Podcast #204: Thoracotomy

Podcast #204: Thoracotomy

Author: Aaron Lessen M.D.

Educational Pearls:

  • Thoracotomy is a potentially life-saving procedure. However, outcomes are often poor and the procedure itself poses many risks to provider and patient.
  • Chance of surviving a thoracotomy when there is no cardiac activity on ultrasound is 0%.
  • Performing a thoracotomy is unlikely to benefit patients with no cardiac activity on ultrasound or patients that lost vital signs greater than 10 minutes before starting the procedure.
  • A thoracotomy is maximally beneficial in patients with a penetrating chest injury that occurred less than 10 minutes before the procedure.

References: K. Inaba et al, "FAST Ultrasound Examination as a Predictor of Outcomes After Resuscitative Thoracotomy: A Prospective Evaluation" Ann. of Surgery, 2015. https://www.ncbi.nlm.nih.gov/pubmed/26258320

Jaksot(1147)

Podcast #280: Isolated Aphasia in Stroke

Podcast #280: Isolated Aphasia in Stroke

Author: Aaron Lessen, M.D. Educational Pearls Patients with an ischemic stroke from occlusion of the left middle cerebral artery often present with aphasia in addition to other neurological deficits....

11 Joulu 20171min

Podcast #279: Sedation After Intubation

Podcast #279: Sedation After Intubation

Author: Aaron Lessen, M.D. Educational Pearls Post-intubation care should always include pain control and adequate sedation. Commonly used sedation agents include propofol, ketamine and versed. Howev...

8 Joulu 20171min

Podcast #278: Subdural Hematomas

Podcast #278: Subdural Hematomas

Educational Pearls Subdural hematomas can happen in the elderly because of brain atrophy, and can manifest with neurological deficit. Subdural hematomas are caused by rupture of the bridging veins of...

6 Joulu 20172min

Podcast #277: Mucor

Podcast #277: Mucor

Author: Don Stader, M.D. Educational Pearls Mucor/Rhizopus fungal infections usually present in diabetic or immunocompromised patients as a black, necrotic lesion on the face. The fungus invades the ...

4 Joulu 20172min

Podcast #276: Angioedema

Podcast #276: Angioedema

Author: John Winkler, M.D. Educational Pearls Angioedema is immediately life-threatening due to airway obstruction. Mechanisms include allergic reaction (histamine-related) or bradykinin-related (ACE...

1 Joulu 20173min

Podcast #275: Battery Ingestions

Podcast #275: Battery Ingestions

Author: Nick Hatch, M.D. Educational Pearls Unlike coin ingestions, button batteries can cause necrosis of the GI tract. If lodged in the esophagus, removal within 2 hours is important, because they ...

29 Marras 20174min

Podcast #274: Pediatric Sedation

Podcast #274: Pediatric Sedation

Author: Aaron Lessen, M.D. Educational Pearls A recent prospective observational study was performed to examine the safety of different sedation medications in the pediatric ED. This study included 6...

27 Marras 20172min

Podcast #273:  Bag Valve Masks

Podcast #273: Bag Valve Masks

Author: Sam Killian, M.D. Educational Pearls Difficulty with bag valve mask (BVM) ventilation can be addressed using the MOANS mnemonic. Mask seal, Obesity/obstruction, Age, No teeth, Sleep apnea. O...

17 Marras 20173min

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