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Emergency Medicine Cases

Ep 107 Blunt Ocular Trauma Live from The EM Cases Course

Emergency Medicine Cases

Dr. Anton Helman

Science, Courses, Medicine, Health & Fitness, Education

4.7602 Ratings

🗓️ 27 February 2018

⏱️ 59 minutes

🧾️ Download transcript

Summary

In this live podcast on Blunt Ocular Trauma from The EM Cases Course 2018 with Anna MacDonald we discuss the most important diagnoses to consider, describe how physical exam in queen while CT can misguide you, explain a simple approach to orbital compartment syndrome with retrobulbar hematoma, give you tips on lateral canthotomy, how to pick up subtle hyphemas, why sickle cell patients are high risk, describe the key clinical clues to subtle globe rupture, the role of tranexamic acid in eye bleeds and much more...

Transcript

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0:00.0

Anton Helman here from EMCases.

0:02.2

Now, before we get into the wild world of ocular trauma recorded live at the 2018 EMCases course in Toronto,

0:08.9

I thought I'd give you a little taste of what the participants and faculty learned at the conference in sort of a popery of audio bites.

0:16.8

Thanks so much to Dr. Barb Tatum and Michelle Yee for conducting these interviews at the course.

0:28.3

I learned about how it is safe and pretty simple to do an idea of the peritons or abscess in the emergency department and some little pearls that you can use,

0:39.5

such as using a safety guard for scalpel blade and for a needle driver to prevent going into the carotid artery

0:46.5

when you're doing a procedure. You don't necessarily need to refer them to E&T. You can do this in the

0:51.0

emerge and have them out of the door within an hour.

0:54.5

The external rotation of the ankle is like chest pain going to the back. You can't miss it.

1:01.5

I am Gotham Walia. I am a general practitioner working in the emergency department at Uxbridge Cottage

1:07.2

Hospital in Uxbridge. One of the take-home points that I took away from today's great session was about the

1:15.4

rise of thrombectomy in stroke.

1:18.7

So I work at a site where we refer out to our strokes to a regional stroke center

1:25.4

and been guided previously that patients outside of the

1:30.4

four to five hour window really don't benefit from referral to a stroke center.

1:35.2

So being able to review some of the latest studies that have come out about a month ago

1:39.7

have been quite helpful and will also be helpful for me when I'm talking to consultants,

1:45.7

the stroke physician on the other line in terms of trying to get a patient to the appropriate

1:51.5

disposition. So that's a big take-home point for me today. I think definitely more and more of

1:57.4

us are moving away from antibiotics in adult patients with culture-proven strepherangitis.

2:03.9

These days in developed countries, in urban centers, particularly, there's extremely, extremely

2:09.3

low risk of getting rheumatic fever. So the number needed to treat for rheumatic fever is crazy high.

...

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