An overview of common hand injuries, including mallet finger, boxer’s fracture, and more!
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While resuscitative thoracotomy and REBOA are often viewed as heroic procedures, both carry an exorbitant amount of mortality and morbidity, and few centers around the country are able to competently offer these options. It seems appropriate to consider alternatives, especially with the emergence of bedside ultrasound and its increasing applicability in the emergency setting. PEAC or US-guided PEAC may be more feasible, performable by mostly untrained staff, and may temporize bleeding to permit transfer to definitive care.
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A 73 year-old male presents to the emergency department complaining of chest pain following an assault. The patient is alert and greets you when you enter the room to evaluate him. He has bilateral breath sounds, but you question if the right lung field sounds diminished as compared to the left. He has a strong radial pulse with a normal rate and a blood pressure of 123/84. He is oriented to person, place, and time. He lifts his gown to draw your attention to his left chest wall, where he reports being struck by an unknown assailant’s fists. His oxygen saturation is 98% on room air. He endorses a slight feeling of dyspnea, but says “it’s just because it hurts, doc.” He explains that it was a brief assault and he didn’t sustain any blows to his head.
He denies past medical history. His appendix was removed when he was a child. He takes no medications. He has no known allergies. A chest x-ray is performed:
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A 26 year-old male presents after a motorcycle accident. He was the helmeted, single-occupant of a motorcycle that crashed into the back of a stopped car. There are no external signs of injury, but he believes his neck may have hit the handlebars as he was thrown from the bike. He denies loss of consciousness. His only complaint is that his voice sounds hoarse and he is having difficulty swallowing. He denies any intoxicants…
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