Category Archives: Trauma

Straight, No Chaser: Questions You Should Ask When You Have a Laceration

laceration

I wonder if any of us avoid lacerations over the course of our lives. It seems that everyone I know or every patient I have cared for has a scar and a story to accompany it. Fortunately, it’s not as simple (or complicated) as going to the emergency room and getting stitches when a cut (laceration) occurs. Today’s Straight, No Chaser offers you simple facts and questions to ask your physician when you find yourself or someone else you’re caring for needing care for a laceration. Believe me, you want to know the correct questions to ask, and you want to have an understanding of expected outcomes.

When should I deal with these cuts at home?

Remember that a laceration is a manual breakdown of the body’s most basic defense against toxins and other agents entering your body. This creates a significant risk for subsequent infection. In most cases it is advisable to get a laceration at least evaluated, which doesn’t mean you’ll necessarily need stitches.

Are there things I can do at home to help?

We now know that tap water is as effective as the saline used in hospital or clinic settings to clean wounds. If you’re at home, copious rinsing of the wounds with warm water followed by applying clean wrappings is a good idea.

Are there things I shouldn’t do at home in an attempt to help?

Detergents, hydrogen peroxide and povidone-iodine solutions should be avoided, as they can damage the integrity of the skin.

How long after a cut can I get stitches?

This depends on the location of the wound, your health and factors such as mechanism, contamination and risk for subsequent infection. As a rule, you should get lacerations evaluated within 12 hours after the injury. Under all circumstances you should be seen within 24 hours after an injury.

What happens if I come in too late to get stitches?

Depending on circumstances, your physician has additional options that can reduce the infection risk and optimize the cosmetic outcome. Some older wounds may be loosely closed, followed by a definitive repair in a few days if all goes well (i.e. no signs of infection in the interim). Other wounds may be packed with protective gauze as an alternative. Still others will simply need to heal on its own. Your physician can discuss when and why each option is preferable.

lac repair with staples

Will I always need stitches?

No. Sometimes what appears to be a cut is actually a scratch. Other times, lacerations can or need to be repaired with other options, such as steri-strips (a version of medical taping), tissue adhesive (you call it medical glue) or staples.

laceration_chin dermabond_chinlac0

What’s the glue that’s being used? 

In many circumstances, tissue adhesives not only can be used but should be used. Tissue adhesives have similar results as sutures in cosmetic results (i.e. appearance), breakdown rates, and infection risk. That said, some types of wounds, some situations and some locations prevent the use of tissue adhesives. Ask your physician if a tissue adhesive is a reasonable option.

Can I just use some form of glue at home?

No. It’s not the same, and if you try using some commercial glue, paste or needle and thread on your cuts at home, you’re asking for a ferocious infection in a few days.

Will I always need a shot for my numbing medicine?

No. Ask your physician if a topical medicine option is appropriate, especially in children or those otherwise wanting to avoid needles.

stitches

How long do stitches stay in?

Here are some guidelines based on the location of the laceration.

Face Three to five days
Scalp Seven to 10 days
Arms Seven to 10 days
Trunk 10 to 14 days
Legs 10 to 14 days
Hands or feet 10 to 14 days
Palms or soles 14 to 21 days

How do I care for myself after the cut has been fixed?

Follow-up for repaired lacerations is pretty similar regardless of the method used to repair. Consider the following.

  • Keep the wound clean and dry using a protective dressing for at least 24 hours after the repair, unless tissue adhesive was used, in which case no dressing should be applied.
  • An antibiotic or white petrolatum ointment can be applied daily to wounds not repaired with tissue adhesives. That’s right, white petroleum ointments are just as effective as antibiotic preparations.
  • If you’ve received a tissue adhesive, you must avoid white petroleum or antibiotic ointments over the wound site, as these can dissolve the tissue adhesive, causing the wound to break open.

Anything else?

Even if you’re not asked, you should always ask if you need a tetanus vaccine after a laceration. The answer will always be yes if it’s been more than 10 years since your last immunization, and in selected cases it will be indicated if it’s been more than 5 years.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Leave a comment

Filed under Skin/Dermatology, Trauma

Straight, No Chaser: How to Survive a Motor Vehicle Collision

 

As you drive the expressways of some cities, you can now see signs displaying how many traffic deaths have occurred during the year. I’m sure the purpose of these announcements is to keep drivers alert to the real dangers of driving and to remind us to drive safely. We discussed the magnitude of motor vehicles crashes (they’re not accidents) in the last Straight, No Chaser. However, when prevention hasn’t kept you out of harm’s way, what you do next can make a world of difference. Here are 10 quick tips to keep you upright.

If you see an accident happening in front of you …

Whitetail deer jumping a fence into a roadway.

1) Move away from the steering wheel/dashboard. That airbag will be coming at you at approximately 200 MPH. It can cause burns and other injuries on its own. You want both hands on the wheel as loose as possible during impact.

2) If possible, angle the car for a glancing blow. Try to avoid the head-on collision, especially with the bigger object. Similarly, the ‘T-bone’ side impact collision is especially dangerous, as the car is structurally weaker on the side, and the side is closer to passengers.

3) Slow down as best you can, but also try to control your deceleration. The faster the impact, the worse the damage will be.

4) If there’s time and you haven’t already, get that seat belt on.

5) If there’s time, get any potential projectile from where it may strike you. That’s off the seat, dashboard and cup holders. Hot coffee in your face or being slashed by your phone won’t feel good.

After the crash …

mvc1

6) Call emergency medical services as your first move after a crash.

7) If you have any neck pain, as best you can, do not move. Period.

8) If you are pregnant, get onto your left side while you wait.

9) After a crash, switch off your engine, do not smoke, and stop anyone else from smoking. You will not be in a position to put out any fire you start and if flammables are in either car, you could be setting up an explosion.

10) Do not attempt to remove injured people from a vehicle yourself; leave that to the paramedics. You could be aggravating a neck (spinal) injury that is not obvious at that point.

It bears repeating: the best way to survive car crashes is not to be involved in one.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Leave a comment

Filed under Trauma

Straight, No Chaser: Motor Vehicle Crashes – Risky Behaviors, Injuries and Prevention

 

Image result for fatal motor crashes per day 2017

‘Tis not our task to preach but to inform. Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer. Forewarned is forearmed. There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding. If there was such a thing as Human Shark Week, the biggest and baddest predator in the trauma world would be motor vehicle crashes.

Motor vehicle collisions are the single leading cause of death among those between ages 5-34 in the US. More than 4.26 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2016.. Traffic fatalities increased by 6 percent from 2015 to 2016 (up to 40,200) in the United States (102 people per day). Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.

Risky Behavior:

Image result for us car injuries 2017Danger is enhanced by various distractions and inadequate protection. The mistake people make is not understanding that much of the danger is outside of your control – other drivers. If you’re impaired or distracted, you can’t respond effectively. I’ve seen it all.

  1. Drinking while driving – Stop it with the “I can handle my liquor” nonsense. Someone dies every hour from drinking while driving. It’s not just drunk driving, it’s impaired driving. Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
  2. Texting while driving
  3. Eating while driving
  4. Reading while driving
  5. Doing your hair/shaving/makeup while driving
  6. Kissing and other sexual activities while driving
  7. Motorcycle driving/riding without a helmet
  8. Letting your children drive without a license and/or formal training: it’s all too true. Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
  9. Letting your children ride in the front of the car
  10. Not wearing seat belts (the biggest mistake of them all)

Injuries:

I’ve seen nearly every conceivable injury from motor vehicle collisions. It doesn’t take as much effort as you’d think to have a very bad life after a crash.  Consider the following possible going head to toe (and yes, the list is abbreviated)…

  • Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
  • Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
  • Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
  • Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
  • Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
  • Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

MVC-Utilization of Safety Equipment Among Those Injured in a Motor Vehicle Crash

  1. Seat belt use reduces serious injuries and deaths in crashes by 50%. Air bags provide added protection but are not a substitute for seat belts in a crash.
  2. Wear a seat belt every time, every trip.
  3. Seat all kids under 12 in the back seat.
  4. Seat backseat passengers in the middle (it’s the safest spot in the car)
  5. Regarding any function on a smartphone, if you can’t be hands free, it can wait. If you must use your hands, pull over.
  6. Remember designated drivers?  Yes, that’s still a thing.
  7. If you’re on a motorcycle, wear a helmet, every time, every trip.
  8. Protect your teen.  No license, no vehicle.  Consider driving school.

motorvehiclecar_crash_01641

Impaired and distracted driving will cause you harm; it’s not an “if it’ll happen” situation, it’s “when it happens.” Please consider the points I’ve mentioned and the lives of passengers/other drivers when deciding how you handle your vehicle.  Good luck on the road.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Leave a comment

Filed under Trauma

Straight, No Chaser: The Role of Gunshot Wounds in a Nation at War with Itself

gunviolence

Apparently there is going to be an ongoing need to address this… Somewhere in the midst of reconciling the parts of me that are physician, public health professional and African-American male, I realized that I don’t have the luxury to simply review the medical aspects of gunshot wounds. As an African-American, I have lived my entire life learning and having it reinforced that I and others of my kind are a misunderstanding or inappropriate interaction away from becoming a statistic (and not just via the police). As a physician I get to treat, and as a public health professional I get to report and fashion broad solutions to various challenges, but as an African-American, I get to live a certain reality that for me began when my father died from a so-called “random gunshot” wound when I was a small child.

GunshotWoundsBrain_300x

The trauma inflicted by a gunshot wound is not theoretical. It is a medical lie that such a thing as a warning shot exists, if indeed a bullet enters your body. Penetrating injuries to virtually all areas of the body (brain, neck, chest, back, abdomen, groin, extremities) can be fatal. Gunshot wounds have several ways of injuring you, including the direct damage to tissue, indirect damage from the shock waves and direct damage from fragments (of the bullet or bone). When you shoot someone, you have factored in a possibility that the wound you inflict could be fatal. Police officers shooting individuals are aiming at areas correlating with defined statistic probabilities of death, none of which is zero. Those trained in firearm use make choices: shooting to kill instead of to subdue is a deadly choice among other options. No one should ever be allowed to claim otherwise.

castle

We live in a country that is without debate the most violent country on earth, both outside of and within all parts of our borders. From the individual’s rights to bear militia levels of arms to the police’s increasing position as military units, from the contradictions of allowing both “Open Carry” and “Stand Your Ground,” we are spiraling toward an inevitable conclusion. Stop being so deficient of attention about what’s happening before our eyes, and think and ask what the inevitable conclusion of all of this is going to be.

Regardless of your political persuasion, there are issues to be addressed. Although the news of the day isn’t pointed in this direction, the extent of this madness has begun to envelope children as well.

gun-violence

Consider the following facts from the Children’s Defense fund,

  • 7,768 children and teens were killed with a gun during 2013-2015. That’s enough to fill 388 classrooms of 20 children. 2,799 were killed in 2015 alone.
  • Young Blacks are being exterminated by gunshot wounds in this country.  Black children and teens accounted for 14% of the total child population while each day in America 8  children or teens are killed with a gun; black children and teens account for 3 of those daily deaths. Are you just going to read this statement passively without wondering about and contributing to a solution?
  • Gun violence remains the leading cause of death for Black children and teens.  In 2015, 9.5 out of every 1,000 Black children and teens were killed with a gun; a rate four times higher than the rate for White children and teens (2.5 per 1,000). A Black child or teen was killed with a gun every 7 hours and 25 minutes.
  • Since 1963, the number of children and teens killed by guns on American soil was more than three times higher than the number of U.S. soldiers killed by hostiles in wars abroad. Nearly 180,000 children and teens dies from guns in the U.S. between 1963-2015.

Using more recently available data, the Centers for Disease Control and Prevention lists the number of firearm-induced deaths in 2015 as 36,252.

GunViolenceend

What is it going to take to get the American public and leaders to stand up to protect the lives and safety of children over the lobbies of gun owners and sellers? America can walk and chew gum at the same time. We can fashion reasonable safety measures and restrictions that will save lives while working within the framework of current interpretations of the Constitution by the Supreme Court. This will not occur without pressure from the populace.

Martin Luther King, Jr had two famous and related quotes that are relevant and applicable here.

  • “Our lives begin to end the day we become silent about things that matter.”
  • “In the end, we will remember not the words of our enemies, but the silence of our friends.”

If you are not willing to take specific actions to eradicate the challenges facing us, that makes your condolences somewhat hollow after tragedies have occurred. It is past time to get involved in whatever way you can or choose. The life you save may be your own.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPres

Leave a comment

Filed under Trauma

Straight, No Chaser: Avoiding Summertime Sports Injuries

Sport-Injury

It’s not just kids that get injured in the summer having fun. Those of you weekend warriors, recreational and actual athletes are very much at risk also. Now, professional athletes are at risk for injuries for different reasons than weekend warriors. Although accidents happen to everyone, poor conditioning and training, propensities not to stretch or warm up, relatively poorer playing conditions, and use of inferior equipment (or lack of use of any at all) make your adventures a little more risky. Straight, No Chaser has reviewed many common sports injuries. Links to some are listed below, and others you can read up on just by typing what you’re looking for into the search box on the right.

The most common sports injuries include the following conditions.

Of course, the most common aren’t all the rage. Everyone’s concerned about concussions. Here’s a Straight, No Chaser review of concussions.

The weekend warrior is too often engaged in a testosterone fest and doesn’t listen to his body. If you get hurt, stop. If you don’t listen to your body, something more serious could be on the verge of happening.

sports-injuries soccer

Here are some tips to help you avoid sports injuries.

  • Always warm up, regardless of the sport. It’s especially helpful to stretch the Achilles tendon, hamstring and quadriceps areas and hold the positions without a bouncing motion.
  • Avoid bending knees past 90 degrees.
  • Avoid twisting knees. This is best done by keeping your feet as flat as possible during stretches and running.
  • If you’re jumping, land with your knees bent.
  • Cool down following vigorous sports. You want your heart rate to come down gradually.
  • Wear properly fitting shoes. You can avoid stress fractures and sprains by wearing shoes that provide shock absorption and stability.
  • Avoid running on hard surfaces like asphalt and concrete. It’s preferable to run on softer, flat surfaces. Appreciate that running uphill may increase the stress on the Achilles tendon and the leg itself.
  • Know when to stop.

We’ve discussed the RICE method of treating strains and sprains in the past. Make a habit of this for even minor ankle, knee, wrist, elbow and shoulder sprains. It helps with pain and swelling, and it also speeds recovery.

Whether you’re enjoying the Big Game or just your game, it’s good to know what you’re looking to avoid. Don’t let a sports injury sneak up behind you. If you are in need of information or advice, contact your personal healthcare consultants at 844-SMA-TALK or www.sterlingmedicaladvice.com. Have a great day, and enjoy the game.

sports-injuries-matador-gored-in-butt

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Leave a comment

Filed under Musculoskeletal System, Sports Medicine, Trauma

Straight, No Chaser: Fireworks Safety

For many, the Fourth of July is a time of celebration, happiness and creation of good family memories. In the emergency room it’s one of the two worst days to have to work (excluding any Friday the 13ths that occur during a full moon…). I’d bet it’s even worse for firefighters, as over 50,000 fires are caused each year as a result of using fireworks. The presence of fireworks, grills, alcohol, driving and other hazardous activities make for an eventful day filled with many different types of trauma and drama, including the following:

  • Burns
  • Eye injuries
  • Finger/hand lacerations and amputations
  • Motor vehicle collisions

fireworks02

That said, this isn’t about us; it’s about you. Let’s take advantage of this opportunity to provide you with some safety tips to prevent injuries and enjoy your holiday. Yes, some of these may sound simplistic, but failure to follow these tips are the reasons people end up in emergency rooms.

firework-safety-logo

  • Tip #1 is to leave the fireworks to the professionals. If you want to enjoy a fireworks celebration, attend a public display. Your biggest risk here will be getting stuck in traffic.
  • If you like fireworks, get the legal kind. You can always identify legal fireworks by their being labeled with the manufacturer’s name and address. Also don’t try to make your own fireworks. Doesn’t that just sound like a formula for disaster?
  • Speaking of disasters, if you are going to use fireworks, don’t drink alcohol until everything’s done. Think about it. Alcohol + fire + explosives by design aren’t meant to have a happy ending.
  • Store your animals. They will become spooked by the fireworks and can have their hearing damaged by the blasts or otherwise hurt themselves escaping.

200338612-001

  • If you allow fireworks in the home, don’t allow use by kids – or do so at your own risk. Did you know that sparklers, which many parents allow as a “safer” alternative to firecrackers, can get as hot as 1,800 degrees Fahrenheit?
  • Keep any fireworks outdoors, and keep a water supply nearby. These things cause fires.
  • Here’s a common mistake: do not light fireworks while holding. This is how your hands get burned or fingers get blown off.
  • Wear eye shields when using fireworks. Folks have lost vision and eyes playing with fireworks.
  • Do not keep fireworks in your pocket, as the friction can ignite them.
  • Never point fireworks at anything other than the sky or an open space. Buildings can catch on fire, and individuals will be injured.

jason-pierre-paul-031516-getty-ftrjpg_bv1qkql0c3k212jyobfbhbsxu

  • Do not light fireworks in glass or metal containers. They explode and end up stuck in people.
  • Only attempt to light one firework at a time.
  • Never attempt to relight a dud. If it ends up not being a dud, it can fire unpredictably. If you have a dud, soak it in water for twenty minutes before attempting to discard it.
  • In fact, soak all fireworks in water prior to trashing them.
  • Do not allow kids to pick up fireworks after an event. You and they don’t know if any are still active.
  • Finally, remember that fireworks are not legal everywhere. You’d rather check and be safe then be fined or arrested if your activity is discovered.

fireworksinjuries

To be complete, here are some tips in the unfortunate event that an injury occurs as a result of fireworks.

  • Go to the closest major medical center immediately. This is an example of “time is tissue.” Don’t dally at home, and I’d recommend not even stopping at the closest emergency room. In the example when your eye or limb is at risk, you’re going to want to be at a trauma and/or burn center.
  • If an eye injury occurs as a result of fireworks, don’t rub or otherwise touch it. You’re more likely to cause additional damage than do anything constructive. Along the same line, don’t spend the time attempting to flush your eyes. Grab a shield or anything that can be used to protect the eye, and get to the emergency room. If you have sustained this injury, your eye is at risk.
  • If a minor burn occurs as a result of fireworks, remove clothing, and avoid ice. If you have access to water while waiting for an ambulance, run cool (not cold) water over the burn.

fireworksforpros

Happy Fourth of July, and I hope you feel that way at day’s end.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Comments Off on Straight, No Chaser: Fireworks Safety

Filed under Environmental, Trauma

Straight, No Chaser: Your Questions About Gunshots and Stab Wounds

GSW

There has been a lot going on in the news this entire year related to trauma, particularly gunshot wounds. This Straight, No Chaser answers your questions related to penetrating injuries from bullets and stabs.

Your Top Five Questions

1. Why don’t we remove the bullets every time? 

bullet removal from heart

Removing bullets may cause more damage than leaving them in the body. Sometimes it’s not worth the effort.

2. What’s with the tubes that go in the chest?

40542_1

Chest tubes are used to treat a pneumothorax (a collapsed lung). The problem is there’s air in the space between the lung and the chest wall. This can interfere with normal breathing and may be life threatening. The tubes go through the chest wall to release the air from that space, thus allowing re-expansion of the lungs.

3. Why would doctors ever need to slit someone’s throat to save his or her life?

crich

That describes either a cricothyrotomy or a tracheostomy, and it’s not “slitting” the throat as much as it is creating an opening in the airway to permit airflow. This is usually necessary because of some airway obstruction at the upper throat (foreign body in the throat, etc.) with an inability to clear it. This procedure is only done to save a life.

4. Why would you die from a wound to the thigh?

Fractures of certain bones and laceration of certain blood vessels might cause so much blood loss that you could bleed to death. Infection and blood clots are additional considerations that could be life-threatening. We’ll spare you the pictures.

5. What about gunshot or stab wounds to someone pregnant?

Penetrating trauma to the abdomen is typically less fatal to the mother than to a fetus because the fetus is literally acting as a shield. In the event any wound has placed the mother’s life at risk or the mother has died from the wound, under certain extreme circumstances, an emergency C-section may be performed to save the baby.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Comments Off on Straight, No Chaser: Your Questions About Gunshots and Stab Wounds

Filed under Trauma

Straight, No Chaser: Penetrating Trauma (Gunshot and Stab Wounds)

penetrating trauma gun

Penetrating trauma (PT) is of such magnitude in this country that it is nearly impossible to do it justice in short form. This is primarily a medical blog, and as such I’ll defer addressing the politics of it all. The fact remains that gunshot and stab wounds take an astounding toll on human life in the U.S, with over 16,000 homicides annually (approximately 45 deaths every day). The ramifications of these wounds encompass much more than medical considerations, but I’ll devote this space to discussing basics of penetrating trauma.

penetrating trauma weapons

What Happens

By design, intentional stab and gunshot wounds aim to kill. Any area of the body can be shot or stabbed. Unintentional injuries are also a source of common emergency room presentations. Major ERs and Trauma Centers are known within the industry as the “knife and gun clubs.”

Penetrating injuries to virtually all areas (brain, neck, chest, back, abdomen, groin, extremities) can be fatal. Gunshot wounds have several ways of injuring you, including the direct damage to tissue, indirect damage from the shock waves and direct damage from fragments (of the bullet or bone).

  • PT that reaches blood vessels can cause fatal bleeding. In the abdomen, the liver is the most commonly injured organ because of its large size. It can bleed enough to cause shock and death.
  • PT that reaches the spinal cord can cause paralysis and death.
  • PT to the brain can cause all manners of dysfunction, including loss of speech, motion, sensation, bodily functions, paralysis and death.
  • PT to the chest can cause puncture, rupture and/or loss of lung and heart function, leading to a pretty rapid death.

Be reminded that although both gunshot wounds and stab wounds involve penetration and may puncture your internal organs, gunshots are more prone to deeper penetration with higher energy and may create exit wounds, causing damage throughout its course.

What You Can Do

Here are the things you must consider after becoming a victim of penetrating trauma.

  • Get to safety. Perpetrators of penetrating trauma mean to hurt you and often mean for you to be dead. They may be looking to finish the job. I’ve been involved in many scenarios where individuals came to the ER to do just that.
  • Once you’re safe,immediately call 911 regardless of how you feel. You may be in shock and your body will fight feverishly to normalize how you feel – right up until you crash. In other words, you can’t trust how you feel. Another vital consideration about getting medical attention rapidly is what we call “The Golden Hour.” The opportunity to address many of the truly life threatening considerations in penetrating trauma is best done within the first 60 minutes of the injury.
  • Once you’re safe, apply pressure (clean towels) to any bleeding sites. Cover yourself with blankets as needed to preserve heat.
  • Avoid movement. Gunshot wounds are associated with spinal cord injuries, so movement could be dangerous.

JHSH-ED

What You Should Expect

Treatment of penetrating trauma is very dramatic and necessarily regimented due to the early lack of knowledge of the depth and location of injuries. As such, assessment and treatment protocols generally are in place for the region of the body penetrated. The first consideration is always ensuring that the patient’s Airway is intact, Breathing is still ongoing, and Circulation (blood flow) is sufficient (The “ABCs” of Trauma management). After that, use of x-rays, CT scans and other radiologic modalities to identify the location and extent of injuries will be employed based on the stability of the patient. Sometimes immediate surgical intervention is needed.

This is another situation where prevention is the best course of action. Avoiding injuries when possible should go without saying but often does not. Gun safety for gun owners is crucial to avoid unintentional injuries. Attention to detail is very important when handling guns and knives. Unintentional injuries tend to occur when handlers of these weapons get too comfortable. Unfortunately, once penetrating trauma has occurred, it seems like a game of chance. For every person who is told, “If that bullet was one more inch to the right, you’d be paralyzed (or dead),” another family has to be told to make arrangements. Unfortunately, my father was the victim of a random fatal gunshot wound when I was six years old, so I know that story all too well.

If you remember anything from this blog post, remember time is of the essence. Get your loved one to us inside of ‘The Golden Hour” to give the best chance of a good outcome.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Comments Off on Straight, No Chaser: Penetrating Trauma (Gunshot and Stab Wounds)

Filed under Trauma

Straight, No Chaser: Do’s and Don’ts of Treating Electrical Injuries

In a previous Straight, No Chaser, we discussed the “what” of electrical injuries and lightning. In this post, we discuss the “what-to-do” and “what-not-to-do” if and when you find yourself shocked or caring for someone else who was.

Let’s begin with prevention. It is easier for you to avoid a hazardous situation than to have to deal with it while injured. Let’s start with the children.

 electrical-outlet-child-proof

  • Talk to your children about electricity. Review hazardous and safe behaviors.
  • Use child safety plugs in all electrical outlets. This shouldn’t come as a surprise to anyone anymore.
  • Take the next step and keep all electrical cords out of children’s reach.
  • Keep children away from electrical devices, especially those plugged in.
  • Intermittently check electrical cords, and make sure they aren’t cut or split with loose, exposed wiring visible and accessible.
  • Take the extra step of reading and following manufacturer’s safety instructions when using electrical appliances. Learning the right places to plug live wires on the fly is not the best idea.
  • Stay away from electrical devices while wet. This includes touching faucets or pipes while using them. Take the time to take the extra step.
  • Learn where the power boxes are in your house. If you ever need to turn them off, the first step is knowing the correct location for them.

Lineman_Rescue

Now, let’s review steps NOT to take if you’re electrocuted or near someone who was.

  • Don’t touch someone still in contact with the source of the electricity. The body is an excellent conductor of electrical current, and you’ll become part of the link.
  • Not only should you not touch, you shouldn’t even get close. Stay at least 20 feet (about three to four body lengths) away from someone being electrocuted until the power is turned off. The high-voltage current of power lines can dance their way onto you if given the opportunity.
  • Regardless of the distance, don’t try to rescue someone near an active high-voltage power line.
  • Don’t play doctor. If the power does get shut off, don’t move the victim. You’re likely to cause more harm than good. The force associated with electrical injuries often cause injuries, including to the head or spine. The exception to this would be the presence of a fire or the risk of an explosion.
  • Don’t play doctor, part two: Forget what you’ve heard. Please don’t slather the burns with butter or apply ice, ointment or any other medications. In fact, avoid placing any type of adhesive dressing or big bulky dressings. Your best move is to spend that time on the phone with emergency medical services.
  • You’re still not a doctor! Avoid the urge to break open burn blisters or peel off dead skin. Sometimes don’t-do-something-just-stand-there is the best course of action.

Ok, you really want to do something to help? Here are safe, reasonable steps to take. 

  • First things first: Ensure your own safety, whether from the electricity, any fire or possibility of an explosion. If there’s any water on the floor while this is occurring get out while you can.

shut off powerbox

  • Take advantage of your being smart enough to have learned how to cut off the power and do so. I’d recommend working backwards in this order: turn off the circuit breakers, remove the fuse from the fuse box, and unplug the cord. Remember, appliances can still allow for electrical current flow even in the off position. Simply cutting it off might neither be safe nor effective.
  • Call your local emergency medical service number (e.g., 911) at the first safe opportunity.

electrocution1

  • If the current can’t be turned off, and you determine it is safe to do so, find something made of rubber or another non-conducting material, such as a broom, chair or rug to push the person away from the source of the current. Don’t even think about using metal or something wet. Whenever you’re doing whatever you’re doing, stand on something rubber.
  • Do you know CPR? You may need it here. If the victim is no longer near the source of electricity, take needed steps. One very simple yet effective step is to raise the legs about the level of the heart. Again, avoid movement of the head, neck or lower spine.
  • If the person has a burn, remove any clothing that comes off easily without disturbing the rest of the body. Rinse any burns in cool running water until the pain subsides, and if possible give first aid. Do not go to great lengths here. The ambulance is likely to arrive before you get to do much here.
  • Stay with the victim until medical assistance arrives, unless the situation demands a quit exit.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Comments Off on Straight, No Chaser: Do’s and Don’ts of Treating Electrical Injuries

Filed under General Health and Wellness, Musculoskeletal System, Neurology, Trauma

Straight, No Chaser: TMJ (Temporomandibular Joint) Syndrome

TMJ pain

TMJ. Those of you who have TMJ syndrome are likely already shaking your head in understanding. Those of you who don’t, be thankful. Take the advice of those who do and read this post to appreciate steps you can take to avoid developing it.

TMJ (temporomandibular joint) syndrome/disorders refer to symptoms developed in the chewing muscles and joints connecting your lower jaw to your skull. In other words, you’re having problems with your jaw joint. Given that the TMJ closes your mouth, and you’re using it all day to talk and chew, having this poses a lot of problems.

To understand various causes of TMJ, start by appreciating that most anything affecting all the various structures connecting the joint can contribute to the disorder. This includes problems with the joint itself or to its surrounding muscles, tendons and bones. Therefore, there isn’t just one cause. Many things you do or have done can contribute to difficulties with the joint. Here are some examples:

  • Arthritis (degenerative joint disease)
  • Having a bad (poorly aligned) bite
  • Having to wear braces
  • Lack of sleep (insufficient rest and recuperation for overworked muscles)
  • Poor diet
  • Poor posture (e.g., holding the head forward while looking at a computer all day, straining the muscles of the face and neck)
  • Stress and grinding your teeth
  • Trauma to the jaw resulting in fractures or dislocations

tmj_2

Knowing this makes prevention easy.

  • Limit or avoid hard foods and excessively chewing gum. Although you don’t think about it much, you can wear out the joints in your mouth just as you can a hip or a knee.
  • Learn to reduce your overall levels of stress and muscle tension.
  • Practice and maintain good posture of your head and neck.
  • Use protective measures when engaged in activities that can produce jaw fractures and dislocations.

It’s pretty easy to figure out the symptoms you may have if there is a problem with your jaw or TMJ.

TMJ sx

  • Aching facial pain
  • Clicking, popping or grating of the mouth when opening or closing it
  • Difficulty opening and/or closing the mouth
  • Difficulty/pain biting or chewing
  • Earache
  • Headache
  • Jaw pain or tenderness
  • Locking of the jaw

Treatment strategies vary widely based on severity and cause of the joint issues. Many patients get by with over the counter medications, relaxation techniques, heat or ice to the face and prevention of additional damage. More complicated measures may include use of prescription pain medicines, muscle relaxants, corticosteroids or antidepressants. Bite guards (aka splints, mouth guards/appliances) may be recommended if you have problems with teeth grinding. Your physician will make appropriate recommendations based on your individual circumstances.

The good news is for many patients symptoms come and go, and they are reasonably well treated with minor interventions. The bad news is if you go unidentified or untreated, you may suffer chronic facial pain and/or headache, and this is not a pleasant experience. Therefore, if you discover yourself having difficulty opening and closing your mouth or eating, please address it early and see your doctor or dentist right away. You really don’t want to deal with the consequences of inaction.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Comments Off on Straight, No Chaser: TMJ (Temporomandibular Joint) Syndrome

Filed under Head/Eyes/Ears/Nose/Throat, Trauma