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



Download


Leave a Comment





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!

[caption id="attachment_7050" align="aligncenter" width="814"] Hard Signs in Penetrating Neck Injury (Sperry 2013)[/caption]

[caption id="attachment_7051" align="aligncenter" width="1040"] Management Algorithm for Penetrating Neck Injury (Sperry 2013)[/capti...