This episode of the podcast is a live recording from the PREMIER Conference of John O Neil discussing penetrating injuries with learning points that are useful for clinicians who look after both adult and paediatric patients.
There are three main mechanisms – violence, impalement and self harm, although the first is by far the most common.
Penetrating injuries are rare but have significant morbidity and mortality. The key is early and accurate diagnosis, and many can be managed conservatively. The distribution of penetrating injuries across the UK differs widely, with most in the London area, although as seen in the news recently can happen anywhere.
Remember how traumatic it is to be a trauma patient. We put you on a bed, cut off your clothes, stick needles in you and take your family away. Some will also just not engage with you (teenage boys particularly) making assessment difficult. Be kind. Don’t get frustrated.
Physiologically there may be a strong vagal response that can hide some of the signs we’d expect. Also, bear in mind the events prior to the injury – the child may have been running a considerable distance (before and after the incident) raising their lactate (but don’t assume this is the cause). Children tend to ‘fall off a cliff’ – they appear well, but can suddenly decompensate – keep the momentum to definitive management going and do not be falsely reassured.
John mentioned a great friend of St Emlyn’s Vic Brazil and we would heartily endorse you have a look at her work.
You can find more information about the Reducing Knife Crime initiative here
Ep 230 - Top Twenty Papers of 2023 - Part 2 - Haemorrhage and Cardiac
Ep 229 - Top Twenty Papers of 2023 - Part 1 - Airway
Ep 228 - January 2024 Monthly Round Up - New Year Resolutions, intubating poisoned patients and wellbeing in the ED
Ep 227 - December 2023 Round Up -Major bleeding decison making, E-scooters, AI and advanced resuscitation possibilities
Ep 226 - October and November 2023 Monthly Round Up - Trauma, Resuscitation, Aortic Dissection and Silence
Ep 225 - A deep dive into ECMO with Andy Curry
Ep 224 - September 2023 Monthly Round Up - Top Ten Papers and more
Ep 223 - July and August 2023 Monthly Round Up
Ep 222 - Monthly Round Up June 2023 - Airways, AMAX4, Head Injuries, TXA and more
Ep 221 - Brief Resolved Unexplained Events with Jilly Boden at the PREMIER Conference
Ep 219 - Blast Injuries with Chris Hillman at the PREMIER Conference
Ep 218 - Non epileptiform seziures with Steve Warriner at the PREMIER Conference
Ep 217 - Weaning the wheezy child with David James at the PREMIER Conference
Ep 216 - April 2023 Monthly Round Up: HALO procedures and Blood Transfusion
Ep 215 - March 2023 Monthly Round Up
Ep 214 - Shock from St Emlyn’s Medical School
Ep 213 - Sensitivity and Specificity (CAN 10)
Ep 212 - February 2023 Monthly Round Up
Ep 211 - Semi structured interviews (CAN 9)
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