Blunt Cardiac Injury: Emergency Department Diagnosis and Management (Trauma CME) -
Publication Date: March 2019 (Volume 21, Number 3)
CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-A or 2-B CME credits. CME expires 03/01/2022.
Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits, subject to your state and institutional approval.
Eric J. Morley, MD
Associate Professor, Clinical Director, Department of Emergency Medicine, Deputy Chief Medical Informatics Officer, Stony Brook Medicine, Stony Brook, NY
Bryan English, MD
Assistant Professor, Department of Emergency Medicine, Stony Brook Medicine, Stony Brook, NY
David B. Cohen, MD, FACEP
Associate Professor, Department of Emergency Medicine, Stony Brook Medicine, Stony Brook, NY
William F. Paolo, MD
Associate Professor, Residency Program Director, SUNY Upstate Medical University, Syracuse, NY
Jennifer Maccagnano, DO, FACOEP
Assistant Professor, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY; Emergency Medicine Attending Physician, Brookdale Hospital Medical Center and Maimonides Medical Center, Brooklyn, NY
Ashley Norse, MD, FACEP
Associate Chair of Operations, Department of Emergency Medicine, University of Florida Health Jacksonville, Jacksonville, FL
Blunt cardiac injury describes a range of cardiac injury patterns resulting from blunt force trauma to the chest. Due to the multitude of potential anatomical injuries blunt force trauma can cause, the clinical manifestations may range from simple ectopic beats to fulminant cardiac failure and death. Because there is no definitive, gold-standard diagnostic test for cardiac injury, the emergency clinician must utilize an enhanced index of suspicion in the clinical setting combined with an evidence-based diagnostic testing approach in order to arrive at the diagnosis. This review focuses on the clinical cues, diagnostic testing, and clinical manifestations of blunt cardiac injury as well as best-practice management strategies.
Excerpt From This Issue
You are working a quiet morning shift when 2 patients are brought in after a motor vehicle crash. The first patient is hypotensive, and the FAST exam reveals a pericardial effusion. You know that time is of the essence, so you rapidly assess the options and wonder whether a needle pericardiocentesis is the best option…