Hello, med students. My name is Zach Olson, and thank you for downloading this week's

episode of the EM Clerkship Podcast. Today we will be continuing our trauma series. A few weeks ago,

we discussed lung and chest wall injuries. This week, we will be staying above the diaphragm and discussing

cardiovascular trauma. Hey, Doc, so we have a 47-year-old female. She's a driver in a vehicle

versus guardrail. Found unconscious with rapid labor breathing at the scene

NPA was placed. Bagging got us 96% on O2. Looks like she bent the steering wheel in half with her chest,

discoloration and instability noted to the anterior chest bilateral femo fractures. Ultrasound showed free fluid

in the abdomen as well,

so you guys know, facial lax. BP was 94 over 65 minutes ago. We were giving 200 millilit

boluses just to maintain. That's what she's gotten 400 milliliters total. Pulse is 140,

respirations at 36. EKG was all over the place. You could look at that. Some of that might actually be some artifact, but there you go.

Yep.

Any questions?

Anybody?

In this episode, there are three major diagnoses that I want you to know.

Cardiac Tampanod, aortic dissection, and blunt cardiac injury, previously known as cardiac contusion.

Those are the big three.

And since the workup for each of these is completely different and the treatments are different,

in this episode we will go through each one individually,

almost like three mini-critical diagnosis episodes.

First, cardiac tamponad. This is most commonly seen with penetrating chest trauma, but it can

also happen with blunt trauma. The heart itself is surrounded by a tough, fibrous sac called the paracardium.

...