Category Archives: Trauma

General Surgery, Print Release, Trauma

PUBLISHED: Exploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot Wound

Exploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot Wound
Matthew Daniel1; Ashley Suah, MD2; Brian Williams, MD2
1Edward Via College of Osteopathic Medicine – Auburn
2UChicago Medicine

Gunshot wounds to the abdomen are one of the most classic trauma cases a surgeon will come across in their career. The high velocity of a bullet can cause massive internal and external trauma to the abdomen. Exploration of the small bowel using laparotomy is often indicated after a penetrating traumatic injury or when peritoneal signs are present.

This video article shows the most common techniques for performing an exploratory laparotomy. In this case, the abdomen was explored and was revealed to show a through-and-through gunshot wound to the jejunum, as well as a partial-thickness tear of the proximal cecum; the abdomen was explored for any smaller bleeds or leaks, and the abdomen was closed.

General Surgery, Orthopedic Trauma, Orthopedics, Print Release, Trauma

PUBLISHED: Ankle-Brachial Index, CT Angiography, and Proximal Tibial Traction for Gunshot Femoral Fracture

Ankle-Brachial Index, CT Angiography, and Proximal Tibial Traction for Gunshot Femoral Fracture
Johnathan R. Kent, MD; James Jeffries, MD; Andrew Straszewski, MD; Kenneth L. Wilson, MD
University of Chicago Medicine

This video demonstrates an algorithm for evaluating suspected vascular injury secondary to penetrating extremity trauma on a 42-year-old man who sustained a gunshot wound to his left lower extremity. Descriptions of how to perform an arterial-brachial index (ABI) and arterial-pulse index (API) are reviewed, along with criteria to determine if a CT angiography is indicated. Relevant imaging is reviewed with a radiology resident with descriptions of how to systematically assess the scans for injury. Lastly, a tibial traction pin is placed as a temporizing measure for long bone fractures to prevent shortening and to help with pain management.

Cardiac Surgery, Print Release, Trauma

PUBLISHED: Introduction to Bedside Cardiac Ultrasound

Introduction to Bedside Cardiac Ultrasound

Allyson Peterson, MD
UChicago Medicine

Nadim Michael Hafez, MD
UChicago Medicine

Point of care cardiac ultrasound is a key diagnostic tool in evaluating any patient who is in extremis. Indications for a bedside cardiac ultrasound include cardiac arrest, unexplained hypotension, syncope, shortness of breath, chest pain, and altered mental status. There are no absolute contraindications for a limited bedside cardiac ultrasound. Point of care cardiac ultrasound mainly consists of four views: the parasternal long, parasternal short, apical four chamber, and subxiphoid views. Here, Dr. Peterson and Dr. Hafez at UChicago Medicine discuss image acquisition, pearls and pitfalls, and pathology for each of these views as an introduction to the bedside cardiac ultrasound.

Preprint Release, Trauma

PREPRINT RELEASE: AIRWAY TECHNIQUES AND EQUIPMENT

Airway Techniques and Equipment
UChicago Medicine

Dany Accilien, MD
Emergency Medicine Resident
The University of Chicago Pritzker School of Medicine

Dexter C. Graves, MD
Emergency Medicine Resident
The University of Chicago Pritzker School of Medicine

Nicholas Ludmer, MD
Assistant Professor of Emergency Medicine
The University of Chicago Pritzker School of Medicine

Stephen Estime, MD
Assistant Professor of Anesthesiology and Critical Care
The University of Chicago Pritzker School of Medicine

Abdullah Hasan Pratt, MD
Assistant Professor of Emergency Medicine
The University of Chicago Pritzker School of Medicine

In this video, Dr. Pratt goes over airway management techniques in trauma resuscitation. It outlines the preparation and equipment used in patients with impending airway failure that require manual or mechanical ventilation. Also discussed are the innovative airway towers used in the University of Chicago emergency room as well as the general approach to airway management. The different types of laryngoscopy, assist devices, and cricothyroidotomy surgical airway procedures are also presented.

General Surgery, Print Release, Trauma

PUBLISHED: Extended Focused Assessment with Sonography for Trauma (EFAST) Exam

Extended Focused Assessment with Sonography for Trauma (EFAST) Exam
UChicago Medicine

Daven Patel, MD, MPH
Resident Physician
Emergency Medicine

Kristin Lewis, MD, MA
Resident Physician
Emergency Medicine

Allyson Peterson, MD
Resident Physician
Emergency Medicine

Nadim Michael Hafez, MD
Assistant Professor of Medicine
Emergency Medicine

This video covers information related to the FAST exam, which evaluates the pericardial, hepatorenal, splenorenal, and suprapubic regions for free fluid in a trauma patient as well as the extended version, which includes an additional evaluation of the pleural spaces for a pneumothorax. It goes through probe selection, probe placement and image acquisition, image optimization, and pitfalls and pearls for the subxiphoid/subcostal, right upper quadrant, left upper quadrant, suprapubic, and pleural views.

General Surgery, Preprint Release, Trauma

PREPRINT RELEASE: Airway Equipment

Airway Equipment

Nicholas Ludmer, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Abdullah Hasan Pratt, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Stephen Estime, MD
Assistant Professor of Anesthesia and Trauma Critical Care
UChicago Medicine

In this video, Dr. Ludmer at UChicago Medicine describes the airway equipment that they have available for when a patient has an airway problem.

General Surgery, Preprint Release, Trauma

PREPRINT RELEASE: Airway Assessment for Trauma Patient

Airway Assessment for Trauma Patient

Nicholas Ludmer, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Abdullah Hasan Pratt, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Stephen Estime, MD
Assistant Professor of Anesthesia and Trauma Critical Care
UChicago Medicine

In this video, Dr. Ludmer at UChicago Medicine describes the airway assessment for a trauma patient.

General Surgery, Preprint Release, Trauma

PREPRINT RELEASE: Pharmacology for Rapid Sequence Intubation (RSI) Airway Management in Trauma Patients

Pharmacology for Rapid Sequence Intubation (RSI) Airway Management in Trauma Patients
UChicago Medicine

Laura Celmins, PharmD, BCPS, BCCCP
Clinical Pharmacy Specialist
Emergency Medicine

In this video, Laura Celmins, a clinical pharmacist in the emergency department at UChicago Medicine, discusses rapid sequence intubation (RSI) medications as part of the airway management for trauma patients.

General Surgery, Preprint Release, Trauma

PREPRINT RELEASE: Trauma Resuscitation Demonstration in a Stable Patient with a Minor Perforating Wound

Trauma Resuscitation Demonstration in a Stable Patient with a Minor Perforating Wound
UChicago Medicine

Priya Prakash, MD
Assistant Professor of Surgery
Trauma, Critical Care, and Emergency Surgery
UChicago Medicine

The patient in this case is a 17-year-old male who presented in stable condition with a minor, superficial, perforating saber wound. In this video article, Dr. Priya Prakash at UChicago Medicine demonstrates a trauma resuscitation and removes the saber.

General Surgery, Preprint Release, Trauma

PREPRINT RELEASE: Extended Focused Assessment with Sonography for Trauma (EFAST) Exam


Extended Focused Assessment with Sonography for Trauma (EFAST) Exam
UChicago Medicine

Daven Patel, MD, MPH
Resident Physician
Emergency Medicine

Kristin Lewis, MD, MA
Resident Physician
Emergency Medicine

Allyson Peterson, MD
Resident Physician
Emergency Medicine

Nadim Michael Hafez, MD
Assistant Professor of Medicine
Emergency Medicine

In this video, Dr. Hafez discusses and demonstrates how to perform an EFAST exam.