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Cranial burr holes in the emergency department: to drill or not to drill?
  1. Michael Abernethy
  1. Emergency Medicine, University of Wisconsin Madison, Madison, WI 53706, USA
  1. Correspondence to Dr Michael Abernethy, Emergency Medicine, University of Wisconsin Madison, Madison, WI 53706, USA; ma2{at}

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Several years ago, I was working in a small community ED. A young man who had been stabbed in the right chest was dropped off in the ambulance bay. He was pale with a rapid and weak pulse. He then went unresponsive. I quickly performed a needle thoracostomy followed by a 32F chest drain evacuating approximately 400 mL of blood. There was an immediate improvement in his perfusion and overall condition. He was eventually transferred to the regional trauma centre and had an uneventful hospital stay.

Later that same evening, a large (150 kg) middle aged man was brought in by ambulance …

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  • Contributors MA is the sole author of this commentary.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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