Credits: 3
Offered: Winter Semesters
This course will review Trauma, Nontraumatic Musculoskeletal Disorders, Abdominal and Chest Emergencies. The student will be able to recognize and treat the disorders. The student will feel comfortable seeing and treating these patients in the emergency department.
Trauma Emergencies Learning Outcomes
- Describe how to perform a primary and secondary survey in evaluation of the trauma patient as outlined in the Advanced Trauma and Life Support (ATLS) guidelines.
- Explain the importance of considering the mechanism of injury in trauma patients.
- Understand how to calculate patients Glasgow Coma Scale (GCS) in the evaluation of patients following head trauma.
- Assess the trauma patient’s vital signs and recognize the potential of significant trauma in the presence of normal vital signs.
- Explain the use of radiographs and labs in the initial management of the trauma patient and understand their limitations.
- Describe treatment priorities in the patient that presents with multisystem trauma.
- Describe the role of the focused assessment with sonography in trauma (FAST) exam in the trauma patient.
- Describe the signs and symptoms of hemorrhagic shock.
- Name the indications and contraindications for emergency procedures in the trauma patient, such as endotracheal intubation, cricothyroidotomy, tube thoracostomy, emergency department thoracotomy and central venous catheter insertion. Describe in detail how these procedures are performed and their possible complications.
- Understand the difference between blunt and penetrating trauma and the workup.
- Describe the treatment in the head trauma patient.
- Describe the principle of primary and secondary brain injuries in the head trauma patient.
- Describe the management of spinal-cord injuries. Name the indications and potential benefit of steroids in patients with significant neurologic deficits following spinal-cord trauma.
- Describe the presentation, physical findings, diagnostic evaluation, and treatment of traumatic aortic disruption, cardiac contusion, pulmonary contusion, rib fractures, clavicle fracture, sternal fracture, flail chest, hemothorax, pericardial tamponade and pneumothorax.
- Describe the most commonly encountered intra-abdominal injuries in blunt abdominal trauma and how these injuries are diagnosed and treated.
- Describe the different genitourinary organ traumatic injuries that can be seen.
- Explain the management of patients who present with pelvic fractures. Appreciate the potential for severe hemorrhage in addition to intra-abdominal and pelvic organ injuries.
- Describe the presentation, physical findings, diagnostic evaluation and treatment of bony and soft tissue facial trauma.
- Explain the management of traumatic amputations. Understand the proper means in which to preserve the amputated appendage.
- Describe the management of common joint dislocations and fractures, including glenohumeral, elbow, interphalangeal, hip, knee and ankle.
- Understand the signs and symptoms of compartment syndromes and understand their treatment.
- Evaluate patients with open fractures and penetrating joint trauma and explain the appropriate ED treatment of such injuries.
- Describe the diagnostic approach and ED treatment of nontraumatic neck and back pain.
- Understand the workup and treatment for a spinous process fracture, transverse process fracture and a compression fracture.
- Name the various “red flags” that should prompt diagnostic imaging and specialty consultation in cases of neck or back pain.
- Compare and contrast the clinical presentation of spinal-cord compression, disk herniation and spinal epidural abscess.
- Name the limitations of plain films and computed tomography (CT) scans in the evaluation of nontraumatic neck and/or back pain.
- Explain the indications for obtaining an emergent MRI in patients with neck or back pain.
- Describe the clinical presentation, diagnostic evaluation and treatment of common hand infections, including cellulitis, flexor tenosynovitis, deep space infections, closed fist injuries, paronychia, felon and herpetic whitlow.
- Understand how to treat an infection from an animal bite.
- Describe how to perform an arthrocentesis of the major joints. Know how to interpret the results of joint fluid analysis to differentiate septic arthritis and other causes (e.g., gout, pseudogout).
- Describe the clinical presentation, diagnostic evaluation and treatment of common overuse syndromes, including carpal tunnel syndrome, DeQuervain’s tenosynovitis, plantar fasciitis and tendonitis.
- Describe the management of sprains, strains and tendon injuries.
Abdominal Emergencies Learning Outcomes
- Describe how abdominal wall hernias are diagnosed and explain the appropriate treatment and disposition patients who present with this condition.
- Explain how the following disorders of the esophagus may present, how they are diagnosed and their appropriate treatment, such as esophagitis, GERD, caustic exposures, dysmotilities, Boerhaave’s syndrome, foreign bodies, Mallory-Weiss syndrome, strictures and stenosis and varices.
- Understand viral hepatitis.
- Describe the complications of liver failure and cirrhosis, such as bleeding, hepatic encephalopathy, hepatorenal syndrome and spontaneous bacterial peritonitis. List the laboratory abnormalities that may be encountered with these conditions.
- Explain how cholecystitis may present, how one would work up a patient with this suspected diagnosis and the appropriate management of this disease.
- Describe the syndrome of ascending cholangitis and how it is treated.
- Explain how pancreatitis is diagnosed and treated.
- Compare and contrast acute and chronic pancreatitis.
- Explain the complications of ulcerative colitis.
- Describe the typical symptoms of Crohn's disease.
- Explain the diagnostic approach to the patient with Crohn’s disease who presents to the ED with abdominal pain.
- Understand the workup and treatment for diverticulitis.
- Describe the diagnosis and management of irritable bowel syndrome.
- Describe the appropriate diagnostic approach and treatment for the patient who presents with diarrhea.
- Understand treatment for Meckel’s diverticulum.
- Describe the risk factors, clinical presentation, diagnostic evaluation and treatment for partial and complete bowel obstruction.
- Describe the common symptoms of peptic ulcer disease and gastritis and how they may be managed in the ED.
- Compare and contrast the clinical presentation, diagnostic evaluation and treatment of upper vs. lower GI bleeding.
- Compare and contrast a mechanical bowel obstruction versus an ileus.
- Explain the risk factors, clinical presentation, diagnostic evaluation and treatment of an aortoenteric fistula.
- Describe the manifestations of mesenteric ischemia, as well as the risk factors, diagnosis and treatment.
- Describe the typical and atypical manifestations of acute appendicitis, as well as the diagnostic approach to the patient with possible appendicitis.
- Describe the patient populations in which acute appendicitis is commonly missed.
- Compare and contrast the pathophysiology, clinical presentation, diagnostic evaluation and treatment of gastric, cecal and sigmoid volvulus.
- Describe the clinical presentation, diagnostic evaluation and treatment of toxic megacolon.
Chest Emergencies Learning Outcomes
- Discuss some of the etiologies of noncardiogenic pulmonary edema and how to treat this entity.
- Explain the presentation and treatment of a pleural effusion.
- Understand the presentation and workup for tuberculosis.
- Discuss the pathophysiology and nuances of treatment of an exacerbation of asthma.
- Define bronchitis and describe its treatment.
- Explain the diagnosis and treatment of an exacerbation of COPD.
- What are some of the complications of cystic fibrosis?
- Describe the clinical presentation, diagnostic evaluation and treatment for a patient who presents to the ED following exposure to toxic gases/fumes.
- Describe the signs and symptoms of costochondritis. Also, what is the treatment?
- Explain the diagnosis and treatment of mediastinitis.
- Explain the risk factors, clinical presentation, diagnostic evaluation and treatment for pneumomediastinum and pneumothorax.
- Compare and contrast the pathophysiology, diagnostic evaluation and treatment for spontaneous pneumothorax vs. tension pneumothorax.
- Discuss the various types of pneumonia, including patterns of presentation and treatment such as aspiration, atypical, bacterial, fungal and viral.
- Identify and treat ARDS.