ITE month

Neck Zones

• Zone I: Clavicles/sternum to the cricoid cartilage
• Zone II: Cricoid cartilage to the angle of the mandible>> STRAIGHT TO THE OR
• Zone III: Superior to the angle of the mandible to skull area

Hard signs:

• Hypotension, arterial bleeding, rapidly expanding hematotma, pulse deficit, bruit >>> STRAIGHT TO THE OR

UNSTABLE C SPINE FRACTURES

“Jefferson Bit off a Hangman’s Toe”

• Jefferson Fx
• Bilateral facet joint dislocation
• Odontoid
• Atlanto axial dislocation
• Hangman fracture
• Teardrop fracture

LE FORT FRACTURES

Indication for ED thoracotomy

• Penetrating chest trauma + witnessed arrest/loss of vitals

Indication for OR Thoracotomy?

• Initial Chest tube output??
• 1500cc or 200cc/hr

Glasgow Coma Scale

Blast Injury

Most common site of basilar skull fracture:

• Petrous portion of temporal bone

Clonidine overdose>>Naloxone 0.1 mg/kg IV

• clonidine acts as an alpha 2 agonist and narcan at high dose will compete for same resceptor
• consider intubation for airway protection

TCA overdose

• Sodium channel blocking medications
• Tricyclic antidepressants (= most common)
  • In overdose, the tricyclics produce rapid onset (within 1-2 hours) of:
  • Sedation and coma
  • Seizures
  • Hypotension
  • Tachycardia
  • Broad complex dysrhythmias
  • Anticholinergic syndrome (tachycardia, mydriasis, dry mouth)
• QRS complex >120 ms

Treatment:

• Administer IV sodium bicarbonate until you see changes in EKG
• 1-2 mEq/kg as intravenous push every 5 minutes as needed for termination of wide-complex tachydysrhythmia or prolonged QRS interval >120 milliseconds (ms).