After our last post, a few viewers have suggested that we continue the trend of elevated compartment pressures and address a super duper rare yet potentially life saving procedure today. So, escharotomy....here-a we go!
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Compartment syndrome can occur in any extremity, but the most common presentation you'll see is in the anterior compartment of the lower limb. It is an incredibly difficult diagnosis to make clinically, which is huge potential pitfall as correct identification can be delayed or even missed entirely.
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Classically, patients will exhibit Beck’s Triad...Unfortunately, as we mentioned above only a minority of patients will exhibit all three. So the bottom line is that if you see someone who you think might be worth having their heart looked at, go ahead and slap an ultrasound probe on their chest.
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You always have to remember that you cannot do a traditional cric on a child. Their cricothyroid membranes are just too small to accommodate an endotracheal tube, and you have an incredible high likelihood of damaging local structures.
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Most providers I've talked to can count the number of cric's they've had in their career on one hand, but they remember every single, bloody detail of theirs, and will continue to do so until the day they die...
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Enter the Sengstaken-Blakemore Tube, basically a last ditch effort for balloon tamponade. This procedure is not a common one given the prevalence and efficacy of endoscopy, but when you're all out of options it's either this or a body bag.
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