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 151 - October 2019 Round Up
Ep 150 - REBOA with Zaf Qasim
Ep 149 - September 2019 Round Up
Ep 148 - CRASH-3
Ep 147 - August 2019 Round Up
Ep 146 - European Resus Council meeting Slovenia 2019
Ep 145 - The UK Resuscitationist with Dan Horner at #stemlynsLIVE
Ep 144 - July 2019 Round Up
Ep 143 - The Future of Diagnostics with Rick Body
Ep 142 - Psychological performance in the Resus Room with Ashley Liebig
Ep 141 - June 2019 Round Up
Ep 140 - GI emergencies with Chris Gray at #stemlynsLIVE
Ep 139 - May 2019 Round Up
Ep 138 - Traumatic Cardiac Arrest with Prof Jason Smith RN
Ep 137 - Beyond ATLS with Alan Grayson at #stemlynsLIVE
Ep 136 - Wellbeing for the broken with Liz Crowe
Ep 135 - April 2019 Round Up
Ep 134 - March 2019 Round Up
Ep 133 - February 2019 Round Up
Ep 132 - Aortic Emergencies with George Wills at #stemlynsLIVE
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