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Ortho Pearls: Metacarpal Fracture Management

Cook County EM Blog

The Case: A 40-year-old male with no past medical history presented to the emergency department after he was assaulted with closed fists just prior to arrival. Patient Course: Radiographs demonstrated a displaced, comminuted midshaft fracture of the fourth metacarpal. Metacarpal fractures: treatment and complications.

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Annals of B Pod: Phlegmasia Cerulea Dolens

Taming the SRU

She was concerned that this was not improving and decided to come to the emergency department (ED). Notable Diagnostics CBC : unremarkable, BMP : unremarkable X-ray imaging of the left hand, wrist, and forearm: chronic degenerative changes without acute fracture or bony abnormality. 2000 Dec;45(6):644-6. Ann Plast Surg.

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Diagnostics: Inflammatory Markers

Taming the SRU

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. Evaluation of fever in the emergency department. ng/mL (strongly recommended against antibiotics), 0.1-0.25

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You don’t need labs or CT scans in children who have recovered after a simple febrile or first time seizure

PEMBlog

battle sign bruises around the mastoid, raccoon eyes, or other bruising and lacerations) or reported by history – but could be identified (later) with a bleed or fracture on a head CT scan if your index of suspicion is high or the seizure is going well beyond the expected duration and not responding well to antiepileptics.

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The 86th Bubble Wrap x Aghia Sophia Children’s ED

Don't Forget the Bubbles

This single-centre prospective study focused on a quality improvement (QI) project to reduce the overuse of chest X-rays (CXR) in paediatric patients with acute asthma exacerbations (AAE) arriving at the emergency department (ED ). Arch Acad Emerg Med. Pediatric Emergency Medical Journal 2023;10(4):109-117.

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Pain Management of Common Chief Complaints in the ED

EMDocs

Costochondritis, rib fractures, and pericarditis are common causes of chest pain that can be treated with multimodal regimens. 7 Rib and Sternal Fractures: Rib fractures are often caused by blunt chest trauma. Up to two-thirds of rib fractures are missed on initial chest radiographs. Am J Emerg Med.

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Unstable Pelvic Trauma Patient: ED Presentations, Evaluation, and Management

EMDocs

How should pelvic fractures be identified in unstable trauma patients? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently. 2 Vertical shear fractures are also unstable.