This week we feature a short primer on penetrating chest trauma focusing on circulation first over airway and breathing.


https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_80_0_Final_Cut.m4a



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Tags: ED Thoracotomy, EFAST, Resuscitative Thoracotomy, Trauma, Ultrasound





Show Notes
Take Home Points

Don’t rush to the airway. In most situations, you have some time so resuscitate before you intubate. Give blood products and get the BP up a bit to give yourself a little better physiologic situation in which to intubate.
Start your massive transfusion immediately if the patient is shocked. There’s always a delay in getting products but the earlier you start, the shorter the delay.
Include US in your primary survey. Your E-FAST should start with the cardiac window, then go to the lungs and then, finally, the abdomen. This order focuses on finding pathology you can fix immediately.
If the patient is shocked and peri-arrest or recently lost vitals, open the chest and look for a fixable injury. Start with opening the pericardium to relieve tamponade, identify and repair cardiac wounds and cross clamp the aorta.

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EMCrit: Podcast 081 - An Interview on Severe Trauma with Karim Brohi
LITFL: Penetrating Chest Trauma
EM:RAP: How to Crack the Chest
EM: RAP: Stabbed in the Chest

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