Episode 146.0 – Morning Report Pearls V
Core EM - Emergency Medicine Podcast
English - May 21, 2018 11:00 - 7 minutes - 5.83 MB - ★★★★★ - 128 ratingsMedicine Health & Fitness Homepage Download Apple Podcasts Google Podcasts Overcast Castro Pocket Casts RSS feed
More pearls from our fantastic morning report series at Bellevue.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_146_0_Final_Cut.m4a
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Tags: Endocarditis, Ludwig's Angina, Penetrating Neck Trauma
Show Notes
Take Home Points
In patients with neck pain, consider Ludwig’s angina particularly if they have any swelling, fever, truisms or respiratory difficulty. Consider early airway management and get your consultants involved early for operative management
Endocarditis is a tricky diagnosis and will often be subtle. Any patient with a prosthetic valve and a fever has endocarditis until proven otherwise. Suspect it in any patient with fever and a murmur, get lots of cultures and remember that TEE is the gold standard but, TTE is highly specific
Finally, penetrating neck trauma. Patients with hard signs – airway compromise, ongoing brisk bleeding, an expanding/pulsatile hematoma, neurologic compromise, shock or hematemesis should go directly to the OR and don’t probe the wounds!
More pearls from our fantastic morning report series at Bellevue.
https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_146_0_Final_Cut.m4a
Download
Leave a Comment
Tags: Endocarditis, Ludwig's Angina, Penetrating Neck Trauma
Show Notes
Take Home Points
In patients with neck pain, consider Ludwig’s angina particularly if they have any swelling, fever, truisms or respiratory difficulty. Consider early airway management and get your consultants involved early for operative management
Endocarditis is a tricky diagnosis and will often be subtle. Any patient with a prosthetic valve and a fever has endocarditis until proven otherwise. Suspect it in any patient with fever and a murmur, get lots of cultures and remember that TEE is the gold standard but, TTE is highly specific
Finally, penetrating neck trauma. Patients with hard signs – airway compromise, ongoing brisk bleeding, an expanding/pulsatile hematoma, neurologic compromise, shock or hematemesis should go directly to the OR and don’t probe the wounds!
Hard Signs in Penetrating Neck Injury (Sperry 2013)
Management Algorithm for Penetrating Neck Injury (Sperry 2013)
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LITFL: Ludwig’s Angina
Core EM: Infective Endocarditis
EM Cases: Endocarditis and Blood Culture Interpretation
Sperry JL et al. Western Trauma Association Critical Decisions in Trauma: Penetrating Neck Trauma. J Trauma Acute Care Surg 2013; 75(6): 936-41. PMID: 24256663 [OPEN ACCESS]
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