruction to the oropharynx or nasal vestibule.

Trauma Visual EM

A Low Cost Escharotomy Simulation Model for Residency Education

Christopher Sampson, MD^*, Catherine D Parker, MD^*, Edward Burns, MD^{^}, Marty Ruyan, BSN, RN^†, Dena Higbee, EdS^† and Timothy Koboldt, MD^*

DOI: https://doi.org/10.21980/J8D34V Issue 3:3 No ratings yet.

By the end of this educational session, the learner will be able to: 1) Understand the indications for an escharotomy. 2) List equipment needed to perform an escharotomy. 3) Demonstrate how to perform an escharotomy. 4) Perform an escharotomy and experience the sensation of cutting through simulated burned tissue. 5) Understand post-escharotomy management and referral to specialist.

Procedures Innovations Trauma

Fight Bite with Tendon Laceration

Michelle Chang, MD^*, Grant Wei, MD^*, Christopher J Bryczkowski, MD^*, Sha Yan, DO^* and Chirag N Shah, MD^*

DOI: https://doi.org/10.21980/J8MP7QIssue 3:3 No ratings yet.

The video shows a water bath ultrasound of the right 4th digit, demonstrating soft tissue swelling with a hypoechoic region along the tendon consistent with edema and tendon disruption (see video and annotated still image).

Orthopedics Trauma Visual EM

Glass Foreign Body Hand Radiograph

Hamid Ehsani-Nia, DO^* and Joshua Bucher, MD^*

DOI: https://doi.org/10.21980/J8W92HIssue 3:2 No ratings yet.

History of present illness: A 27-year-old female sustained an injury to her left hand after she tripped and fell on a vase. She presented to the emergency department (ED) complaining of pain over the laceration. Upon examination, patient presented with multiple small abrasions of the medial aspect of the left 5thdigit that are minimally tender. Additionally, she has one 0.5cm

Trauma Ultrasound Visual EM

Pneumomediastinum After Cervical Stab Wound

Chad Correa, BS^* and Emily Ma, MD^{^}

DOI: https://doi.org/10.21980/J87P79 Issue 3:1 No ratings yet.

Anteroposterior (AP) chest X-ray showed subcutaneous emphysema of the neck, surrounding the trachea (red arrows), right side greater than left, and a streak of gas adjacent to the aortic arch (white arrow). Computed tomography angiogram (CTA) of the neck showed air outside of the trachea, positive for pneumomediastinum (blue arrows).

Trauma Respiratory Visual EM

Laceration Repair for Emergency Physicians

Alisa Wray, MD^* and Shannon Toohey, MD, MAEd^*

DOI: https://doi.org/10.21980/J8TP7K Issue 2:4 No ratings yet.

By the end of this educational session, the learner will: 1) understand indications and contraindications for suture repair of lacerations, 2) compare when various types of wound repair are appropriate: such as sutures, staples, tissue adhesive and tissue tape, as well as what size of suture material is appropriate depending on the location of the laceration on the body, 3) list the appropriate types and sizes of suture for various locations and types of lacerations, 4) understand the definitions of the three types of wound closure (primary, secondary and delayed primary) and when they are appropriate, 5) understand the basics of local anesthetic including which anesthetic to use and the maximum dose for each, 6) understand when sutures should be removed, 7) list various suturing techniques and their indications, and 8) improve comfort levels in performing various suturing techniques including: simple interrupted, horizontal mattress, vertical mattress, and corner repair. If desired, instructors can individually assess the learner sutures using the attached complete validated suture checklist to show proficiency in these techniques. Please see the brief wrap-up section at the end of the manuscript.

Procedures Team Based Learning (TBL)Trauma

Open Book Pelvic Fracture

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8CK7H Issue 2:3 No ratings yet.

The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis.

Orthopedics Trauma Visual EM

Realistic Chest Tube Simulator Using Pork Belly with Skin

Donald Patrick Mebust, MD^* and Jonathan Kei, MD^*

DOI: https://doi.org/10.21980/J8R03J Issue 2:3 No ratings yet.

By the end of this instructional session learners will be able to: 1) discuss the indications, contraindications, and complications associated with chest tube thoracostomy, 2) competently perform chest tube insertion on a simulator, and 3) properly secure chest tube.

Procedures Innovations Respiratory Trauma

Open Pneumothorax

Bart Paull, MD^*, Zachary Jarou, MD^* and David Richards, MD^*

DOI: https://doi.org/10.21980/J88036 Issue 2:3 No ratings yet.

A large chest wound was clinically obvious. A chest radiograph performed after intubation showed subcutaneous emphysema, an anterior rib fracture, and a right-sided pneumothorax. He was then taken to the operating room for further management.

Trauma Respiratory Visual EM

K-9 Police Dog Bite

Vy Han, MD^* and John R. Marshall, MD^*

DOI: https://doi.org/10.21980/J8B88GIssue 2:1 No ratings yet.

The photograph is of the anterior compartment of the right lower leg demonstrating multiple deep lacerations with exposed and torn muscle. X-ray showed no foreign body.

Trauma Visual EM