May 21, 2018

Episode 146.0 – Morning Report Pearls V

7 minutes

More pearls from our fantastic morning report series at Bellevue.

https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_146_0_Final_Cut.m4a

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Tags: Endocarditis, Ludwig's Angina, Penetrating Neck Trauma

Show Notes

Take Home Points

In patients with neck pain, consider Ludwig’s angina particularly if they have any swelling, fever, truisms or respiratory difficulty. Consider early airway management and get your consultants involved early for operative management

Endocarditis is a tricky diagnosis and will often be subtle. Any patient with a prosthetic valve and a fever has endocarditis until proven otherwise. Suspect it in any patient with fever and a murmur, get lots of cultures and remember that TEE is the gold standard but, TTE is highly specific

Finally, penetrating neck trauma. Patients with hard signs – airway compromise, ongoing brisk bleeding, an expanding/pulsatile hematoma, neurologic compromise, shock or hematemesis should go directly to the OR and don’t probe the wounds!

Hard Signs in Penetrating Neck Injury (Sperry 2013)

Management Algorithm for Penetrating Neck Injury (Sperry 2013)

Read More

LITFL: Ludwig’s Angina

Core EM: Infective Endocarditis

EM Cases: Endocarditis and Blood Culture Interpretation

Sperry JL et al. Western Trauma Association Critical Decisions in Trauma: Penetrating Neck Trauma. J Trauma Acute Care Surg 2013; 75(6): 936-41. PMID: 24256663 [OPEN ACCESS]

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