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 72 - Wellbeing with Liz Crowe
Ep - 71 SMACC Dublin Day 3 Round Up
Ep - 70 SMACC Dublin Day 2 Round Up.
Ep 69 - SMACC Dublin Day 1 Round Up
Ep 68 - An Englishman in South Africa with Robert Lloyd
Ep 67 - Intro to EM: Sepsis
Ep 66 - When Professional and Personal Worlds Collide with Liz Crowe
Ep 65 - The management of Paediatric trauma in the UK with Ross Fisher
Ep 64 - International Meeting for Simulation in Healthcarewith Sandra Viggers and Vic Brazil
Ep 63 - The Role of UK Trauma Units with Tim Coates (LTC)
Ep 62 - The role of paediatric surgeons in trauma with Ross Fisher (LTC)
Ep 61 - Grief at Christmas with Liz Crowe
Ep 61 - Londoon Trauma Conference 2015 Day 2 Summary
Ep 60 - Londoon Trauma Conference 2015 Day 1 Summary
Ep 59 - Lessons learned from the November Paris attacks with Youri Yordanov
Ep 58 - Clinical Judgement for the Emergency Physician
Ep 57 - When things go wrong - the difficult conversation
Ep 56 - Intro to EM: How to refer a patient
Ep 55 - Communicating (not Breaking) Bad News with Liz Crowe
Ep 54 - Intro to EM: Analgesia in the ED.
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