ER Doctor Answers Injury Questions From Twitter | Tech Support | WIRED

In the emergency department all the time I think I'm sorry your bone is broken and they say, "I'm glad it's not broken and I tell them no, it's actually exactly the same thing. Hi, I'm Dr. J." max sacrifice and today I will answer your

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from Twitter this is

injury

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this is from sid 1998 how many concussions is too many concussions asking for a friend I'm thinking from the way you handed it to me that you're actually asking for yourself a concussion is the state you are in mentally temporarily after a mild traumatic brain

injury

symptoms range from decreased attention span lethargy or feeling very tired feeling a little confused severe headaches sensitivity to light and nausea feeling like you are going to vomit So there's a very wide range of symptoms that you can have with this condition.

It depends on the type of concussion, the size of the concussion, and also the severity of subsequent symptoms. I would say the most feared outcome of multiple concussions is something called cte. or chronic traumatic encephalopathy People with chronic traumatic encephalopathy, many of them are boxers or football players, who suffer repetitive head trauma end up with very serious long-term problems such as dementia, very severe headaches, behavioral changes, aggressiveness and suicidal tendencies. There was a study that showed that approximately 17 concussions were the average for many people who had chronic traumatic encephalopathy, but the answer is to avoid concussions at all costs by holohona.

What happens when you break a bone and don't set it correctly? It depends on where the fracture is, how severe the fracture is, and how well the bones are aligned. I hear about people you know who really get hurt. An advantage, you know, that they look in the wrong direction. They say I'm going to be a man and fix it on the spot. Do not do that. You have no idea what the lesion looks like beneath the surface of your skin. You may not need any realignment, so don't try to reposition your bones. Don't try to put your dislocations back into place.

Please don't do this at home. It is also entering a joint. A joint is basically where two bones meet. We have joints throughout the body and if a fracture enters that joint, it is more important that that fracture heals very, very well and that everything is aligned because you can imagine. if there are bone fragments inside the joint and then you try to move the limb and it can be very painful and can lead to a significant amount of arthritis in the long run, so go see an orthopedic

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, don't try to fix your own braces at home that's my answer this is not fabia I think I've dislocated my shoulder help how can I know if I've dislocated it first of all you'll know if you have a dislocation or a fracture because it will be one of the most painful things you've ever experienced in your life. life and these are things that need to be checked by

doctor

s so don't try to diagnose yourself at home using dr google and try to put things back in place but I will say it in the emergency department before I get x-rays , if someone thinks there is a shoulder dislocation, I will ask them to take the affected arm and try to touch the other shoulder, so if someone has a shoulder dislocation they won't do it.

I can do it, so that's one of the things I do after I get a shoulder in place, which is incredibly satisfying. I should say that we check to see if it is back in place before the x-rays, seeing if that arm goes up to the contralateral one. shoulder that is the opposite shoulder this question is from amseries how do you know when stitches are needed? Ask for a friend. It's a difficult answer. There are certain points that we place because it will simply have a better cosmetic result. This is how it will look. better in the long run, but there are other spots, really deep lacerations that absolutely need to be sewn up, for example, if it gets deep enough to reach this layer called fascia.

Now the fascia is like a very dense tissue and it holds certain structures in place, think of it as layers, like layers of a cake or something, so that particular layer called the fascial plane that separates those two areas often needs be repaired, so we will put points there to recover it. together and if you don't, the muscles or structures that are underneath that fascial plane can herniate and will cause some problems. I should also mention that there are absorbable sutures and non-absorbable sutures, there are certain points that we do not want your body to absorb, for example, if there is a tendon that has been cut and we are repairing it, many times we are going to use a non-absorbable suture, we want Let that point remain in place because it is necessary.

Tendons take a long time to heal completely, there are other areas of the body or certain situations where we want the stitches to dissolve and those dissolvable or absorbable stitches are made of synthetic polymers or animal intestines, so come to the emergency department and we could sew animal intestines into you okay the next question is from justin wolfson i broke my femur in a car accident and by the way i have some clues this is a terribly painful experience so justin wolf said that my My heart goes out to you bro, how much strength does it take to break a damn femur?

How do they get that rod in there? Don't I need that missing bone marrow and how do they heal before this surgery existed? The response is very strong. it's about 4000 newtons of force 4000 newtons is about 900 pounds here in Earth's gravity so you might think about a sea lion or a really big moose that's how much force it takes you think about surgeries in general. Being a very gentle and precise operation, orthopedic surgeries are not gentle, they are applying force there, they are using muscles because it really requires a significant amount of force to perform these surgeries and put the bones back into place to put that rod in. your femur, they basically have to line it up where the cavity is where your bone marrow is and it's called an intramedullary rod, they line it up and take a big hammer and go until it's completely in, so it's violent and it takes a lot of strength and It's impressive to see.

Don't I need that missing bone mirror? No, you don't really mean it, you have bone marrow in the rest of your bones. You'll be fine. Last question, how were they cured before? surgery existed and the answer is very, very bad, they probably didn't heal very well that person maybe they never walked again if they had a car accident in the year 1500, okay, the next question is from Kieran Kalan, why did the Are leg cramps so painful? It is painful, which is why leg cramps are known as medial tibial stress syndrome and it is basically when there is inflammation of many of the structures around the tibia.

The tibia is this long bone here on the lower extremity, right next to the fibula, which is the thinnest bone. who runs along the side hallways always have shin splints, many cheerleaders have shin splints and this can be very, very painful. Now here's the thing, although that pain should resolve with rest, it will definitely be seen if that pain doesn't resolve with the cessation of that. activity this is from London Hearts One What is a defibrillator? Do I have to be trained to use it? So a defibrillator is basically a device that delivers electricity to the heart.

The bottom part of your heart is the ventricles. And when the heart does it naturally. What happens is the top squeezes first the atria squeezes the bottom squeezes then boom boom boom boom so if the bottom of the heart doesn't get a good squeeze, look what I did there with Hardy, that was a total accident. You're not going to get blood flowing to your brain or your extremities and you're going to start dying when you get into these dangerous heart rhythms. You will get electricity from the heart as soon as possible. Order an AED or automated external defibrillator.

Don't worry, you can do this, you can save someone's life, call 9-1-1 too because they are trained and will know what to do, especially in the field, but if you can get an AED it will help you. I tell you to place these pads on your chest and on your back and basically you are going to insert the heart and that is going to reach where the electricity runs between the two pads if you do not have access to an AED and or you are a professional, this is what you're going to need, this is called a lifesaver package, so this bad boy is worth over fifty thousand dollars in a machine.

What we do is connect this to someone's chest, when it is connected, you will be able to see the rhythm that the heart is in, you will be able to know if that person has ventricular fibrillation or ventricular tachycardia and then we can determine if they need defibrillation or something called cardioversion synchronized. This will basically take someone who will inevitably die and bring them back to life very quickly. This is one of the best inventions that modern medicine has. To be honest, this is quite surprising. The next question is from PT Works and the question is what is the most serious or painful. injury you have ever experienced, I mean the most serious injuries are those where the patient arrives dead when you classify traumas according to the type of impact, so you will say like motor vehicle versus cyclist or train versus pedestrian, you can imagine that.

Train versus pedestrian was the most serious thing I have ever seen in the emergency department. The guy, not to gross you out, had a traumatic amputation, meaning his arm was forcibly torn off and he was already dead when he came in. And that is the most serious injury I have ever seen. Some of the most painful injuries I see are actually those that cause ischemia. Now ischemia is a lack of blood flow to the tissue or a lack of oxygen, so if there's an injury you like. tears the blood vessel or causes a certain abnormality that would decrease blood flow to a certain area that is exquisitely painful I hope you never have to experience something like this in your life and this is a midfielder it is a terror in the Achilles tendon the worst injury that exists that an athlete can suffer from, so I should tell you what the Achilles tendon is.

Your Achilles tendon is this tendon back here that attaches your calf basically to your foot and allows you to flex your foot and when this bursts you can't do this anymore and that's pretty important for running, walking, jumping, etc., this is a shocking morbid injury, but I would say this is not the worst injury an athlete can suffer because if you think about a spinal cord injury, you get a cervical spine injury that essentially likes to fracture the bones. here in the neck and it ends up pushing on your spinal cord and you may never be able to walk, use your arms or legs.

I believe paralysis is the worst injury an athlete can suffer. The next question is from Let's do med legal. Is it okay to treat my dog ​​bite injury at home, not at all, these have a very high risk of infection. You need antibiotics. Also, when was the last time you had a tetanus shot? Also, anger is a problem. The chances are pretty low, but if you receive it. Guess how 100 percent fatal it is now if you can catch the animal and it's a stray animal, that's different. What they do is observe the dog for several days and make sure that he does not show any signs of rabies, if not. okay, you don't have to get all the rabies shots and stuff like that, but if it's a rando dog that you ran away from and you're never going to see again, you need to get the rabies shot, you also want to get x-rays to make sure that there is not a large piece of bone below the surface because again, the risk of infection is very high by 41 sheisty, what is Tommy John surgery?

Let me bring my little arm model right here, this is your humerus, right? This is your soul here and this is your radius and what happens in people who require Tommy John surgery is that they end up having a rupture of this tendon called the ulnar collateral ligament. The oldest collateral ligament connects the humerus, which is this bone here. to the ulna and if you're throwing overhead all day every day for years and years and years, you put yourself at risk, especially if you're putting a lot of force behind it, you're throwing fastballs and once that thing blows up, You are going to be in a lot of pain when you throw.

It will be very tender in the area where the ligament is naturally. So what do they do during Tommy John surgery? They end up taking a tendon to fix the ligament. They take a tendon from your forearm, your hamstring or your foot and they will reconnect those bones to stabilize that area on the medial aspect of your elbow and they wonder if they don't need the tendon that they are taking from the other area of ​​your body and the answer is no. , actually, you'll be fine without it p1p31150 I have no idea what that means, but how do you know if you have a broken rib? be very painful if it hurts a lot or you have difficulty breathing, you absolutely need to be seen becauseyou can have pain on one side and you think, oh, it's just a broken rib, whatever, they don't do surgery on that.

It's true, but what can happen is that that rib, if it fractures and punctures the lung, can burst a lung, can have a collapsed lung, if air enters the thoracic cavity that is outside the lung, can compress it to the point in which one you have difficulty breathing and two, it can put so much pressure on the chest cavity that it can cut off the blood supply to the heart, it can squeeze the blood vessels, the clothing that is responsible for making blood return to the heart, you can imagine that it's only a matter of time before you die if you don't get blood flow to your heart, because if you don't get blood flow to your heart, you don't get blood flow to the rest of your body.

So if you think you have a rib fracture, get it checked out, it may be more serious than you think. The next question is how to treat a cooking oil burn. I think I hate scars. a cooking oil burn when treated in person unfortunately you need to be treated this is not something you should treat at home you have lesions of different depths with burns almost all need some type of antibiotic cream to put on there Now neosporin works very good for a burn, especially if it just looks like a sunburn and there are no bubbles or anything it's probably a first degree burn with a superficial thickness, but when you start to get to those deeper burns, when it's bubbling on the surface, go see a doctor to determine how deep the injury is and then in the long term, depending on where the burn is, you may end up needing the skin graft, which is where they take skin from another part of the body and then we attach it to the area. where is the burn because our skin plays a very important role: we make sure that we do not lose a lot of water in our environment, but the skin also protects us against infections, so the risk of infections is very high also if the If the burn is over a joint, it may have scarring that resists normal movement of the elbow, and it may develop contractures and may need to be released surgically, so see a doctor, especially if it is bubbling or turning whitish.

Ruby Straw Hat What is the difference between a sprain and a strain? A sprain is when you have an injury to your ligaments. Ligaments directly connect bone to bone. Tendons are affected when you have a strain. I said it wrong and tendons connect muscle to bone and how? It's hard to say because they are both very painful, but one of the big differences is that muscle strains can end up having a lot of cramping associated with the muscles that

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nically can occur with sprains. Also, it's a little less likely and you may have limited movement around that joint that's affected, now that with the sprain strain you won't have as much muscle spasm and you may have more movement in that joint because of the ligament that was there. kind of stabilization and keeping it in place is injured, stretched, maybe totally torn, so you might be able to move it more than you could before, you might have instability in that joint, so that's the difference between a sprain and Can a Luxon rope break?

Your funny bone is not a rhetorical question. I really say that in a locker room the funny bone can be a very painful injury and it's usually very temporary, but what happens is you have an ulnar nerve, you have this big old nerve right on the medial aspect. the middle side of your elbow and that nerve is responsible for your ability to feel there and that's why when you hit it your fingers can tense up and you get a really weird tingling sensation all over your hand so I can't break your funny bone, but it can hurt a lot, it's okay, that's all for now.

I hope you learned something today. I'm Dr. J. Maxx and I say goodbye.