If you hear gunfire, safest to assume that's what it is. As many did today, leave everything, grab kids & RUN. Take path w ⬆️buildings & trees (⬆️stuff in the way=⬇️chance of clear shot) Put as much distance between you & shooter as possible 1/
If hiding behind car (not ideal) crouch behind engine block. Carry a tourniquet/stop the bleed kit in your car, and if possible on your person at major events, where crowds make them a potential target. Know how to use it, & hold pressure on a wound. Take stop the bleed class 2/
As a trauma surgeon, I wish it weren't as necessary to know these things as it is to know about wearing seatbelts & helmets, yet in 🇺🇸 this isn't a theoretical risk anymore. These steps may save a life one day, yours or someone else's.
The problem is if we don't limit the human to human transmission of #COVID19 it will continue to spread. While most people will get a mild illness, a significant number (about 10x as many as with regular flu) will need ICU care, including ventilators & other advanced equipment 2/
If number of pts continues to snowball, as it will if we carry on w business as usual, this will QUICKLY overwhelm our hospitals, which already live at capacity most times.
The USA can manage a short term disaster; unfortunately without containment this will drag on for months 3/
Had 2 cases of Compartment Syndrome last week incl 1 from snakebite (rare in this era of antivenom!)
Reminded me it is often a delayed Dx, & consequently also a frequent cause for malpractice litigation #MedEd thread: Please do NOT look for the 5Ps which mean its much too late 1/
Instead, look for 1. Firm, tight muscle compartment (compare to other side) 2. Exquisite tenderness to even gentle squeeze
Most important, the sina qua non of compartment syndrome is: 3. SEVERE PAIN on PASSIVE STRETCH of Muscles in that Compartment 2/
For the exams: lower leg has 4, thigh has 3, forearm & upper arm have 2 significant compts each.
But in real life, anterior compts usually affected so:
To test lower leg, do ankle dorsiflexion
For thigh, bend at the knee
In the arm, perform wrist & elbow extension respectively 3/