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

Episoder(1147)

Podcast #250: Desmopressin

Podcast #250: Desmopressin

Author: Rachael Duncan, PharmD BCPS BCCCP Educational Pearls Desmopressin is an ADH mimetic and helps retain water, release von Willibrand Factor (in high doses), and treat diabetes insipidus (in low...

11 Sep 20173min

Podcast #249: Detecting Pulses

Podcast #249: Detecting Pulses

Author: Jared Scott, M.D. Educational Pearls Overall, medical providers are bad at detecting pulses. However, only 2% of patients do not have a detectable DP pulse. In one study, for patients with l...

10 Sep 20173min

Podcast #248: Family Presence During Resuscitation

Podcast #248: Family Presence During Resuscitation

Author: Aaron Lessen, M.D. Educational Pearls Traditionally the family is removed from the room during procedures and codes, but recent research shows that family presence may be beneficial. 50% pati...

8 Sep 20173min

Podcast #249: D-Dimer

Podcast #249: D-Dimer

Author: Michael Hunt, M.D. Educational Pearls In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification...

6 Sep 20173min

Podcast #248: Patent Foramen Ovale

Podcast #248: Patent Foramen Ovale

Author: Jared Scott, M.D. Educational Pearls The foramen ovale (FO) connects the left and right atria to allow oxygenated blood to bypass the developing lungs, it usually closes at birth but for some...

4 Sep 20173min

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Author: Don Stader, M.D. Educational Pearls Ear pain is a common complaint in adults and kids. A red, hot, painful ear with involvement of the pinna could indicate perichondritis - an infection of th...

2 Sep 20176min

Podcast #246: Fever in Sepsis

Podcast #246: Fever in Sepsis

Author: Nick Hatch, M.D. Educational Pearls A recent observational cohort study found that the biggest predictor for sepsis survival was fever. Those with higher fevers had better outcomes. Some poss...

31 Aug 20172min

Podcast #245: Hypoglycemia

Podcast #245: Hypoglycemia

Author: Dylan Luyten, M.D. Educational Pearls Hypoglycemia is very common in type 2 diabetics, and is often caused by insulin overdose or missed meals. Knowing the peak time of action for common diab...

29 Aug 20174min

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