September 28, 2018
Plain film anteroposterior (AP) radiography of the chest shows left-sided subcutaneous emphysema (red arrow) with overlapping muscle striations of the pectoralis major (green arrow). After chest tube placement (blue arrow), AP chest radiography shows persistent left-sided subcutaneous emphysema (red arrow). CT of the chest shows pneumomediastinum (blue arrow), left apical pneumothorax (pink arrow), and subcutaneous emphysema (red arrow) at the level of T2. At the level of T6, rib fractures can be visualized on the CT (yellow arrow). At the level of T8, left sided pneumothorax is also seen (pink arrow) as the absence of lung tissue on CT.
September 28, 2018
On exam,there is a large swath of skin with evidence of thermal injury involving the neck, shoulder, chest, and face, including damage to the ear, external nostril, and lips. Burns exhibit varying degrees of severity and total approximately 4.5% of the body surface area. Several areas are charred and insensate to pinprick. The left earlobe is partially burned off. Patient’s airway is patent with no evidence of thermal injury or obstruction to the oropharynx or nasal vestibule.
July 14, 2018
By the end of this educational session, the learner will be able to: 1) Understand the indications for an escharotomy. 2) List equipment needed to perform an escharotomy. 3) Demonstrate how to perform an escharotomy. 4) Perform an escharotomy and experience the sensation of cutting through simulated burned tissue. 5) Understand post-escharotomy management and referral to specialist.
July 14, 2018
The video shows a water bath ultrasound of the right 4th digit, demonstrating soft tissue swelling with a hypoechoic region along the tendon consistent with edema and tendon disruption (see video and annotated still image).
April 13, 2018
History of present illness: A 27-year-old female sustained an injury to her left hand after she tripped and fell on […]
January 8, 2018
Anteroposterior (AP) chest X-ray showed subcutaneous emphysema of the neck, surrounding the trachea (red arrows), right side greater than left, and a streak of gas adjacent to the aortic arch (white arrow). Computed tomography angiogram (CTA) of the neck showed air outside of the trachea, positive for pneumomediastinum (blue arrows).
October 11, 2017
By the end of this educational session, the learner will: 1) understand indications and contraindications for suture repair of lacerations, 2) compare when various types of wound repair are appropriate: such as sutures, staples, tissue adhesive and tissue tape, as well as what size of suture material is appropriate depending on the location of the laceration on the body, 3) list the appropriate types and sizes of suture for various locations and types of lacerations, 4) understand the definitions of the three types of wound closure (primary, secondary and delayed primary) and when they are appropriate, 5) understand the basics of local anesthetic including which anesthetic to use and the maximum dose for each, 6) understand when sutures should be removed, 7) list various suturing techniques and their indications, and 8) improve comfort levels in performing various suturing techniques including: simple interrupted, horizontal mattress, vertical mattress, and corner repair. If desired, instructors can individually assess the learner sutures using the attached complete validated suture checklist to show proficiency in these techniques. Please see the brief wrap-up section at the end of the manuscript.
October 11, 2017
The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis.
