Penetrating Neck Trauma: Simulation Case Debriefing

Slides:

Advertisements

Similar presentations

Blunt trauma patient intubated in field, has decreased breath sounds on left, hemodynamically stable, sat 96% Next move: A) advance ET tube B) needle thoracostomy.

Advertisements

Jamaica Hospital Trauma Conference July 21st, 2014 Greg Eckenrode

THE CERVICAL SPINE IN THE OBTUNDED PATIENT Lisa Harkness- Adult NP Trauma.

Abdominal Trauma Nestor Nestor, M.D., M.Sc. January 17, 2007.

PERFORMANCE IMPROVEMENT AND QUALITY ASSURANCE A Trauma Receiving Facility’s Perspective Lisa Fawcett RN, CEN Sheridan Memorial Hospital Plentywood, MT.

Management of Penetrating Neck Trauma Shashidhar S. Reddy, MD, MPH Shawn D. Newlands, MD, PhD.

Michael D McGonigal MD Regions Hospital. Objectives Discuss new developments in FAST exam of the torso Review the diagnosis of abdominal and pelvic vascular.

ACEP Clinical Policy: Adult Headache Patients. Ponte Vedra Beach, FL June 24, Clinical Decision Making in Emergency Medicine Ponte Vedra Beach,

Neck Trauma. §Penetrating trauma §Blunt trauma §Near - Hanging & Strangulation.

CDR JOHN P WEI, USN MC MD 4th Medical Battalion, 4th MLG BSRF-12 ABDOMINAL TRAUMA.

Trauma Overview David B. Reedy, M.D., FACEP

Penetrating Abdominal Injury Is Exploratory Laparotomy Still the Standard Treatment? Dr Annie NK Chiu UCH JHSGR 21st Apr 2012.

Penetrating Neck Injuries. Case 1 –19 year old male in Casuarina –stabbed back of neck with steak knife (8cm) –Zone II injury –haemodynamically stable.

Penetrating Neck Trauma

Acetabular fractures: the first three days.

I.1 ii.2 iii.3 iv.4 1+1=. i.1 ii.2 iii.3 iv.4 1+1=

I.1 ii.2 iii.3 iv.4 1+1=. i.1 ii.2 iii.3 iv.4 1+1=

University of Michigan

Provisional Stability & Damage Control In Orthopaedic Surgery

Spine and Spinal Cord Trauma. Objectives Anatomy/physiology Evaluate a patient with spinal injury Identify common spinal injuries and Xray features Appropriately.

 ~1.2 million HS / 200,000 college & pro athletes  Largest number of sports-related injuries among organized team sports in the United States  Spinal.

The potential impact of adherence to a guideline on the utilization of head CT scans in traumatic head injury patients. Frederick K. Korley M.D.

Management of Rib Fractures. Clinical Anatomy 12 pairs of ribs Attach posteriorly to vertebrae Rib 8-12 are “false ribs” Ribs 1-3 are relatively well.

Instructor Name: Title: Unit:

Health-Process Evidence-Based Clinical Practice Guidelines for Trauma on Thoracic Area Jonathan Malabanan MD OMMC October 11, 2007.

A Structured Trauma Team Approach to the Initial Management of Trauma.

Penetrating Neck Trauma Algorithm

Controversies in Abdominal Trauma. Controversies in Emergency Ultrasound Should EM physicians perform ultrasound? Should EM physicians perform ultrasound?

Overview of ATLS William P. Bozeman, MD, FACEP Assistant Professor, Dept. of Emergency Medicine University of Florida Health Sciences Center / Jacksonville.

ED trauma meeting 26 th July 2012 C spine Bonanza.

FACE, NECK, & EYE INJURY. WHY? Body armor works –9% mortality of injuries, compared to 24% in Vietnam or 30% in WWII Improved compliance with Kevlar wear.

Penetrating neck trauma

1 TRAUMA CASUALTY ASSESSMENT RIFLES LIFESAVERS. 2 Tactical Combat Casualty Care Care Under Fire –“The best medicine on any battlefield is fire superiority”

Scott Weingart, MD Assistant Professor Director of ED Critical Care Elmhurst Hospital Center Mount Sinai School of Medicine New York, NY

Objective To assess the impact of the increasing use of MDCT angiography in the setting of blunt and penetrating neck trauma on the use of digital subtraction.

Utility of Red Flags in the Headache Patient in the ED L. Garcia-Castrillo, MD, SEMES Department of Emergency Medicine University Hospital Marques de Valdecilla.

UTHCT 1 Chest Pain: Diagnostic Challenges Jose R Jimenez M.D. Family Medicine Dept. U.T. Health Center at Tyler.

Introduction to Trauma Erik G. Van Eaton, MD Assistant Professor Department of Surgery Division of HMC Trauma Univ. of Washington Seattle, Washington Erik.

Penetrating Carotid Artery Injury

SFGH Cervical Spine Clearance Protocol

. Anatomy of spine.

APPROACH TO ABDOMINAL TRAUMA

Clearing the Pediatric Cervical Spine

Trauma Anatomic Regions

Emergency Preparedness and Assessment

Initial management of multiple trauma patient

2.15 Copyright UKCS #

Applications of Diagnostic Imaging Computed Tomography

1.3B Copyright UKCS #

Normal Exam C-Collar CT Abnormal Neck CT C-Spine Fx Normal Patient

Applications of Diagnostic Imaging Nuclear Medicine

Abdominal vascular injuries

تریاژ بیمارستانی دکتر احسان مدیریان متخصص طب اورژانس استادیار دانشگاه علوم پزشکی قزوین.

Penetrating Neck Injuries

Applications of Diagnostic Imaging X-Ray

Introduction to Trauma

Emergency Preparedness and Assessment

Facilitated By: Mark Merlin, DO, EMT-P, FACEP

Chapter 5 Patient Assessment

Solving Equations 3x+7 –7 13 –7 =.

Daily changes in ED use compared to baseline utilization in October and November 2012 for patients with diabetes in New York City evacuation zone level.

Disaster question (24 ) It is Friday 1600 hrs and you are the consultant in charge of the emergency department in a tertiary hospital. You have been notified.

Face and Throat Injuries

Summary of 2002 data. Summary of 2002 data. All patients with head injuries (HI) for the nine month control period are included. The new protocol was.

Summary of 2001 data. Summary of 2001 data. All patients with head injuries (HI) for the seven month control period are included. Royal College of Surgeons.

Presentation transcript:

Penetrating Neck Trauma: Simulation Case Debriefing Cullen B. Hegarty, M.D. Regions Hospital Department of Emergency Medicine

Debriefing: How did the case feel? What went well? What would you change/do differently? Crisis Resource Management review Review of objectives and optimal management of the case

Case checklist: Address IV access, fluids Order appropriate labs/blood products Complete primary and secondary survey with full exposure/skin exam and vascular exam noted Pain management Early airway management with rescue technique(s) if needed Coordinate final disposition for patient

Penetrating Neck Trauma: Penetrating Neck Injury Karim Brohi, trauma.org 7:6, June 2002

Injuries: Stab wounds to the neck can result in: -Vascular -Neurologic -Laryngotracheal and/or -GI injuries

ED Management: Basic stabilization techniques -ATLS Primary/Secondary surveys -emphasis on exposure for other injuries -screening x-rays (ex: CXR) -early airway management Diagnostic workup of injury

Diagnostic work-up Zone III: angiography if stable Zone I: CXR, angiography, GI study (esophagoscopy vs contrast study) if stable Zone II: OR for exploration versus (if stable) -studies of potential injuries: angiogram, bronchoscopy, and GI study -CT soft tissue neck -clinical observation for signs/symptoms All ‘Zones’ if unstable may need OR

Summary: Review of case, performance of clinical management and team Review of penetrating neck injury -Zones of neck -Basic trauma stabilization techniques -Management of injuries based on location of wound/zone

References: Penetrating Neck Injury Karim Brohi, trauma.org 7:6, June 2002 http://www.trauma.org/vascular/neckneur.html Hamilton et al: Chapter 48 ‘Head and Neck Trauma’, pp 843-869. ‘Emergency Medicine- An Approach to Clinical Problem-Solving, 2nd Edition’,Philladelphia, W.B. Saunders Company, 2003.