Penetrating Trauma Clinical Episode of the Disaster Podcast

In this week’s episode of the Disaster Podcast, we start off with a discussion of the possibility of dual hurricanes in close proximity inside the Atlantic Basin. This gives rise to the term Fujiwara Effect, which discusses the impacts two nearby storm systems have on each other based upon their relative storm strengths. Disaster meteorologist Dan DePodwin joins us to describe the tropical weather systems affecting the U.S. at this time and define this specialized weather event. We shift gears to our clinical topic, effects of various penetrating trauma on body systems. Dr. Joe gives and overview of the topic in various situations. Becky DePodwin, our disaster emergency management expert, asked about penetrating trauma caused by high speed wind events like tornados and hurricanes. Co-hosts Sam Bradley and Jamie Davis ask Joe about different aspects of penetrating thoracic trauma including a look at simple and tension pneumothorax injuries. Joe gives a great overview of this particular injury and field assessment and treatment. He says that the sign of tracheal deviation and jugular vein distention are over-valued as useful assessment tools in pneumothorax. Catch the episode for his full discussion. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Atlantic Storms and FujiwHara Effect The Disaster Podcast returned after a few weeks of absence, with Jamie Davis and Sam Bradley discussing current Atlantic storms and the Fujiwhara effect with meteorologist Dan. Dan explained that Tropical Storm Humberto and a potential Tropical Storm Imelda could interact in a rare phenomenon where storms circle each other, potentially steering Imelda away from the U.S. East Coast. He noted that while this interaction is less common in the Atlantic than the Western Pacific, the second half of hurricane season is expected to be more active due to favorable conditions. The discussion concluded with Jamie and Sam considering a potential disaster movie plot, while Dan clarified that while the Fujiwara effect adds complexity to storm modeling, accurate intensity predictions are crucial for forecasting its impact. Penetrating Trauma and Treatment Mechanisms Dr. Joe Holley explained the mechanics of penetrating trauma, focusing on how bullets transfer energy and cause damage through blast cavitation, which can be more severe with high-velocity, jacketed bullets designed to mushroom upon impact. He noted that while knowing the caliber or type of injury can influence treatment decisions, the primary focus is on controlling hemorrhage and addressing specific injuries like damaged organs or foreign objects. Becky raised questions about penetrating injuries from high-speed wind events, such as tornadoes, which Dr. Holley described as similarly violent but often more complicated due to the nature of the projectiles and increased risk of infection. Chest Trauma: Types and Treatment Sam and Joe discussed the complexities of chest trauma, focusing on the differences between open and tension pneumothorax. Joe explained how air escapes from the lung in a pneumothorax, leading to lung collapse, while in a tension pneumothorax, air is trapped in the chest cavity, causing increased pressure and potential damage to surrounding structures. Jamie highlighted the importance of transporting patients with such injuries to specialized trauma centers, as local hospitals may not have the expertise to handle these cases. Joe also mentioned that EMS can provide initial interventions like using a one-way valve bandage or inserting a needle to relieve pressure in a tension pneumothorax, but these patients often require more advanced care, including chest tubes and possible surgery. Head Injuries: Causes and Treatments Dr. Joe provided an in-depth explanation of head injuries, ranging from concussions to severe brain damage, including the causes and treatments of subdural and epidural hematomas. He emphasized the importance of managing intracranial pressure and described the use of a pressure monitor and spinal fluid drainage in severe cases. Dr. Joe also discussed the challenges of diagnosing tension pneumothorax in the field, noting that tracheal deviation and jugular venous distension are not reliable indicators and that healthcare providers should focus on listening for differences in breath sounds and chest movement, as well as assessing respiratory distress and hemodynamic compromise. Emergency Medicine Clinical Signs Reliability The group discussed the importance of understanding the reliability of clinical signs in emergency medicine, particularly focusing on the distinction between positive and...