Penetrating injury
Patient (condition)
 
Aliases:
Knife wound

Topic aliases are alternate phrasings for a particular topic.


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CXR is not a sensitive test (28-72%) for detecting pneumothorax in the supine patient with blunt chest trauma. Ultrasound is better (86-98%). refl.in/7y

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CXR is not a sensitive test for detecting pneumothorax in the supine patient. Ultrasound is better. refl.in/7y

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If a patient has a knife in their back and it is not for surgical exploration, consider a lateral position on the trolley, awake, next to the operating table, fully monitored. If the patient deteriorates after the removal of the knife, roll onto the table supine and intubate. refl.in/6e

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If removing knife, without exploration, in a stable patient, an awake patient would allow for monitoring of patient status. refl.in/6e

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If a pneumothorax is suspected, avoid PPV where possible to avoid tensioning. If PPV is needed, insert ICC preinduction, or insert post-induction if small and only if patient deteriorates

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If intubating patient on their side for potential thoracotomy (knife in back and will be surgically explored), use single lumen ETT then bronchial blocker or double lumen ETT over exchange catheter

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If removing knife from chest of stable patient, one lung ventilation may be required emergently. refl.in/6e

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If performing emergency department thoracotomy & dealing with cardiac laceration, if unable to suture, insert urinary catheter into laceration & inflate to tamponade. #ref

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In a model of near-fatal hemorrhage with a vascular injury, attempts to restore blood pressure with crystalloid result in increased hemorrhage volume and markedly higher mortality. refl.in/80

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"The vigorous administration of fluids to patients with penetrating chest trauma has the potential to significantly increase blood loss" Sakles et al Annal Emerg Med 29: 392-399 1997 refl.in/7z

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