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 171 - May 2020 Round Up
Ep 170 - COVID-19 Journal Club #7 (June 2020)
Ep 169 - COVID-19 Journal Club #6 (May 2020)
Ep 168 - COVID-19 Journal Club #5 (May 2020)
Ep 167 - Troponin Update and LoDED Study Review with Rick Body
Ep 166 - COVID-19 Journal Club #4 (May 2020)
Ep 165 - April 2020 Round Up
Ep 164 - COVID-19 Journal Club #3
Ep 163 - COVID-19 Journal Club #2
Ep 162 - Beyond the ED: COVID-19 and Critical Care with Dan Horner
Ep 161 - COVID-19 Journal Club #1
Ep 160 - March 2020 Round Up
Ep 159 - Covid 19. Lessons from Sports and Exercise Medicinewith John Rogers and Nathan Lewis
Ep 158 - Understanding Fear and Anxiety around COVID19 with Liz Crowe
Ep 157 - ICU for the non-intensivist with Sarah Thorton
Ep 156 - February 2020 Round Up
Ep 155 - Covid-19 Podcast from Italy with Roberto Cosentini March 2020
Ep 154 - January 2020 Round Up
Ep 153 - December 2019 Round Up
Ep 152 - November podcast round up on St Emlyn's
Create your
podcast in
minutes
It is Free
Good Mood Revolution
The Relaxback UK Show
On Call With Dr. Anselm Anyoha
Precision Medicine Forum Podcast
The Doctor’s Farmacy with Mark Hyman, M.D.
The Peter Attia Drive