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Emergency Medicine Cases
EM Quick Hits 60 Post-Tonsillectomy Hemorrhage, Post-CABG Infections, Bougie Tips, Pelvic Fracture Bleeds, Debriefing: Why, When & How
Oct 22, 2024
52:10
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Kevin Wasko, Chief of the ED at North York General Hospital, shares insights on managing post-tonsillectomy hemorrhages. Brit Long discusses critical strategies for assessing and managing post-CABG incision infections. Anand Swaminathan provides expert tips on using gum elastic bougies for airway management. Leah Flannigan highlights the importance of identifying vascular injuries in pelvic fractures. Andrew Petrosoniak emphasizes the value of debriefing in trauma resuscitations, enhancing team performance and patient outcomes.
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Quick takeaways
- Understanding the classification and management of post-tonsillectomy hemorrhage is vital for timely intervention and patient stabilization.
- Implementing structured debriefing after clinical events can enhance team performance, improve communication, and ultimately lead to better patient outcomes.
Deep dives
Understanding Post-Tonsillectomy Bleeding
There are two primary classifications of post-tonsillectomy bleeding: primary and secondary. Primary bleeds occur within the first 24 hours, often tied to intraoperative factors or underlying coagulopathy, while secondary bleeds can arise from five to fourteen days post-surgery due to clot sloughing. Understanding the timing and nature of these bleeds is essential, as secondary bleeds may start as mere trickles but can escalate to significant hemorrhages. It’s crucial to involve ENT specialists early in the management of these patients to ensure timely and effective care.
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