Hello, med students. My name is Zach Olson and thank you for downloading this episode of the EM

Clerkship Podcast. This month I've been in the city of Memphis, eaten some barbecue and seeing a ton

of ridiculous trauma on my trauma rotation. And so sticking sticking with this theme, over the next several episodes,

we're going to be talking about different types of trauma, starting with today's case.

University Hospital of Delta 7 Med Flight, Andrew with a trauma alert.

We have a 19-year-old male patient with an unrestrained driver and head-on collision with ejection.

Patient intubated on Zine, currently BP 200 over 140, pulse of 110, showing good end tidal waveforms.

Pupils are unequal and fixed.

Glucose is 140.

Skin is pale and clammy.

It's showing sinus stack on the monitor.

The patient is bordered and collars at this time.

Flight time to your facility is approximately 10 minutes.

Lots going on here, but unrestrained driver, blown pupil, sounds like a bad head injury

probably. In ATLS, this is primary survey, letter D, disability, head injury.

The most important thing to remember from this episode is your imaging.

CT scan without contrast.

We'll get into when to order this in a bit, but the CT scan without contrast is the most important test for one big reason.

It highlights blood.

Blood turns up white on a CT head without contrast.

It's easy to see, and that is why it's your primary imaging of choice in head injury patients.

Now, our approach. First, think through

...