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A Different Type of Tension Headache: A Case Report of Traumatic Tension Pneumocephalus

Travis P Sharkey-Toppen, MD, PhD*, Dominique I Dabija, MD, MS* and Christopher San Miguel, MD*

DOI: https://doi.org/10.21980/J8DH0G Issue 6:2 No ratings yet.
CT head without contrast demonstrated a minimally displaced fracture of the frontal sinuses at the midline underlying his known laceration that involved the anterior and posterior tables of the calvarium. This is seen on the sagittal view and indicated by the blue arrow. There was a small volume of underlying subarachnoid hemorrhage along the falx. There was also extensive pneumocephalus most pronounced along the bilateral anterior frontal convexity associated with the frontal sinus fracture, seen on the axial image and indicated by the red arrow. This pattern of air is commonly referred to as the “Mount Fuji” sign.6 Other intracranial air can also be seen on the sagittal image and is indicated by the white arrow.
NeurologyTraumaVisual EM

Jefferson Fracture and the Classification System for Atlas Fractures, A Case Report

Miguel Angel Martinez-Romo, MD* and Christopher Eric McCoy, MD, MPH*

DOI: https://doi.org/10.21980/J88P9C Issue 6:2 No ratings yet.
Computed tomography (CT) revealed a burst fracture (Jefferson) of the anterior arch (white arrows) and of the posterior arch (yellow arrows) of the first cervical vertebrae (C1). There was also a fracture of the right lateral mass (blue arrow) of C1 with mild lateral subluxation of the lateral masses (curved arrows).
OrthopedicsTraumaVisual EM

A Case Report of a Transected Carotid Artery Caused by a Stab Wound to the Neck

Jennifer Roh, MD* and Kylie Prentice, BS*

DOI: https://doi.org/10.21980/J8BP8M Issue 6:1 No ratings yet.
The post intubation chest x-ray (CXR) showed severe rightward displacement of the trachea (purple arrow). The computed tomography angiogram (CTA) showed transection of the left common carotid artery (LCCA), extensive neck hematoma without extravasation and severe tracheal deviation to the right (blue arrow). The intravenous (IV) contrasted chest computed tomography (CT) image showed a lateral contrast projection from the aortic arch at the level of the isthmus (green and pink arrows). There were no other significant injuries reported on the CT scans of the chest, abdomen and pelvis.
Cardiology/VascularTraumaVisual EM

Posterior Sternoclavicular Dislocation: A Case Report

Stephanie Songey, DO*, Christopher Goodwill, DO* and Kimberly Sokol, MD, MS, MACM*

DOI: https://doi.org/10.21980/J8363Q Issue 6:1 No ratings yet.
Chest X-ray revealed an inferiorly displaced right clavicle at the right sternoclavicular joint (blue arrow). A computed tomography angiogram (CTA) of the chest was therefore obtained and revealed a right posterior sternoclavicular dislocation with resultant compression of the left brachiocephalic vein (purple arrow). Even though the right clavicle is displaced, the anatomy of the brachiocephalic vein is such that it is positioned to the right of midline, placing the left brachiocephalic vein posterior to the right clavicle. The right brachiocephalic and common carotid artery were normal in appearance. The CTA also revealed a comminuted fracture of the left anterior second rib at the costochondral junction that had not been previously seen on the x-ray.
OrthopedicsTraumaVisual EM

Case Report: Traumatic Tension Pneumothorax in a Pediatric Patient

Zachary Tritsch, MD*, Gayle Galan, MD*, Gary Oates, MD* and Janelle Thomas, MD*

DOI: https://doi.org/10.21980/J8ZD1S Issue 6:1 No ratings yet.
Chest X-ray demonstrated significant right-sided pneumothorax (with red outline showing border of collapsed right lung) with cardio mediastinal shift to the left (shown by blue arrows) indicative of a tension pneumothorax
PediatricsRespiratoryTraumaVisual EM

Owning the Trauma Bay: Teaching Trauma Resuscitation to Emergency Medicine Residents and Nurses through In-situ Simulation

Andrew Bellino, MD*, Alexandra June Gordon, MD^, Al’ai Alvarez, MD*  and Kimberly Schertzer, MD*

DOI: https://doi.org/10.21980/J8WK9X Issue 5:4 No ratings yet.
ABSTRACT: Audience: The following two cases were designed to address learning objectives specific to interns, junior residents, and senior residents in emergency medicine, as well as trauma-certified emergency nurses.  Introduction: Traumatic and unintentional injuries account for 5.8 million deaths across the globe each year, with a high proportion of those deaths occurring within the initial hour from the time of
SimulationTrauma

Simulated Mass Casualty Incident Triage Exercise for Training Medical Personnel

Alaina Brinley Rajagopal, MD, PhD*, Nathan Jasperse, BS* and Megan Boysen Osborn, MD, MHPE* 

DOI: https://doi.org/10.21980/J82H1R Issue 5:4 No ratings yet.
By the end of this exercise, learners should be able to (1) recite the basic START patient categories (2) discuss the physical exam signs associated with each START category, (3) assign roles to medical providers in a mass casualty scenario, (4) accurately categorize patients into triage categories: green, yellow, red, and black, and (5) manage limited resources when demand exceeds availability.
EMSSmall Group LearningTrauma

Adult Clavicular Fracture Case Report

Jessica L Sea, PhD*, Nadia Zuabi, MD* and Alisa Wray, MD, MAEd*

DOI: https://doi.org/10.21980/J8FM0TIssue 5:4 No ratings yet.
The patient's chest and clavicular radiographs showed a comminuted displaced acute fracture of the right mid-clavicle (green, blue, yellow). The clavicular fracture was also visible on the chest computed tomography (CT). The remainder of his trauma workup was negative for acute findings.
OrthopedicsTraumaVisual EM

Case Report of Distal Radioulnar Joint and Posterior Elbow Dislocation

Danielle Matonis, MD*, Katelyn Wittel, BS* and Alisa Wray, MD, MAEd*

DOI: https://doi.org/10.21980/J89S6K Issue 5:4 No ratings yet.
Radiographs of the left elbow and wrist were obtained. Left elbow radiographs showed simple posterolateral dislocation of the olecranon (red) without fracture of the olecranon (red) or trochlea (blue). Left wrist lateral radiographs demonstrated DRUJ dislocation with dorsal displacement of the distal ulna (green) without fracture or widening of the radioulnar joint (purple). Post-reduction radiographs demonstrated appropriate alignment of the elbow with the trochlea seated in the olecranon and improved alignment of the DRUJ.
OrthopedicsTraumaVisual EM

A Case Report of Epidural Hematoma After Traumatic Brain Injury

Ronald Goubert, BS*, Alisa Wray, MD, MAEd* and Danielle Matonis, MD

DOI: https://doi.org/10.21980/J8R059 Issue 5:3 No ratings yet.
Non-contrast CT head demonstrated a right sided EDH (red arrow) with overlying scalp hematoma, left-sided subdural hematoma (blue arrow), and bilateral subarachnoid hemorrhages. No skull fractures were noted.
NeurologyTraumaVisual EM
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