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 34 - Intro to EM: Problems in Early Pregnancy
Ep 33 - Impact Brain Apnoea with Gareth Davies from London HEMS (LTC 2014)
Ep 32 - The Christmas review podcast 2014
Ep 31 - London Trauma Conference: Day three round up.
Ep 30 - London Trauma Conference: Day two round up.
Ep 29 - London Trauma Conference: Day one round up.
Ep 28 - Iain and Nat preview the amazing London Trauma Conference.
Ep 27 - Intro to EM: The patient with chest pain
Ep 26 - Intro to EM: The ED approach to the child with shortness of breath
Ep 24 - Getting started in Emergency Medicine Research
Ep 23 - Smacc Chicago update
Ep 22 - Button Battery ingestion in children
Ep 21 - Code for Cash and Credibility
Ep 20 - Understanding Troponin Part 3: The NICE guidance.
Ep19 - In Situ and Guerrilla Sim in the ED
Ep 18 - Victoria Brazil on great presentations with St.Emlyn's
Ep 17 - Diffuse Axonal Injury with John Hell
Ep 16 - Intro to EM: The patient with syncope (transient loss of consiousness)
Ep 15 - Understanding Troponin Part 2
Ep 14 - Exeter CEM conference with Adam Reuben
Create your
podcast in
minutes
It is Free
Good Mood Revolution
Good Nurse Bad Nurse
The Relaxback UK Show
On Call With Dr. Anselm Anyoha
The Doctor’s Farmacy with Mark Hyman, M.D.
The Peter Attia Drive