Regional anesthesia numbs a specific part, or larger area, of the body. Hypodermic injections of local anesthetic were first described by the Austrian ophthalmologist, Dr. Karl Koller in 1884. But 19th Century syringes were unsatisfactory. https://bit.ly/1StJhTq
Our journey started a few months ago in May. So much has happened! We have been living in our Airstream full time for two months. Currently we’re on our way to Salt Spring Island with a quick stop in Vancouver for a course on casting fractures. This is all in preparation for my new job as a rural community physician. I am so looking forward to opening my new practice. Exciting times.#saltspringisland#familyphysician#emergencymedicine#airstream#airstreamlife#yvr#keeponlearning
Often I hear patients upset or mad about the long wait in the emergency room. When you look at this picture remind yourself next time you go to the Emergency room with a cough or sore throat and your waiting two hours to been seen. That’s because we were trying to save someone’s life who was 32 years old and went into sudden cardiac arrest with no past medical history. Just remember we would not have you sitting in the waiting room so we can sit in back and drink coffee, sometimes we barely get to sit down, pee, or answer or loved ones call if we had an emergency. WHY? Because we care, we’re nurses, and we love what we do! But we hate to hear your complaints on why you been waiting so long! Like Grandma Sue you have a cough and a sore throat I promise, your not gonna die😭😆👩⚕️#nursingstudents#nursesunite#blacknursesrock#cnalife#rn#powerhousenurses#lpn#emergencymedicine#criticalrole#criticalcarenurse .
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If you are placing a chest seal for large chest wall defects be aware of the possibility of developing tension pneumothorax. What about positive pressure ventilation in this patient?
Thoracic injuries are responsible for one-quarter of all trauma-related deaths. Following rib fracture, pneumothorax is the second most common thoracic injury, occurring in 30% of patients with thoracic trauma. An open pneumothorax occurs when a chest wall injury results in direct communication between the atmosphere and pleura.1-2 It is estimated that open pneumothorax occurs in 80% of all penetrating chest wounds, with stab wounds being more common than gunshot wounds or impalement. Open pneumothoraces can lead to ventilatory insufficiency and rapid respiratory decompensation.2
Advanced Trauma Life Support recommends that the initial management of an open pneumothorax is placement of an occlusive dressing taped on three sides to create a ‘flutter-valve’ mechanism. This should then be followed by tube thoracostomy and repair of the chest wall defect.3 The placement of an occlusive dressing or initial wound closure without subsequent tube thoracostomy may result in the development of a tension pneumothorax.2
The patient was intubated and mechanical ventilation was initiated without complication. Due to the large size of the wound, an occlusive dressing was not placed in the emergency department and the patient was rapidly transported to the operating room for further management. In the operating room two chest tubes were placed. Operative findings included a right hemopneumothorax, multiple rib fractures, and a manubrial fracture.
After initial operative management, he was further stabilized in an intensive care unit. After several subsequent surgeries, he was discharged home
And we are back again!! Dr. Tony Seupaul and Chief Resident Dr. Daniel Holleyman representing UAMS EM on SGEM. Check out the link below to hear about the role (or lack thereof) of tamsulosin in kidney stones and please enjoy the following memes made by Dr. Ken Milne himself.