Category: Trauma

Gun Laws and Mass Shootings: A Call to Action

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Written by Sarah Aly, DO
This post first appeared on REBEL EM

Background: Rob Elementary. Columbine. Sandy Hook. Pulse Night Club. Tops Grocery Store. Irvine Taiwanese Presbyterian Church. Virginia Beach. The Tree of Life Synagogue. Santa Fe High School. The New York City Subway. The Las Vegas Harvest Music Festival. Aurora Movie Theater. The El Paso Walmart. Tulsa. The list goes on.

The United States has a unique epidemic: mass shootings. There is no universal definition of a mass shooting but it is often referred to as an event where greater than four individuals are killed by a single perpetrator (Everytown Research & Policy, 2022). Outside of the US, mass shootings are rare events (Bloomberg 2022, Snopes 2018).

In the United States, we continue to have an average of 19 mass shootings per year (Everytown Research & Policy, 2022). Medical providers, especially Emergency Physicians, bear witness to the toll of mass shootings as we sit on the interface between the community and the hospital. As a result, it is important for us to understand the role of public policy in this epidemic.

Clinical Question: Do states with permissive gun laws have more mass shootings than states with restrictive gun laws?

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REBEL Core Cast – Basics of EM – Introduction

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Written by EJ Wright, MD
This post first appeared on REBEL Cast

Welcome to the EMRA Basics of Emergency Medicine Podcast. I am your host EJ Wright, and the following series is an all encompassing approach to the most common chief complaints in the ED based on the well known EMRA Basics of Emergency Medicine, A Chief Complaint-Based Guide. Each cast will highlight myself and a guest attending physician as we take new learners through the differentials, red flags, physical exam findings, and a sample presentation that you need to know to treat patients in the ED.

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Blunt chest trauma

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Being in a car accident, even the most benign one imaginable, can be stressful for patients. Inherently, if they have any chest pain they’re going to be convinced they’ve sheared their aorta right off its hinges. While that may be of concern to them, we are pretty certain that their aorta is still intact if they still are alive, but did they sustain a cardiac contusion? How do we even figure out if they had one? And what the heck do we do with them if they did in fact have a cardiac contusion?

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Fat embolism syndrome

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Typically when we start talking about anything related to fat embolisms our minds go immediately to trauma and long bone fractures as the cause, but this isn’t always the case. The constellation of signs and symptoms of respiratory insufficiency, neurologic dysfunction and petechial rash which are typically associated with fat embolism syndrome can also be caused by pancreatitis, sickle cell disease and liposuction; all of which show up regularly in the Emergency Department. With mortality rates as high as 20%, despite the fact that FES usually doesn’t present for at least 12 hours after the initial event, it should be something that we are aware of.

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