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February 10, 2013 by Scott Weingart, MD FCCM

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Filed Under: EMCrit Tagged With: members, podcasts

Cite this post as:

Scott Weingart, MD FCCM. Join the EMCrit G+ Community Page. EMCrit Blog. Published on February 10, 2013. Accessed on March 22nd 2023. Available at [https://emcrit.org/emcrit/emcrit-google-community-page/ ].

Financial Disclosures:

Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.

CME Review

Original Release: February 10, 2013
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025

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Fionna Lowe
Fionna Lowe
10 years ago

First of all, thank you Scott for the great podcasts, which have managed to make my recent hour long commute time well spent! I am an Emergency Medicine Trainee in the UK, and as part of of my final exams need to write a in depth critical appraisal topic review (basically a literature review). My topic is ‘ In a patient in traumatic cardiac arrest following blunt trauma, in whom a eFAST scan idetifies a pericardial effusion, is there any benefit of performing an Emergency Department Thoracotomy?’. There is a lot of research out there, but none looking at blunt… Read more »

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Will Sargent
Will Sargent
9 years ago

Hi Scott,
I really liked the chapter about errors in your book, but I can’t find any links on the blog to discussing these.
Any external links/ resources on cognition etc would be great
Will

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Kelly Irwin
Kelly Irwin
9 years ago

I have a question: I listened to the first and second vent lectures which I loved- but you talk about IFR and we don’t have that on our vent (LTV 1200). We have I -time which on an adult on our vent ranges from 0.3 to 3.0. I could find specific i-times for infants and pediatrics but not adults. Without having to do an equation what is the standard i time for an adult? Our vent has been at 1.0, which according to the pediatric information is less than recommended for over 6 years old (1.2). Thanks!

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Johnsa
Johnsa
9 years ago

Hi Scott,

My question relates to the Boston Bombings.
Jeff Bauman lost both his legs in the attack but did not appear to lose a
great quantity of blood.
This is something I do not understand.
Can you clear this up for me ?
I have searched the internet but have been unable to find an answer.
I understand that cauterisation and crushing injuries can restrict blood loss but
I do not think these causes were relevant in this instance.

Many Thanks

John

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Scott Weingart, MD FCCM
Author
Scott Weingart, MD FCCM
9 years ago
Reply to  Johnsa

aside from those mechanisms; hypotension will lead to limited blood loss until someone raises the pressure.

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Johnsa
Johnsa
9 years ago
Reply to  Scott Weingart, MD FCCM

Thank you for responding.

I looked up hypotension and it did not mention trauma as a cause.

Can you explain how it would be a factor in the case of Mr Bauman ?

Many Thanks

John

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Scott Weingart, MD FCCM
Author
Scott Weingart, MD FCCM
9 years ago
Reply to  Johnsa

I’m sorry I don’t understand your question

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Johnsa
Johnsa
9 years ago

Sorry ! Mr Bauman had 2 people lying beneath him soon after the explosion which removed his legs, his right leg above the knee , his left below the knee. I would have expected those 2 people to have had significant amounts of his blood on them. Subsequent photographs do appear to show this to be the case. I am sure there is a good medical reason for this and I would like to know what it is. From your last answer you seemed to imply that hypotension could be a factor given that the other reasons for limiting blood… Read more »

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Gordon Scriba
Gordon Scriba
9 years ago

Hello Scott, Question re: autotransfusion. “Literature at that time (I don’t have it at hand) strongly suggested that activated complement and clotting factors in shed blood from mediastinum / chest could initiate or worsen a consumptive coagulopathy. There was certainly no apparent benefit of this practice to patients and so it was discontinued. Reinfusion only occurs after washing. Subsequently, I have personally seen severe DIC associated with direct re-infusion of unwashed pericardial blood (high bleeding rate) following complications of ablation procedures. Re-infusing activated clotting factors, activated complement, etc. can obviously be harmful re: coagulopathy.” (hematologist). When PRBCs are available, should… Read more »

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