Critical Care

Back to Basics: Open & Depressed Skull Fractures

This post is not intended to be a comprehensive review of skull fracture types and management, but rather a discussion of two subtypes of skull fracture – open and depressed fractures.  I chose this topic because it’s something I saw frequently during my recent elective working in an emergency department in Kumasi, Ghana.  In the United States at trauma centers these patients are frequently managed immediately by neurosurgery; however, with few consultants available, I was able to be more involved in the prolonged care of these patients. If faced with these types of severe head/skull injuries in a community hospital, it is important to feel comfortable with the initial management.  

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Advanced Procedures: How to Create a Pericardiocentesis Model

Pericardiocentesis is a rarely performed, but potentially life-saving procedure. Commerical models are prohibitively expensive, but students and residents (and critical care fellows) still need to learn the mechanics, ideally with an ultrasound compatibile model. This week's post gives a step by step guide towards making a cheap, easy to fabricate phantom based on this fantastic paper published in the Journal of Emergency Medicne 2012: https://www.ncbi.nlm.nih.gov/pubmed/21925818

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