Anaesthesia, Trauma & Critical Care

Topics covered in the manual:- Primary Survey Kinematics of Trauma Airway Trauma Cardio-Thoracic Trauma Shock & Circulation Preservation (including fluid resuscitation, permissive hypotension &massive transfusion protocol) Abdominal Trauma Pelvic Trauma Neuro Trauma Spinal Trauma Extremity Trauma Burns & Thermal Injury Bombs, Blasts & Ballistics Drowning Crush Injury & Suspension Trauma Paediatric & Obstetric Trauma Special […]

Top 10 Posts of 2016

  10. All Shock Explained 9. Priapism Non-ischemic (high-flow) Ischemic (low-flow) Physical Exam Typically painless, not fully tumescent Painful, fully tumescent with corpus cavernosa rigidity without involvement of corpus spongiosum and glans penis Aetiology High-flow priapism is extremely rare and most commonly associated with antecedent trauma including blunt trauma, or resulting from needle injury of […]

Burns Resuscitation

Signs of impending airway compromise include: stridor, wheezing, subjective dyspnea, and a hoarse voice. Carbon monoxide (CO) poisoning may manifest with persistent neurologic symptoms or even as cardiac arrest. Burns <15% TBSA generaly require only PO fluid resuscitation. Do not include first degree burns in the calculation of % TBSA. Generally crystalloid solutions should be […]

Inhalational Injury

Classically, the diagnosis of inhalation injury was subjective and made on the basis of clinical findings. Pertinent information includes exposure to flame, smoke, or chemicals (industrial and household), duration of exposure, exposure in an enclosed space, and loss of consciousness or disability. Pertinent physical exam findings include facial burns, singed facial or nasal hair, soot […]

With the cold comes fires, here’s a great resource for managing burns

  The aim of these guidelines is to provide a consistent standard of management for burn injuries managed outside of a Burn Service, particularly in the early stages after injury, to improve patient care and outcomes. The guidelines are based on scientific evidence where available and consensus expert opinion

Minor burn treatment

Minor burn treatment includes cooling, cleansing, and debridement of the wounds upfront. Blisters are usually left intact. Povidone-iodine (Betadine) is cytotoxic and delays wound healing – DO NOT USE ON OPEN WOUNDS. Chlorhexidine can be used in combination with a gauze dressing, and it does not interfere with wound re-epithelialization. It is also long-acting.

Pediatric Burn Resuscitation

Take the time to estimate the TBSA involved. This will greatly influence the management! Initial fluid calculations for replacement (ex, using Parkland formula) should be ADDED to maintenance fluids. NEVER forget the sugar! You don’t need to add it to their resuscitation fluids, but their maintenance fluids need glucose. If the patient remains in your […]

It’s cold, children burn…this is what to do…

Did you know about the RULE OF TENS for Fluid Resuscitation in Burns?

Burns Rule of TENS: 1. Estimate burn size (TBSA) to the nearest 10%. 2. Multiply %TBSA x 10 = Initial fluid rate in mL/hr (for adult patients weighing 40 kg to 80 kg). 3. For every 10 kg above 80 kg add 100 mL/hr to the rate. Add to Anti-Banner

It’s getting cold so here’s a review of carbon monoxide poisoning

“Symptoms are variable and physical exam and pulse-oximetry are unreliable. Maintain high level of suspicion with emphasis on historical factors. Start the patient on O2 as soon as the diagnosis is suspected.”