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SW to heart
Errington Thompson errington at erringtonthompson.comMon Dec 1 22:15:04 GMT 2008
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Tim - Why the contrast swallow? Errington C. Thompson, MD Trauma/Surgical Critical Care Talk Show Host - WPEK www.whereistheoutrage.net Asheville, NC -----Original Message----- From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Dr Timothy Hardcastle Sent: Monday, December 01, 2008 2:14 PM To: Trauma & Critical Care mailing list Subject: Re: SW to heart Errington I would explore the neck after a contrast swallow if positive or if hard signs and in zone 2. Otherwise would have observed both injuries. Tim Dr T C Hardcastle M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA) Principal Specialist Trauma Surgeon / Honorary Lecturer UKZN Dept Surgery Deputy Director - IALCH Trauma Service > Question - I had a gentleman who tried to end it all the other night. He > had a SW (slash) to the neck and a single SW inside the cardiac box. The > patient was hemodynamically stable. CXR revealed a left effusion. I did > a > FAST in the ER then I CT of the chest with contrast. My FAST was negative > for pericardial fluid. The CT was read as a small amount of fluid at the > apex of the heart. I took the patient to the OR and explored the neck > wound. Left chest tube 500cc out then nothing. Who would have explored > this patient's chest? > > > > Next morning the patient's heart rate was 100- 110. BP 120/70. Partner > takes the patient to the OR for a pericardial window. It is positive. > Cardiac surgery finds a non-bleeding laceration to the left ventricle. > Who > would have taken this patient to the OR? > > > > Thoughts? > > > > Errington C. Thompson, MD, FACS, FCCM > > Trauma/Surgical Critical Care > > Talk Show Host - WPEK 880 AM > > Asheville, NC > > -- > trauma-list : TRAUMA.ORG > To change your settings or unsubscribe visit: > http://www.trauma.org/index.php?/community/ > -- trauma-list : TRAUMA.ORG To change your settings or unsubscribe visit: http://www.trauma.org/index.php?/community/
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