Helmet Removal

Why should I care about this? Ok, so it may not be that interesting, however, we should still review how to responsibly remove a helmet. In NYC, we very rarely encounter injured patients with a helmet on and that’s probably because they wer…

Lisfranc Injury

Summary Summary Anatomy of the Lisfranc Joint The Lisfranc joint consists of the articulation of the first three metatarsal bases with their respective cuneiforms and the 4th/5th metatarsal bases with the cuboid, along with associated ligam…

Unstable C-Spine Fractures

Intro You are working a BNT shift at Elmhurst and you pick up a patient who is complaining of neck pain after a fall. Do they need to be in a c-collar? Should you order a CT c-spine? What are the unstable c-spine injuries you are looking fo…

Burn Management

Trauma Survey: Burns are trauma, treat these pts as such. Don’t let yourself get distracted by the obvious superficial injuries/wounds and be sure to go down your algorithm so you don’t miss anything. PRIMARY: Airway: Look for signs of acti…

Flail Chest

An uncommon injury caused by three or more rib fractures in two places Injury resulting from blunt trauma such as a motor vehicle accident (75%), falls (15%) or direct percussion to the chest Causes decrease intrathoracic pressure, ineffect…

Time to Bind…

So you’re working a busy A side shift at Elmhurst and you get an alert from EMS about a polytrauma. The patient rolls through the door alert but moaning in pain with obvious road rash to the bilateral lower extremities. He states he was in…

EFAST vs CXR for PTX

Surgical resident X: “We have to get the chest X-ray before we go to CT.” EM resident Y: “Honestly, [surgical colleague X], I don’t think we do. The FAST didn’t have any evidence of pneumothorax, so I think we…

Oops…is that part important?

There you were, minding your own business when EMS brings you a sick-as-can-be patient, intubated in the field for who knows what. Someone gets overzealous with their trauma shears and cuts off the pilot balloon on the endotracheal tube. Th…

Burn Baby Burn

Happy 4th of July! I’m taking the day to review a commonly incurred injury on the holiday: burns. Whether it’s from operating a grill after a few too many libations or an unfortunate encounter with fireworks, the incidence of bu…

Fight Bites

  “Dogs never bite me. Just humans.” -Marilyn Monroe   Human bites are the third most common bite after dog and cat bites. They occur more frequently in males, typically between the late teens and in the twenties. Clos…

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