To thoracotomy, or not to thoracotomy?

Thoracotomy

A chest trauma patient lies before you. When would you perform an emergency thoracotomy? A case-based Q&A approach to the indications and contraindications.

The LITFL Review 033

LITFL2

The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care.

SAQ Paediatrics 020

FACEM SAQ

A 5 year old boy presents with an acute exacerbation of asthma. On examination there is reduced air entry bilaterally with expiratory wheeze. He has tracheal tug, sub costal recession and is tachypnoeic. Initial pulse oximetry reveals oxygen saturation of 85% on room air. He has had no treatment prior to arriving in the emergency department.

SAQ Admin 020

Scenario After a recent significant adverse event following the insertion of a central venous line you have been asked to investigate emergency department central line insertion. Question a. List the factors that may contribute to such adverse events during central venous line placement (30%) b. Describe the measures that may be used to prevent or [...]

SAQ Core 026

FACEM SAQ

You are working in an urban district hospital with no obstetric or neonatal service. A 28 week pregnant woman presents in premature labour. Examination reveals an absence of bleeding and a closed cervical os

Friday inspiration 002

nick_cave_1

The Ship Song Project is a reworking of Cave’s original work with individual lines sung/performed by the most prominent acts to feature at the Sydney Opera House over 2010/2011.

SAQ Trauma 018

FACEM SAQ

A 21 year old man is brought in by ambulance after being struck in the anterior midline of the neck with a hockey stick. Initial evaluation reveals he has a hoarse voice, large haematoma and tenderness of the anterior neck. He is alert and has no other injuries.

SAQ Medicine 025

FACEM SAQ

A 72 year old man presents from a nursing home with 4 days of increasing confusion. His GP letter notes that he has a history of dementia, hypertension and ischaemic heart disease.

VT or not VT? That is the question…

ECG Exigency Thumbnail

“VT or not VT? That is the question…” you muse. Then your patient Bill says “A shock, a shock, my kingdom for a shock”…

SAQ Core 025

FACEM SAQ

Scenario A 55 year old man collapses on emerging from the water after snorkelling on a Queensland beach. He is rapidly transported to the emergency department Question a. List your differential for this man’s condition (30%) b. Outline the features on your assessment that would indicate a marine envenomation (70%) Answer Answer and Interpretation FACEM [...]