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

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Podcast #352: TXA for Epistaxis

Podcast #352: TXA for Epistaxis

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Podcast #351: Indications for AICD

Podcast #351: Indications for AICD

Author: Pete Bakes, MD Educational Pearls: AICD: Automated Implantable Cardioverter-Defibrillator. Can be placed for secondary prevention of cardiac arrest (i.e. history of cardiac arrest not fr...

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Podcast # 350: Pressors and Ischemia

Podcast # 350: Pressors and Ischemia

Author: Nick Hatch, MD. Educational Pearls: A common concern using vasopressors is the risk of digital and mesenteric ischemia. The absolute risk of digital ischemia and/or mesenteric ischemia is...

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Podcast # 349: Fat Emboli

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Author: Sue Chilton, MD Educational Pearls: Triad of fat emboli syndrome is a petechial rash, AMS, and respiratory distress. Petechiae usually start in the axilla. 90% of patients with long bon...

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Podcast # 348: Steakhouse Syndrome

Podcast # 348: Steakhouse Syndrome

Author: Don Stader, MD Educational Pearls: Steakhouse syndrome is an impacted esophageal food bolus. Occurs because they have an esophageal stricture (schatzki ring, scarring, esophagitis). Cla...

2 Jul 20183min

Podcast # 347: Fasting and Procedural Sedation

Podcast # 347: Fasting and Procedural Sedation

Author: Sam Killian, MD Educational Pearls: Recent study examining fasting and adverse events during procedural sedation found no association between fasting duration and any type of adverse event....

29 Jun 20183min

Podcast # 346: Pediatric DKA

Podcast # 346: Pediatric DKA

Author: Chris Holmes, MD Educational Pearls: There is a risk of cerebral edema in pediatrics with DKA if over resuscitated. Recent study comparing normal saline vs. ½ normal saline showed no diff...

27 Jun 20184min

Podcast # 345: Epidural Abscess

Podcast # 345: Epidural Abscess

Author: Sue Chilton, MD Educational Pearls: IV drug use and spinal procedures are major risk factors. Classic triad of back pain, focal neurological deficit and fever. However, presence of fever ...

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