Introduction to Trauma Evaluation & Management 

for Physician Assistant Students

 

This lecture covers is a brief overview of the basic approach to trauma as well as the diagnosis and management of several commonly encountered traumatic conditions.  The content is tailored toward the objectives for the Rush Physician Assistant program.  There is a wealth of information in the lecture, however it only scratches the surface in terms of content so I would recommend supplementing the review of this lecture with your course material.

(Note: the video moves very quickly through the slides so you may need to pause frequently to view all content.  Also the video does not include the audio presentation so no need to adjust your speakers)

Trauma 101: Primary & Secondary Survey

Here's an introduction to trauma and the primary survey. Here we talk about the initial management of the patient within the "golden hour" (the hour in which if we resuscitate the patient we may prevent death). So what do we do in that first hour?

Click here to continue watching...

To CT or not to CT? Low risk head injury in kids

CT scanning of kids has been on the rise, though we recognize the limitations of this test. It's not perfect and has some real costs (money, time, sedation risk, cancer). Who do we need to CT and who can we get away without scanning? The Pediatric Emergency Care Research Network (PECARN) looked at a paltry 42,412 kids and came up with a pretty good tool. It still needs external validation, but 42-thousand?! Wow.

They provide you with a flowchart you can share with parents to help make an educated decision. Click for the PDF file for the episode which includes this flow chart and a copy of the video notes.

Toxicology 101

Toxicology, from the Greek word τοξικός meaning poisonous, merges information from biology, chemistry and medicine and is an integral part of Emergency Medicine. It is also good information for any primary care physician to know.

The following four videos provide the basics of toxicology - general management.

1. Introduction, primary and secondary survey
2. The Toxidromes -- know these
3. Testing & Important Calculations
4. GI Decontamination and Enhanced Elimination

Eventually we'll go over individual toxins.

The Workings of the New Emergency Department

As most of you know we recently transitioned to our new McCormick Foundation Center for Advanced Emergency Response.  It is an outstanding facility which nearly doubles our previous capacity and offers the latest and greatest in terms of patient-centered care.  This post is to help orient you to your upcoming rotation in the Emergency Department.

As you can see from the map below the department is divided into three pods:

• Pod A - will serve primarily as a triage and rapid treatment area.  The concept is that patients seen in this area can be quickly evaluated and either discharged or moved onto Pod B for further treatment.  This pod includes dedicated ENT and Ob/Gyne rooms.
• Pod B - this is the primary area in which you will be working.   Patient's anticipated to require a work-up will be triaged to this pod.  It includes seven critical care rooms on the north side of the pod.  It also includes three dedicated psychiatric rooms.  The south side of this pod includes four observation rooms for patients placed to ED observation (e.g. very low risk chest pain, cellulitis, dehydration, etc.)
• Pod C - during the day this pod will be occupied by employee health.  This pod will serve as an overflow for patients from Pod B as well.  While working shifts in Pod B you will also be responsible for seeing patients in this pod.

Note, pediatric patients will be placed in any available room although we anticipate many will end up being seen in Pod A.  If you are a Pediatric resident or Cook County Resident doing a pediatric shift you will have to keep an eye on the track board to see where pediatric patients are roomed and staff them with the appropriate attending.

The Attending schedule will be divided by pod as well - there will be a pod A attending and a pod B/C attending(s).  You will staff the patients you see with whichever attending is in charge of the pod that patient is in.  You can chart on any available computer.

A couple of additional notes:

• You can find the 'end of shift' evaluation forms in the cabinet adjacent to the EMS radios (located adjacent to room 4 in north side of pod A by the ambulance bay entrance into the ED)- the yellow sheets are for pediatric residents, the white sheets are for adult EM residents. 
• Residents will not have cisco portable phones and will use the land lines available throughout the ED for discussions with consulting or admitting residents. 

Finally there are dedicated Resident lockers in the locker room adjacent to the radiology department by the administrative offices in the southeast corner of the department.  These will be shared lockers so please refrain from leaving anything valuable.  Also it is a co-ed locker room with dedicated male and female bathrooms so please use the bathrooms for changing, etc.  There will be no storage of personal items elsewhere in the department so please make use of the locker rooms.  Also please remember there are no beverages or food allowed in the clinical areas of the department - this will be strictly enforced.  The locker numbers and combinations are below:

Resident 1 -  01166 – combo 25-7-16

Resident 2 -  01164 – combo 21-47-12

Resident 3 -  01152 – combo 25-13-26

Emergency Department Layout