Extremity trauma

Limb injuries following trauma are extremely common ED presentations.   Some limb injuries can be life threatening External exsanguination from arterial bleeding “internal bleeding” from femoral or other long bone fractures an adult can bleed 1.5L from a single femoral # crush syndrome   Other limb injuries are “limb” threatening Read more…

Cricothyroidotomy

This is a procedure performed at the last stage of the “can’t intubate, can’t oxygenate” (CICO) algorithm.   Indications   Can’t intubate, can’t oxygenate Premorbid difficult airway Airway burns Severe facial trauma Obliteration of airway view by massive haemorrhage or vomit     Contraindications   Alternative method of securing airway Read more…

Thoracostomy – blunt dissection technique

Indications Pneumothorax, open pneumothorax or tension pneumothorax Consider using a smaller catheter inserted via seldinger technique for small uncomplicated pneumothoraces Haemothorax / Massive haemothorax Traumatic cardiac arrest  or periarrest situations   Contraindications Drain not indicated or there is an alternative method of insertion (see above) Patient is anticoagulated or has Read more…

Open Pneumothorax

Also known as a “sucking” chest wound, an open pneumothorax results from penetrating chest trauma and creates an air passage from the environment into the thoracic cavity. Depending on the size of the wound, air can become preferentially entrained into the pleural space, causing ipsilateral lung collapse. If air can Read more…