Heavy Lies the Helmet

Episode 128 - Keeping Trauma Close to the Chest

Apr 9, 2025
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ADVICE

Avoid Unnecessary Intubation

  • Do not intubate chest trauma patients unless absolutely necessary to avoid complicating their condition.
  • Allow spontaneous breathing to continue as positive pressure ventilation can worsen pneumothorax.
ANECDOTE

Bullet Can Cause Remote Injuries

  • A patient with a low-caliber gunshot wound had multiple internal injuries away from the entry site.
  • This illustrates that penetrating trauma can cause widespread and unpredictable internal damage.
ADVICE

Needle Only Tension Pneumothorax

  • Only needle a chest if there is a tension pneumothorax with complications like hypoxia or hypotension.
  • Do not needle a pneumothorax without signs of tension; all tension pneumothoraces must be needled.
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