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PROCEDURES

The surgical skills taught at RESUSCITATE

Please note that this list may be modified

BURR HOLE

  • A hole is drilled into the skull and a tube is inserted to drain a haematoma.

  • Click here for video

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LATERAL CANTHOTOMY

  • ​Emergent orbital decompression in retero bulbar haemorrhage.

  • Canthotomy combined with disinsertion of at least the inferior crus of the lateral canthal tendon. 

  • Click here for video

SURGICAL AIRWAY

  • Surgical incision below the glottis in order to achieve direct access to lower respiratory tract bypassing the upper airways.

  • Surgical airway management is often performed as a last resort in 'Can't intubate, can't ventilate' scenario or in complex facial trauma for example.

  • Click here for video

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ULTRASOUND GUIDED NERVE BLOCKS IN TRAUMA

  • Serratus Anterior block

Useful in delivery of analgesia for ICD, Thoracotomy and rib fractures

  • Cervical plexus block

Useful in delivery of analgesia for neck access

  • Fascia iliaca block

Useful in delivery of analgesia for femur fractures

  • And many more!!

 

RESUSITATIVE THORACOTOMY

  • Performed to resuscitate a major trauma patient who has sustained severe thoracic or abdominal trauma and who has lost their cardiac output.

  • The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation. 

  • Finger thoracostomies, Left antero-lateral thoracotomy, Clamshell thoracotomy, Repair of cardiac injuries will all be taught.

  • Click here for video

PRE-PERITONEAL PACKING

(TBC)

  • Pre-peritoneal packing is a method of directly packing the retroperitoneum without the need for a laparotomy

  • Haemodynamically unstable pelvic fracture prior to angiographic embolisation to stop venous bleeding

  • Click here to view video

REBOA

  • REBOA is Resuscitative Endovascular Balloon Occlusion of the Aorta

  • It involves placement of an endovascular balloon in the aorta to control haemorrhage and to augment afterload in traumatic arrest and haemorrhagic shock states

  • Click here to view video

MASSIVE HAEMORRHAGE

A Sengstaken–Blakemore tube is a  inserted through the nose or mouth and used in the management of upper GI Bleed due to varices. The use of the tube was originally described in 1950.

The tube may be difficult to position, particularly in an unwell patient, and may inadvertently be inserted in the trachea hence ETT before the procedure is advised to secure the airway. The tube is often kept in the refrigerator in the hospital's emergency department, ICU and GI ward. 

 

ECPR

  • Extracorporeal cardiopulmonary resuscitation (commonly known as ECPR) is a method of cardiopulmonary resuscitation (CPR) that passes the patient's blood through a machine in a process to oxygenate the blood supply.

  • The use of ECPR to rescue patients with cardiac arrest that is refractory to conventional cardiopulmonary resuscitation has been shown to improve survival in many patient populations.

  • Click here to view video

SUBCLAVIAN CUTDOWN

  • Subclavian artery injuries

  • Axillary artery injuries

Penetrating injuries to the axilla and difficult to directly or indirectly control. Cut down to the vessels will allow ligation of same under direct vision.

RESUSITATIVE HYSTEROTOMY